Pain management

Indication

Effective pain relief and prevention is critical to reduce the need for pain medications, as well as reduce anxiety and complications associated with pain. For a comfortable treatment experience, I strive to be at the forefront of pain relief and prevention.

I rely on a multimodal strategy to relieve pain during aesthetic treatments and after operations. Gentle techniques and distraction methods reduce pain during treatment and my advanced post-operative pain protocol allows me to avoid the use of opioids altogether.

Pain relief in aesthetic medicine

Anesthetic cream

Anesthetic creams offer a targeted approach to preventing and reducing pain in aesthetic medicine. When applied locally, the anesthetic cream provides pain relief in the treated area after ten to twenty minutes. This method reduces the risk of systemic side effects while promoting your comfort with injections and skin treatments. I use carefully formulated preparations for better pain control.

Local anesthesia

The locally applied anesthetic solution helps to relieve pain during injections of biostimulators, hyaluronic acid and during thread lifting.

Nitrous oxide

The inhalation of nitrous oxide is highly valued during aesthetic procedures due to its pain-relieving, anxiety-relieving and stress-reducing effects. Further advantages are the simple self-administration, the rapid onset of action, the short duration of action and the minimal side effects. Also known as “laughing gas”, the agent is sold under the brand name Entonox in a mixture of 50 % oxygen and 50 % nitrous oxide, which ensures maximum safety.

Entonox is quickly broken down by the body, meaning you can drive a vehicle again just twenty minutes after your last inhalation.

CBD oil

CBD, short for cannabidiol, is a highly effective product derived from the hemp plant for pain prevention and treatment. It belongs to the cannabinoids, a group of molecules found in hemp plants. Unlike THC (tetrahydrocannabinol), the main psychoactive substance in marijuana, CBD has no effect on cognitive function.

This means that using pure medical-grade CBD for recovery after surgery or during aesthetic treatment will not cause a psychoactive state. Still, CBD offers benefits in reducing pain, inflammation, anxiety, and stress.

NSAIDs

Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen play an important role in my pain protocol. Compared to other oral painkillers, NSAIDs have the additional benefit of being anti-inflammatory and reducing postoperative swelling. However, the use of NSAIDs should be avoided before certain surgical procedures as they can slightly increase the bleeding tendency.

Anesthesia in the OR

Local anesthesia

For minor surgical procedures such as upper eyelid surgery, I rely primarily on local anesthesia.

The technique involves infiltration of local anesthetic by needle or by infusion using cannula or catheter methods. Depending on the medication used, both rapid and longer-lasting pain relief can be achieved.

Refinement of administration technique and targeted nerve blocks are crucial, particularly for procedures performed while awake or in twilight anesthesia and to relieve postoperative pain. This greatly improves your comfort.

Regional anesthesia

Nerve blocks are an important aspect of pain management in aesthetic surgery. Interruption of pain signals from regional peripheral nerves to the brain requires precise placement of local anesthetic, resulting in numbness throughout the treatment region. This technique provides prolonged pain relief that lasts up to 48 hours after the procedure.

Nerve blocks are used in my Rapid-Recovery-Protocols for breast augmentations and tummy tucks. This significantly reduces the need for painkillers, promoting the healing process and increasing your comfort.

Intravenous sedation (twilight anesthesia)

For major facial procedures, labiaplasties and liposuction, intravenous sedation (twilight anesthesia) is also administered. This method provides deeper pain relief and increased your comfort.

General anesthesia

General anesthesia is the safest option for procedures that require complete muscle relaxation and control over breathing. Procedures under twilight and general anesthesia are carried out with an anesthesia team in my partner clinics.

General anesthesia vs twilight anesthesia

The main difference between general and twilight anesthesia is the depth of sleep. You can still communicate and cooperate with me in during twilight anesthesia, although you will usually have little memory of the surgical procedure afterwards. This is particularly advantageous for body-contouring procedures. After a twilight anesthesia, you are usually awake and ready for discharge more quickly.

With general anesthesia, the dose of medication is increased to the point where you can no longer control the muscles needed to keep the airway open. In this case, the anesthesiologist must secure the airway with a mask or tube and take over breathing. Thanks to modern technology, the risk of nausea, vomiting, disorientation and postoperative fatigue after cosmetic surgery is very low.

Safety and comfort

I believe that the surgeon should concentrate 100% on the surgical procedure and not be distracted by anything else. Creating a deep twilight anesthesia with maximum patient comfort and safety is an art and much more demanding than general anesthesia. It requires strict control of blood pressure, appropriate muscle relaxation, pain control, depth of sedation and oxygen administration. This can only be carried out safely and effectively by experienced anesthesiologists.

Although I try to avoid general anesthesia whenever possible, the safety of aesthetic procedures under general anesthesia is well established. The risk of dying from general anesthesia is extremely low, more than three times lower than the annual risk of a fatal accident in Swiss traffic.