My doctor said he could perform my facelift under local anesthetic and just give me some sedation. I am 42, would general anesthesia be safe for me? I don’t know what is worse – the general anesthesia, or not being fully knocked out.
General anesthesia and local anesthesia with sedation are both good options for facelift surgery. You should probably stick with your surgeon's preference. When the sedation choice is used, I prefer that a board certified anesthesiologist be present for safety issues.
The more important question in my mind is appropriateness of facelift surgery in someone your age. I suggest you attain a second opinion before embarking on surgery.
I perform all facelifts under deep sedation with local anesthesia even though our office surgical facility is also accredited to perform general anesthesia. With local and sedation, you are completely unconscious and it is safer. I don't have to work around a tube in your throat and you wake up more smoothly.
For example, a large recent study showed that the only facelift patients who developed pulmonary emboli (very, very few) were those who were done under general anesthesia.So, for facelfts, I think local with sedation is better. I use general anesthesia for most breast and body operations.
But note that I am talking about DEEP sedation. Mild sedation does not work well for me. I don't want you uncomfortable or moving around while I am working on you. So the kind of sedation matters a lot. For deep sedation, you need a specially trained, board certified anesthesiologist. It is not any kind of a short cut.
I agree with the excellent and comprehensive advice given here.
As a Surgeon who has performed over 1,000 Facelifts with local anesthesia (with mild sedation as requested) I wanted to add a few comments.
In my experience long lasting and natural looking results are easily accomplished with local anesthesia. I have found over the years that in patients with mild to moderate aging changes, in their 40s and 50s and good overall medical health, equivalent results can be acccomplished with local anesthesia that are seen with general anesthesia.
I no longer utilize SMAS plication only procedures as I feel that indeed the duration of the results is not optimum. Rather a combination of cranial suspension with some form of subSMAS elevation provides excellent results that are very durable. These techniques can be easily, safely and comfortably accomplished with local anesthesia.
Also over the years I have started to use tumescent solution (a mixture of local anesthsia, epinephrine, saline and sodium bicarbonate) which allows for safe levels of local anesthetic, mechanical plane dissection, excellent hemostasis and a comfortable injection experience for the Patient.
Platsymaplasty / Neck Lifts or liposuction can also be performed easily at the same time using tumescent solution ensuring that the neck / area under the chin is also completely addressed.
Patients with moderate to severe aging changes or who are undergoing multiple facial rejuvenation procedures are encouraged to undergoe the process with IV Sedation or General anesthesia.
You are asking all the right questions. Continue to do your research with your Physician and in the end you will be able to arrive at an approach that you are both comfortable with and confident in that will get the very best results for you in the safest way possible.
Always speak with Patients who have already had the type of procedure you are considering at least one year ago to gain some valuable insight from their experiences.
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