#Dermatology #SleepAnesthesia #DermatologySleepAnesthesia #UltheraSleep #UltheraSleepAnesthesia #ThermageSleep #UltheraThermageSleep #SleepUlthera #SleepThermage #Propofol #CheongdamANZDermatology #DrChoYoungmin

Today I have brought a somewhat heavy topic.

News articles about sleep anesthesia accidents appear every now and then, so many of you have probably heard about sleep anesthesia, but

In this article, I do not intend to talk about the safety of sleep anesthesia.

Many people have already covered the risks of sleep anesthesia, and ultimately the more attention the doctor in charge pays, the lower the risk of an accident becomes, so if you are considering a procedure under sleep anesthesia, you only need to check how much experience with anesthesia the performing doctor has.

So what will we be talking about today? It is something I hope everyone who receives Ulthera or Thermage under sleep anesthesia will be sure to read.

Among those reading this, there may be some who have had Ulthera or Thermage under sleep anesthesia.

Have you ever checked your total time asleep?

What time you fell asleep, and what time you woke up.

Probably few of you have ever checked this properly.

That's because when you have a procedure, you usually leave your phone in a locker or in the waiting room, and

since there may be cases where you wait a little longer in the procedure room.

It is hard to know exactly what time you fell asleep.

The same applies after the procedure. You will still be recovering from the anesthetic, so you will be groggy and sleepy, and in no state to check the time.

But here's the thing.

Don't you feel you may have stayed at the clinic far too long?

You fasted in the morning and seem to have gone in for the procedure at around lunchtime, but

Have you never had the experience of finishing everything and heading home, only to find it already dark outside?

Of course, it is also possible that you had a really, really long procedure.

Here, let me briefly tell you how long popular dermatology procedures take.
These times are based on an experienced doctor; if the practitioner is slow with their hands, it may take about 10 more minutes.
(This assumes the patient is under anesthesia, so the procedure can be done quickly without much movement.)

Ulthera: about 40 minutes for 600 shots (this is with 1 Ulthera unit; with 2 units, the time is reduced to roughly 60%)
Thermage: about 35-40 minutes for 600 shots, and 1 hour for 900 shots

Let me give you an example.

You are scheduled to have Ulthera 600 shots and Thermage 600 shots today.

After fasting for about 6 hours, arriving at the clinic at 10 a.m., signing the consent form, changing clothes, and cleansing,

Since IV fluids had to be started, an IV line was also placed in the arm, and by then it was about 10:40.

A little later, the doctor comes in, draws a design on your face, gives various explanations, and says the medication is about to go in.

It would be around 11 o'clock. The anesthesia begins.

If the procedure started the moment the sleep anesthesia took effect, Ulthera would finish at 11:40 and Thermage would begin.

When Thermage is also finished, it will comfortably be 12:30.

Even if Botox, fillers, or skin boosters are added, everything should almost always be finished by 1 p.m.

Recovery time from anesthesia varies from person to person, but even if we allow 30 minutes to 1 hour, it is already 2 o'clock.

But what if you open your eyes and it is already 3:30...?

There are only a few possibilities.

the doctor performing the procedure is a beginner

A famous clinic does not mean it only has experienced doctors. You may have met a doctor who was doing Ulthera for the very first time that day.
In my experience, for about the first 2-3 months, a doctor has no right to complain about being called a novice. Since they are not yet skilled, they have no choice but to go slowly, and the procedure time drags on and on..

had been left idle, with no procedure being performed

You may think, 'Surely something like this wouldn't happen,' but famous clinics are booked very full. This is even more true for the booking of a solo director or a director who monopolizes popularity. Everyone wants to be treated by that person.
Because a clinic's purpose is to generate profit, it will try to take on even one more patient by any means.

Let me give you an example. As in the earlier example, there is a booked patient who starts Ulthera and Thermage at 11 o'clock.
Then a patient who registered the same day arrives at 10 o'clock. They happen to have fasted and come prepared, so they can have a procedure that day. They say they want Ulthera 600 shots.
But what if I honestly say, 'There is a booked patient, so please wait 2 hours from now'?
There is a chance of losing that patient. So the clinic says the procedure is possible, gets them ready, and puts them under sleep anesthesia right away.
Then, at 11 o'clock, both the booked patient and the new patient end up lying there under sleep anesthesia.

Option 1. After finishing 600 shots of Ulthera for the reserved customer and 600 shots of Ulthera for the new customer, do 600 shots of Thermage for the reserved customer.

Imagine that you are the 11 o'clock booked patient.

You paid a lot of money and made time to book a famous clinic and a famous director, but

in reality, because of a clinic's greed to take on the person who walked in that morning,

With only anesthetic drugs being administered continuously, you are simply left lying on a bed, just breathing, until the new patient's Ulthera 600 shots are finished.

Because the doctor in charge is performing a procedure in another room, a single nursing assistant will be holding your lifeline in that room.

Option 2. Finish all the booked patients first, then perform the new patient's Ulthera 600 shots.

Imagine that you are a new patient.

You were told it was possible, so you trusted that and went under sleep anesthesia, but at the very earliest you are left alone for over an hour and a half, asleep from the start and only receiving additional medication.

Likewise, while the doctor in charge is treating the booked patient, only a nursing assistant will be by your side. Unless you stop breathing or your oxygen saturation drops, the doctor in charge will have no reason to enter the room where you are lying for an hour and a half.

Some clinics even use the presence of an anesthesiologist as a marketing point, but

Is that anesthesiologist going to perform the procedure?

The only difference is that, when you are left alone without the procedure doctor, there is an anesthesiologist with you rather than a nursing assistant.

Are there several of those anesthesiologists?

In any case, unless there is one anesthesiologist for every sleep-anesthesia patient, it is meaningless. It only means there is a higher chance of someone who can rescue you at the critical moment when you stop breathing.

Those of you reading this who say, 'It doesn't matter to me. I have plenty of time. I can't do it without sedation,' may not relate to this, but

someone who has been struggling with work or childcare and managed to find a little time, or

Patients who came all the way from the provinces to Seoul and already had a hard time, only to have to head home late at night: what have they done to deserve this..

For those planning a procedure, if only to avoid being left unattended and having your safety put at risk, or wasting your precious time,

From now on, please be sure to check the total procedure time.
It is the minimum safeguard that protects you. Please also be sure to check how long it will take before the procedure.

Also, the example above is written in a truly simplified way.

After all, those two are not the only patients.

From 11 a.m. to 3 p.m., how many other customers would there be..

Just five laser toning patients can take up nearly an hour, and if procedures such as fillers or thread lifting are booked in between, with or without sleep anesthesia, another 1-2 hours go by on top of that.

It may truly happen that you lie down at 11 o'clock and go home when it is already dark.

How do I know this?

It is not a fact that only I know, and

this is a story that every director running a dermatology clinic in Gangnam will have seen and heard.

There are clinics that advertise that they perform a lot of Ulthera, but

if you calculate how many directors they have and the number of Ulthera shots performed that day,

Unless they put patients to sleep, lay them out in a row, and push on relentlessly without a break like that, then judging from my common sense and experience,
the numbers they claim are simply impossible to achieve. (This is my personal opinion.)

I really dislike clinics that perform procedures this way.

Doing it that way would make the director a lot of money and help the clinic grow, but

To my eyes, it looks like deceiving naive people who don't know better and defrauding them of their precious time.

Why take away the time and safety of people who want to look prettier and younger, just to line your own pockets?

Even if a doctor works in aesthetics, I hope they do not abandon their conscience.

To repay the trust of those who, thankfully, came to me through fate and booked with me, I believe that time should be devoted entirely to the patient who made the booking.

I have taken up a somewhat unamusing and heavy topic.

Next time, I will return with a more useful article.

Have a good weekend!

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