Anesthesia Care

Anesthetic Care, Revolutionized

At the Our clinic for Aesthetic Medicine we have revolutionized the way anesthetic care is delivered to our patients. As a leader in the delivery of innovative medical care, we believe in the concept of perioperative surgical home (POSH), where patients are followed by anesthesiologist before, during, and long after surgery.

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From the moment you step into our office, your care will be personally deliberated and planned by board certified physicians and world class nursing staff. Our staff anesthesiologist will oversee every aspect of your care from preoperative, to operative, to postoperative care and even beyond.

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Preparing to “Go Under”

Pre-operatively, our staff anesthesiologist will assuage any and all concerns you may have about “going under.” We offer solutions to make wide-awake surgery and “twilight” anesthesia possible. More importantly, we will work to optimize your health and maximize the odds of an expeditious and uneventful recovery. In the operating room, our staff anesthesiologists are known for “easy” take-offs and landings, minimizing the odds of postoperative nausea and vomiting. All providers are board-certified in anesthesia and will make sure you are comfortable and safe throughout the journey.

Anesthesia Care at Our clinic

All staff anesthesiologists are board-certified MDs with a clean history and solid record. They are vetted to provide thoughtful, patient-centered and evidence-based care in a compassionate, thoughtful, and individualized manner.

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Types of Anesthesia

01 Minimal sedation:

This is also known as “anxiolysis.” This state is characterized by a patient that responds normally to verbal commands. Cognitive function and coordination can be impaired but ventilation and cardiovascular function is not altered.

02 Moderate sedation/(Conscious Sedation):

This is a state of depressed consciousness wherein the patient responds purposefully to verbal command, either alone or in association with mild tactile stimulation. No interventions are necessary to maintain a patent airway and demonstrable spontaneous ventilation should be present. Cardiovascular function is usually unchanged.

03 Deep sedation (Monitored Anesthesia Care):

This state of anesthesia is characterized by a patient that cannot be easily aroused, however they respond purposefully. Purposeful response may require repeated or painful stimulation. Ventilation may be reduced or impaired and/or the patient may require assistance to maintain a patent airway. Spontaneous ventilation may be inadequate while cardiovascular function is usually unchanged.

04 General anesthesia:

A state of consciousness wherein the patient is not able to be aroused, even with extremely painful stimuli. Ventilation if very often impaired and assistance is often required to maintaining a patent airway. Positive pressure ventilation may be required due to depressed spontaneous ventilation depressed or drug-induced depression of neuromuscular function. Cardiovascular function may be impaired. This is the type of anesthesia most commonly provided within the operating room (or seen on television) and is used to make you completely unaware that surgery is taking place until you are safely awakened in the recovery room.

What is Monitored Anesthesia Care?

Monitored anesthesia care is a specific service provided by an Anesthesiologist for a diagnostic or therapeutic procedure. Indications for monitored anesthesia care can be related to one or all of the following:

  • The nature of the procedure.
  • The patient’s clinical condition.
  • Potential for conversion to a general anesthetic.

Monitored Anesthesia Care involves the injection of medications through an IV catheter to help you relax, as well as to block pain. A combination of sedative and narcotic medications is combined to help you tolerate a procedure that otherwise would be uncomfortable. In addition, the surgeon may inject a local anesthetic at the site of the procedure for pain control. With this type of anesthesia, you are able to respond to questions, but will be drowsy throughout the procedure and you may not recall it at all.

Monitored anesthesia care may include varying levels of sedation, analgesia, and anxiolysis as necessary. If your doctor is considering administering monitored anesthesia care they must be prepared and qualified to convert to general anesthesia when necessary. If the patient loses consciousness and the ability to respond purposefully, the anesthetic care is considered a general anesthetic regardless of whether airway instrumentation is required. As we consider patient safety the most critical aspect of your care, at the Jonathan Zelken, MD for Aesthetic Medicine, we have a board certified, MD Anesthesiologist directly providing all our anesthetic services.

Candidates for Ambulatory and Outpatient Types of Anesthesia

  • Patients expected to have minimal blood loss.
  • ASA I or ASA II patients who do not require complex or extended postoperative monitoring or postoperative treatment.
  • Patients without Morbidly obesity, significant respiratory disease or obstructive sleep apnea (OSA).
  • Patients without a need for complex pain management or extensive post-operative narcotics.
  • Patients without a fever, cough, sore throat, coryza (watery eyes) or other signs of an upper respiratory infection.

Who is NOT a Candidate

  • Patients expected to have major blood loss.
  • ASA III or ASA IV patients who require complex or extended monitoring, postoperative treatment or hospital admission.
  • Morbidly obese patients with significant respiratory disease. (Obstructive Sleep Apnea is a significant respiratory disease.)
  • Patients with a need for complex pain management syndromes.
  • Patients with cough, fever, sore throat, coryza or other signs of an upper respiratory infection.


Postoperatively, a staff anesthesiologist may follow up with you. This is unique to our practice and ensures that any postoperative issues such as nausea or grogginess are addressed. After a few weeks, you may opt for ongoing care with our wellness team. We specialize in weight loss, metabolism enhancement, hormone replacement and optimization, and will give you the tools to maximize your results and help you meet whatever goals you set for your post-surgical course. This is particularly valuable for patients undergoing body contouring surgery and mommy makeovers.

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