I prefer to do my face lifts with local anesthesia and oral sedation.
Instead of sending heavy medication into the IV line to keep you asleep or sedated throughout the procedure, tumescent anesthesia uses only local anesthesia injected into the face to control pain, and Valium pills to relax you. The term "tumescent" (meaning swollen or puffy) comes from the appearance of the area immediately after injection, before the medicine is absorbed into the surrounding tissues. The medicine that is injected is a solution of saline (salt-water), epinephrine, and Lidocaine. Saline helps to separate the tissues, making the dissection less traumatic for the face. Epinephrine causes the tiny blood vessels in the area to constrict, minimizing bleeding and bruising. Lidocaine numbs the area to provide pain control, similar to what the dentist uses before filling a cavity in a tooth.
The procedure is performed without heavy medication and without a long post-operative recovery. Most patients are comfortably and safely on their way home about an hour after surgery. Since most of the medication used with tumescent anesthesia in The Awake Facelift is eliminated from the body within a few hours, there is no "hangover" effect such as is often experienced after general anesthesia. This also translates to less post operative nausea and vomiting.
Having the patient awake throughout the procedure enables the surgeon to maximize the aesthetic result with the least risk of complications. Nerve function can be continually assessed during surgery by having the patient raise the eyebrows, smile, or perform other facial expressions. Checking nerve function is critical to avoiding the rare complication of facial nerve damage, but this important precaution is impossible using general anesthesia or heavy sedation.
In some cases, patients might not be good candidates for the Awake Facelift, such as if they are tolerant to anesthetics (have a hard time getting numbed up at the dentist), take a lot of pain medications regularly, are very anxious or nervous, or have contributing medical concerns such as cardiac history. These patients are better suited for IV sedation.
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