Anesthesia Alternative for Lidocaine in Facelift Procedure?

Question

I had allergy testing with preservative free lidocaine to rule out methylparaben sensitivity.  I developed red papules and itching at the injection areas.  No life threatening reactions just the rash for several days.Now my plastic surgeon will not do a Facelift unless I use general anesthesia which I don't want to use.  Is there any other local anesthesia that could be substituted for lidocaine? Is a topical skin reaction to PRESERVATIVE FREE lidocaine dangerous?

Larry S. Nichter, MD, MS, FACS · Answer

Marcaine, also called bupivicaine is a different type of local anesthetic (an ester) and lasts longer than lidocaine (an amide) so that it is unlikely you would also be allergic to this medication. However skin testing might be wise before hand in your case. One of the reasons to do this procedure under general of IV sedation is that an anesthesiologist would be present that could take care of any allergic reactions you may have during the procedure. It would seem that your plastic surgeon has your best interests in mind when he made this decision.

Richard J. Bruneteau, MD · Answer

Although
allergies to lidocaine are extremely rare they do occasionally occur. When this
situation arises facelift procedures can still be performed, but the anesthetic
technique needs to be modified. When patients are allergic to
lidocaine other types of local anesthetics may be helpful. Local anesthetics
fall into two categories, these include amides and esters. In most cases when
patients are allergic to an anesthetic, they’re able to use anesthetics from
the opposite group. For instance Lidocaine is an amide. For this reason
patients might be able to use Marcaine which is an ester. Although you’re not interested in
general anesthesia, this might be your best option. General anesthesia offers
high comfort levels and excellent patient safety. The majority of plastic
surgeons prefer this approach to local anesthetic with or without I.V.
sedation. With your history of allergies the presence of an anesthesiologist
provides added safety. If
you’re still interested in facelift surgery, it’s important to discuss these
issues with your plastic surgeon. Your surgeon should be able to formulate a
treatment plan that addresses your concerns about anesthesia.

Toby Mayer, MD · Answer

You can be tested the same way with Marcaine. The surgeon probably feels you will be more comfortable with general anesthesia at the same time which is the way most surgeons do this.

Raj S. Ambay, MD · Answer

I always do my facelifts under general anesthesia but use local anesthesia in addition to allow the anesthesiologist to keep the amount of general anesthesia to a minimum. There are many alternatives to lidocaine but I think that Gen is the way to go for a facelift.  The patient is comfortable and I can focus on the surgery and the outcome.

Reginald Rice, MD, FACS · Answer

There are many alternatives to lidocaine on the market that can be safely used. The most common alternative in my practice is Marcaine, also called bupivicaine. If you wanted to avoid all anesthestic injections, you also could have your facelift done under general anesthesia and your doctor could inject a dilute solution of epinephrine to accomplish the bleeding control that is an important reason for the injections. If no anesthetic injections are done though, you will probably experience more discomfort in the first day or two.

Anesthesia Alternative for Lidocaine in Facelift Procedure?

Answers (9)

Answer: Lidocaine allergy

Answer: Lidocaine allergy

Answer: Marcaine or general anesthesia

Answer: Marcaine or general anesthesia

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Everything you need to know about Facelift

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Anesthesia Alternative for Lidocaine in Facelift Procedure?

Answers (9)

Answer: Lidocaine allergy

Answer: Lidocaine allergy

Answer: Marcaine or general anesthesia

Answer: Marcaine or general anesthesia

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Recommended reading

Everything you need to know about Facelift

Our mission is to create a world where every investment in modern beauty is Worth It.