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Dr. Barry Eppley

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Posts Tagged ‘laryngeal mask intubation’

Protection of the Singer’s Voice during Plastic Surgery

Thursday, April 8th, 2010


Professional singers, like many artists, are also occasional plastic surgery patients for facial and body changes. In my Indianapolis plastic surgery practice, I will see about one or two such patients a year who truly do make their living by singing. In larger metropolitan areas like New York or Los Angeles, for example, vocalists as patients are in much higher numbers for sure.


While singers have the usual questions and concerns about their proposed plastic surgery procedures, they inevitably ask about being put to sleep and whether that will have any negative impact on their voice. This is a very understandable concern that undoubtably stems from the historic use of a ‘breathing tube’ for being put to sleep.


The best answer to this question comes from an anesthesiologist who ultimately is in charge of every patient’s airway during any form of surgery that requires a general anesthetic. I have asked Dr. Mark Fletcher, a board-certified anesthesiologist in Indianapolis with over 25 years of practice experience and one of the finest anesthesiologists that I know, for his thoughts on this ‘high-pitched’ question.  


‘Traditional anesthesia involves using a breathing tube that goes between the vocal cords and into the windpipe.  This is known as endotracheal intubation (ET tube) and involves inserting a plastic tube directly between the vocal cords.  After removing the tube, singers have occasionally experienced hoarseness that is temporary.  In rare cases there is the possibility that permanent changes to a patient’s voice could occur. (although this has not been reported in the medical literature)


But it is possible to have surgery today  with no risk to the delicate vocal cords. This technology is available and is known as using a Laryngeal Mask Airway or LMA.  The LMA was invented and developed by Dr. Archie Brain in England and introduced in the United States in 1988. The LMA functions like a cup inside the mouth,  keeping the airway into the lungs open but it does not pass through the vocal cords or gets anywhere near them. Instead it gently cups the opening to the voicebox from above. Not only does it protect the vocal cords from damage, the LMA is also less likely to make your throat sore. Although an LMA is not an option for every surgical procedure, it can be used for nearly all plastic surgery procedures.’


LMA anesthesia is the norm now for almost all plastic surgery procedures. There are a few facial plastic surgery exceptions, most notably rhinoplasty and facelift. In these procedures, the LMA often gets in the way or distorts the neck so it is still used during these procedures. But in all body plastic surgery, the LMA can be used for general anesthesia.


For professional singing patients, or any patient concerned about any change in their voice (even temporary), LMAs are the modern answer to these voiced concerns.


Dr. Barry Eppley

Indianapolis Indiana


Dr. Barry EppleyDr. Barry Eppley

Dr. Barry Eppley is an extensively trained plastic and cosmetic surgeon with more than 20 years of surgical experience. He is both a licensed physician and dentist as well as double board-certified in both Plastic and Reconstructive Surgery and Oral and Maxillofacial Surgery. This training allows him to perform the most complex surgical procedures from cosmetic changes to the face and body to craniofacial surgery. Dr. Eppley has made extensive contributions to plastic surgery starting with the development of several advanced surgical techniques. He is a revered author, lecturer and educator in the field of plastic and cosmetic surgery.

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