Safety Advantages of An Awake Breast Augmentation

An Awake breast augmentation is a surgical procedure to reshape and resize a woman’s breasts to better fit her ideal measurements while avoiding the potentially dangerous side effects of general anesthesia. Traditionally, plastic surgeons have relied on general anesthetic drugs like propofol to sedate and render a patient unconscious during a surgical procedure. These anesthetics drop the patient’s heart rate, depress breathing, and expose many to life-threatening reactions. Fortunately, in the last few years, plastic surgeons like Dr. Kenneth Kim have recognized the alarming pitfalls of general anesthesia and have worked diligently to perfect a safe, more advantageous approach. In what is now deemed as “awake procedures,” doctors strictly use local anesthesia to effectively block pain receptors and mute any discomfort. Without the harsh side effects of general anesthesia, patients receive remarkably wonderful cosmetic results with less downtime and associated risk.

For women who are dissatisfied with the shape or size of their breasts and would like to see how Dr. Kim’s Awake breast augmentation can boost their self-image, please schedule a personal consultation at our Beverly Hills offices. Here, Dr. Kim will assess your surgical requirements and explain the numerous benefits included with his awake approach. To reach us directly, please call (213) 700-4297.

About General Anesthesia

Before the discovery of ether inhalation by William T.G. Morton in 1846, surgeries were often quick and brutal as patients were fully conscious and awake for the duration of the procedure.[1] Since then, surgeons and medical professionals have continuously sought out better alternatives that block pain and extend more invasive procedures. However, since the advent of general anesthesia (more than 150 years ago), not many advancements or changes have occurred within anesthesia and patients are often exposed to several risks that can have dangerous outcomes.


After general anesthesia is administered, the brain enters a “pseudo-sleep mode” where its pain response quiets, and consciousness loses focus. Although the brain is sedated, neurons continue to light up and increase electrical activity throughout the nervous system. Because the pain response is muted, the brain does not register this activity and the neurons will continue to fire long after the surgery has finished, leading to prolonged pain and discomfort for the patient. In addition to this, the neurological response to general anesthesia kills neurons associated with memory,[2] which is often why patients can’t remember moments leading up to and hours after general anesthesia procedures. Along with spells of prolonged pain and memory loss, other side effects from general anesthesia include:

  • Blood clots
  • Deoxygenation of the body and brain
  • Heart failure
  • Malignant hyperthermia
  • Cognitive dysfunction

With all of these common side effects, doctors and surgeons have begun strategically utilizing local anesthesia to dull specific pain receptors to promote a comfortable and relaxed procedure for a prolonged period of time. During Awake anesthesia, we carefully dilute local anesthetics and administer them to the body. These local anesthetics target both superficial and deep nerves. The experts at Dream Medical Group have the expert skill and knowledge which can, fortunately, be found in abundance at Dream Medical Group but in few other practices.

Why Choose An Awake Approach

When compared to a traditional surgical procedure, an Awake procedure offers a number of benefits that make it more attractive to prospective patients. Those benefits include:

  • No risk of long-term nerve sensitivity
  • The time required using painkillers after your surgery is greatly reduced
  • Lower risk of nausea, fatigue, sore throat, and other unwanted side effects
  • Retain consciousness throughout the procedure
  • The surgeon can interact with their patient during the procedure to make sure the alterations align with the patient’s desired results
  • Surgical costs are less than general anesthesia procedures
  • Less extensive recovery time after your surgery

 About Breast Augmentation

Since the creation of gel implants that mimic mammary tissue in the 1960s, breast augmentation has steadily grown to be one of the top five cosmetic surgeries in the United States.[3] By changing different variables from implant composition to placement and shape, women can achieve their desired physical appearance through expertly customized implants. Breast implants come in either silicone or saline. While 84% of the breast augmentations in 2020 were performed with silicone implants,[4] many women often prefer saline implants because of their unique feel in the breast pocket. Other customizations include the following.


Most women choose to undergo breast augmentation because they wish to add more feminine shape, contours, and volume to their breasts. Implants come in a wide range of different sizes and projections that can increase a woman’s cup size to her specifications. Dr. Kim will explain how different-sized implants will change your cup size based on the amount of natural tissue you currently have.


Breast implants come in two different shapes: round and anatomical. For women interested in creating more volume with less implant material to achieve a fuller appearance, we recommend round implants. On the other hand, anatomical implants have a gradual slope, with fullness in the lower pole of the implant similar to that of a natural breast mound.. These are ideal for patients interested in a more natural result.


Breast implants can be inserted in four places either on top of or under the pectoral muscle, just below the breast gland, or under the pectoral connective tissue. Depending on the size of your implants, the thickness of your pectoral muscle, and how much mammary tissue you have, Dr. Kim will decide which placement is optimal to achieve your desired results.


For those interested in changing the shape and size of their breasts, please feel free to schedule a personal consultation with Dr. Kim. Our breast augmentation patients come to us from just about all walks of life. We do ask our patients to be at a healthy, stable weight. Any future weight fluctuations (including pregnancies) will diminish results. Although recovery from an awake breast augmentation is less than its traditional counterpart, we recommend patients have adequate time in their schedule for recovery where they are expected to lift heavy objects or partake in strenuous activities. Lastly, we ask that women who smoke be able to quit a couple of weeks before surgery and for the entire duration of recovery. Nicotine constricts blood vessels, interrupting the body’s natural healing response.

About Dr. Kim

Dr. Kenneth Kim is a heavily respected, highly sought-after plastic surgeon in both South Korea and Los Angeles. As a surgeon, he has given thousands of patients worldwide their ideal physical appearance. As a lecturer and an academic, Dr. Kim has helped develop innovative plastic surgery approaches, technologies, and techniques to provide the highest level of care to patients and resources to the international medical community. To learn more about Awake procedures and his signature approach, check out this page dedicated to the benefits of Awake Anesthesia.

Personal Consultation

If it is your first time with us, we will begin with a brief new patient intake interview and a physical examination. We will then listen to learn about why you are dissatisfied with the shape and/or size of your breasts. Once we understand your cosmetic concern, Dr. Kim will explain how breast implants work and how they can achieve your desired results. He will help you discern which characteristics are best for your implants. Then, he will explain the Awake approach and help you decide if that approach is right for you. With all this in mind, he will create a personalized treatment plan to address each of your cosmetic concerns. Before leaving our care, we will give you a list of preparatory steps to follow in the interim.


To prepare for your awake breast augmentation, it is best to follow this list of instructions before the date of your surgery.

  • Discontinue taking all blood-thinning medications as these will cause excessive bleeding during your surgery.
  • Avoid nicotine.
  • Designate a caregiver to drive you home. Though local anesthesia is used, you will not be fit to drive after this operation.
  • Prefill all prescription medications beforehand. The last thing you’ll want to do is leave our care and go stand in line at the pharmacy.


For those who desire more comfort during their procedure, Dr. Kim does administer Xanax or Valium to help calm any nerves that are left untouched by local anesthesia. He will then use a local anesthetic in the target tissue. This anesthetic will dull the surrounding nerves. Dr. Kim will check to make sure the anesthetic has taken effect before continuing. A huge benefit to an “awake” procedure is that Dr. Kim can check in on his patients during the procedure. You will be lucid and conscious enough to update him on your condition and even stand up halfway through to make sure the implant’s positioning is achieving its desired effect. In a breast augmentation, Dr. Kim makes only a couple of discreet incisions to place the gel insert. He will carefully suture these once he is done.

Recovery & Results

Another notable advantage of Awake procedures is the absence of groggy downtime patients experience after their surgery. With general anesthesia, patients sometimes require hours to fully regain consciousness and days to feel normal. Post-operative nausea, pain, and anxiety are common for those who come out of general anesthesia. However, after an Awake procedure, patients are lucid and comfortable. After your breast augmentation is complete, we will wrap your chest in a compression garment after surgery. This wrap will help keep the implants in ideal placement and help the treated tissue accept the implants and begin healing. Once the swelling subsides, you will see the feminine contours and volume you’ve always desired. We will assess where you are in the healing process and if any next steps are required during your follow-up consultations.


The cost of your procedure will depend on the surgical techniques and the implants that Dr. Kim uses. We will determine the cost of your unique procedure during your consultation. To learn more about our pricing, please call our office at (213) 700-4297!


  1. Robinson, D. H., & Toledo, A. H. (2012). Historical development of modern anesthesia. Journal of investigative surgery : the official journal of the Academy of Surgical Research, 25(3), 141–149.
  2. Sall, J. W. (2016). Anesthesia Kills Brain Cells, but What Does It Mean? Anesthesiology, 125(6), 1090–1091. 
  3. American Society of Plastic Surgeons. (2019). American Society of Plastic Surgeons Plastic Surgery Statistics 2019. American Society of Plastic Surgeons.
  4. American Society of Plastic Surgeons. (2020). American Society of Plastic Surgeons.