Breast augmentation surgery is one of most historical cosmetic surgeries. As surgical methods evolve, anesthesia also progress with each passing day to enable many kinds of anesthesia originally used only on other parts of the body to be used in beast augmentation surgery now. Within such, the most precise anesthesia with the best recovery rate is high thoracic epidural anesthesia.

Japanese breast surgery authority, Dr. Nagumo is the first doctor who uses this anesthesia on breast augmentation surgery. The number patients reach more than 8,000 people in 10 years, sufficient to prove the safety of such anesthesia. The anesthesia is actually the same as painless labor. A fine catheter is inserted at thoracic vertebra to epidural space, and anesthetic is administered via the catheter. Because the anesthetic does not enter the spine, it does not suppress breathing or motor nerves for limbs but anesthetizes the sense in the anterior chest area. Hence, the patient can be wakened during the surgery to discuss chest profiles or breast size, and thus it is called a breast augmentation surgery using “Self decision making surgery.”

I am the first doctor who introduces this anesthesia into the country and actually uses it in clinical surgery. There have been tens of patients received breast augmentation treated with this highly technical anesthesia. Because trainings of Taiwanese plastic surgeons do not include anesthesia skills, I give it over to the anesthetist of thoracic anesthesia in teaching hospitals to assure the safety of anesthesia and allow high degree of patient satisfaction. According to the analysis from the author's experience, the patients who will to choose this anesthesia often have following requirements or restrictions:

1. Insist on the size of the breasts and like to decide the size on her own during the surgery.
2. Have unpleasant experience in previous general anesthesia.
3. Have experience of a doubtful allergy to general anesthesia.
4. Need to get recovered and go back to work as soon as possible.

Advantages of receiving epidural anesthesia are as followed:
1. To be wakened during the surgery and make decision by oneself the shape and size of breasts to avoid the miscommunication before surgery or dissatisfaction after surgery.
2. To avoid uncomfortable symptoms after receiving general anesthesia, such as pain in the throat, vomit, dizziness and powerless.
3. To avoid possibility of medicinal allergy brought by general anesthesia, or even lethal complications such as malignant hyperthermia.
4. Fast recovery after surgery. Be able to get down from bed for activities at once and go back to work on the next day.

Of course, an anesthesia in such a way requires some attentions:
1. For patients who once hurt or had an operation on their thoracic vertebra, this anesthesia is not appropriate for them.
2. For patients whose emotions are easily aroused, or who have disorders such as high blood pressure or heart failure, the anesthetist needs to be informed in advance.
3. The anesthesia procedure needs to be done by a professional anesthetist instead of a general plastic surgeon, otherwise complications such as epidural puncture may be resulted from unskillful techniques.
4. There is still a possibility that the congenital subdural space is too narrow to administer anesthetics so that general anesthesia is still necessary.
5. A higher expense, approximately twice as much as that for general anesthesia is required.

From what I described above, you should have an idea how epidural anesthesia is used on breast augmentation. In fact, not only breast augmentation surgery, surgeries including breast shrinkage even breast removal can be done by this method to lower the risks of general anesthesia and shorten the anesthesia recovery period, and it improves the recovery of a constitution after surgery remarkably. However, the author must emphasize that epidural anesthesia is one of many anesthesia procedures for breast augmentation. And it must be evaluated by a professional doctor before making a decision whether to receive such an advanced and safe breast augmentation surgery!