I live and work in Los Angeles, one of the plastic surgery capitals of the world. Quite a few of my patients have “had a little work done” — the blandly euphemistic term you’ll hear for plastic surgery makeovers of all kinds. That’s fine. Plastic surgeons have children to feed too.

The problem is this: many of my patients want to convince everyone that their “look” is entirely natural. They don’t want to admit that they’ve had a tummy tuck, an eyelid lift, or breast implants. One patient tried to tell me that the perfectly matched scars behind her ears were the result of a car accident, not a face lift. In front of family members, patients will even deny having dentures. That’s understandable, but unwise from a medical point of view.

The fact is that plastic surgery has implications for future medical care. Your anesthesiologist needs to know about it, and your surgeon does too. It may be cosmetic, but it’s still a bigger deal than getting your eyebrows waxed.

Here’s why we need to know the cosmetic secrets our patients may NOT want to tell us.

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Not so many years ago, surgeons wouldn’t operate on patients they considered too old to tolerate the stress of anesthesia and surgery.  Today, though, patients of every age—from Baby Boomers to the Greatest Generation—undergo anesthesia safely for surgery and diagnostic procedures.

Realistically, even if you believe that 60 is the new 40, concerns about having anesthesia are different for 60-year-olds and their parents than for 20-somethings.  Here are answers to ten frequently asked questions about anesthesia for those of us–myself included–who no longer need to worry about being asked for ID if we order a drink.

Who will be giving me anesthesia? 

It’s important to find out who will be in charge of your anesthesia care.  In some hospitals, a physician anesthesiologist (a medical doctor who specializes in anesthesia) will be personally taking care of you.  In others, a physician anesthesiologist may be supervising anesthesiologist assistants, residents, or nurse anesthetists on an anesthesia care team.  Sometimes a nurse anesthetist may work alone without physician oversight, though this is not permitted in many states.  Ask your surgeon or call the hospital in advance to make sure a physician anesthesiologist will be on site.

What is the chance of a serious complication from anesthesia? 

Better medications and monitoring equipment have made anesthesia remarkably safe, which is why we can offer anesthesia today even to patients in their 90s.  A better question to ask would be this:  What is my chance of complications from the whole experience of anesthesia and surgery? The American College of Surgeons has developed an easy-to-use online calculator that can predict your outcome risk depending on the type of surgery, your age, and any medical problems you already have.  The analysis estimates your chance of a heart attack, pneumonia, infection, and other problems that may occur after anesthesia and surgery.

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