Most of my surgery is performed as day case surgery under twilight sedation in my own ambulatory plastic surgery facility. Larger cases, especially when 2 or 3 procedures are combined, as well as my cleft lip and palate work on children are performed at one of the big hospitals in Cape Town.
The anaesthetists I use are experienced, gentle and familiar with cosmetic surgery. I usually use two women anaesthetists. They will ensure that you are asleep, pain-free and unaware of surgery. I use an anaesthetist for almost all body procedures including liposuction, breast and tummy surgery and for certain facial procedures such as rhinoplasty (nose).
For most facial work, however, I use a very short duration anaesthetic to put you to sleep while I inject the local anaesthetic. Once the local anaesthetic is in, you will not feel pain and I then usually put you on twilight sedation. I have found this to be the most gentle way to perform surgery, the easiest for you and the method that is associated with the most rapid and uncomplicated recovery.
Once anaesthetised, I perform the surgery. In general I try to be a careful and conservative surgeon and I prefer conventional, tried and tested procedures. Wounds are usually closed with dissolving sutures. Drains are infrequently used, although always for tummy tucks. Light dressings and support garments are usually applied at the end of the procedure.
Most patients are able to return home on the day of surgery. Painkillers and detailed instructions are given. If hospital admission is required, then this will be arranged. Domiciliary nursing care is sometimes arranged.
Follow up consultations will be performed, usually on my next routine consulting day and then at weekly or twice weekly intervals until we are both satisfied with your recovery. I like to do long term consultations as well at six monthly or annual intervals.