Q. I desperately want a breast reduction and have even been approved by my insurance company for coverage of the procedure, however, I am so hung up on the potential risks of being put to sleep that I just cannot convince myself to proceed with the surgery. I would like to know your opinion regarding the safety of anesthesia for breast reduction surgery.

A. Breast reduction surgery can be a life changing procedure, and the fact that you are concerned about the anesthesia risks is not that unusual. I cannot count the number of patients who tell me that they are not worried about their surgery, but they are very fearful of the anesthesia. I suspect that there are many reasons for this fear, but probably the most common reason is the fact that you are giving up total control of your life to someone else. To me it is a little like when you fly on a plane and you are totally trusting the pilot to get you to your destination safely, and you have absolutely no control over the situation. However, we know that flying is very safe, and like flying, so is anesthesia. My advice to patients is that if you are healthy, that is, no known heart disease or lung disease or any chronic debilitating medical issues, chances are that nothing will happen to you during or after your anesthesia. Modern anesthesia has come so far, even during my 30-year career as a plastic surgeon. There are better drugs to put you to sleep and better inhalational gases to keep you asleep, and much better ways to minimize post-operative nausea and vomiting. That being said, I suspect that you are less worried about nausea and more worried about some catastrophic event that could occur while you are under anesthesia that leads to you not waking up. If it makes you feel any better, in 30 years of being a surgeon, I have never witnessed an anesthetic death. What that should tell you is that the chances of someone who is healthy dying from anesthesia is very, very rare. That does not mean that catastrophic events never happen, they do, but it is so rare that the events are often sensationalized in the news, think Joan Rivers. Her case was very sad, but it was a confluence of bad decisions by her doctor that led to her death. Basically, unsafe anesthesia was practiced that day. My experience in Greensboro is that we are blessed with some of the best anesthesiologists and nurse anesthetists at the hospitals and the outpatient centers that I have ever worked with, and that I would let them put me or my children to sleep any time. If you are still worried, then I would suggest that you ask your plastic surgeon to set you up with a pre-operative consult with an anesthesiologist before your surgery. This will allow you to meet someone who practices anesthesia and hopefully that person can ease your fears. Also, if you really like the person you meet with, you can request they be your anesthesiologist. Good luck.