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The Benefits of Twilight Anesthesia and Local Tumescent Anesthesia

What is twilight anesthesia, and how does it differ from general anesthesia?

According to the American Society of Anesthesiologists, there are four different types of anesthesia:

  1. General anesthesia, which causes you to lose consciousness.
  2. IV/monitored sedation where the level of sedation ranges from minimally drowsy but able to talk to deep sedation.
  3. Regional anesthesia which numbs a large part of the body, but you remain aware.
  4. Local anesthesia that numbs a specific area of your body, but you are alert and awake.

Here at North Texas Cosmetic Surgery, we only use local with or without IV/monitored sedation, otherwise known as twilight anesthesia, total IV anesthesia or TIVA.

Local tumescent anesthesia lessens blood loss during surgery

The benefits of local anesthesia are numerous but to even add additional benefits the local anesthesia we use here at North Texas Cosmetic Surgery is called tumescent anesthesia. Tumescent anesthesia adds the benefits of a blood vessel constrictor called epinephrine or adrenaline which causes your blood vessels to constrict and get smaller temporarily. These temporarily smaller blood vessels lessen the amount of blood you lose during surgery significantly. Much less than without using tumescent anesthesia.

Another benefit of tumescent anesthesia is that it enables us to perform major surgery and avoid the use of true general anesthesia. True general anesthesia requires you to be intubated with a tube down your throat, be paralyzed and require a respirator or breathing machine to breathe for you during surgery.

Many patients also have nausea, vomiting, headaches, sore throats and other hangover symptoms after general anesthesia gases are used. Since tumescent anesthesia numbs the area of the body that we are working on, we do not have to place you in a subconscious state to avoid the pain of surgery. This enables us to perform surgery purely under local anesthesia while completely conscious, or, in other cases, perform the surgery under local anesthesia and total IV anesthesia without the need for a breathing tube or the hangover effects of general anesthesia.

Twilight anesthesia avoids the side effects of true general anesthesia

Here at North Texas Cosmetic Surgery during TIVA or twilight anesthesia, your pain is controlled with the local anesthesia, but you are also heavily sedated under the supervision of a board certified or board eligible anesthesiologist to allow you to sleep during your procedure but be conscious enough where you are still breathing on your own.

You wake up without the hangover effects of true general anesthesia and the anesthesia gases used with general anesthesia. Patients often describe it as the best sleep they have ever had.

Again, twilight anesthesia in addition to local tumescent anesthesia, is not needed for most of our surgeries, but when it is required, it is much easier to recover from, and it allows our patients to leave our surgery suite and go home within minutes after the procedure is completed. You also leave without the pain experienced when tumescent anesthesia is not utilized.

To learn more about tumescent anesthesia and the surgeries we perform here at North Texas Cosmetic Surgery, visit our website at, contact us or call our office at 972-743-6827 for a free consultation.