This 28 year old health care professional came to Minneapolis Plastic Surgery for improvement in her chin and neck areas. She requested removal of fat in her neck and below her chin (submental area), as well as improved jawline definition. She underwent outpatient fat excision beneath her chin, as well as below the neck muscle (platysma), and a chin implant. Her operation took 65 minutes, and she left the recovery room in 80 minutes alert, dressed, and with no nausea, due mostly to her TIVA general anesthesia. This type of anesthesia is unique to only a few locations, as hospitals and most surgicenters use less expensive, but more nausea-and-vomiting inducing inhalation (gas) anesthesia. Both TIVA and gas are quite safe, but TIVA has a 2-3% post-op nausea and vomiting (PONV) rate compared to the inhalation anesthesia PONV of 7-28%. Besides PONV being not very much fun to endure, it also causes more bruising, bleeding, and re-operations, not to mention scar tissue. We have perfected TIVA for a reason!