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Factors to Consider when Deciding for a Facelift?

I am considering a facelift, age 56. Excellent health. Two of the four consults I have had prefer IV sedation, the other two, general. The estimated time for the surgery is 4.5 hours. This is consistent among all surgeons. The costs is approximately $3000 difference for general. I have been reading pros and cons to both. What factors should I consider in making my decision?

Asked 30 months ago by anonymous57 in San Francisco, CA

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Facelift anesthesia types

Modern superlight anesthetics are quite safe, especially if performed by an anesthesiologist with hospital credentials who has specialized in outpatient cosmetic surgery anesthesia. IV sedation, when performed for a long case, is best performed with an anesthesiologist, not by the doctor himself in my opinion. The reasons for this are many. When local anesthesia is administered, the pulse and blood pressure can rise. The patient can have an unexpected allergic reaction. The patient can... more

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Brent Moelleken, MD

Beverly Hills Plastic Surgeon

ASAPS ASPS

Anesthesia with Facelift Surgery

Part of your confusion is trying to deal with marketing terms. IV sedation is a form of general anesthesia. In one technique drugs are given intravenously; in the other, gases are the source of anesthesia. A deeper anesthetic can be given with gas, but this is rarely done. In a procedure that takes 41/2 hours we find that most patients prefer what you're calling general anesthesia, using minimal gas. There should be no difference in cost.

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Richard W. Fleming, MD

Beverly Hills Facial Plastic Surgeon

Face Lift factors

The factors to consider when deciding on a facelift should be centered on your needs, the surgeons experence,their training and case volume. Your surgeon should be able to show you similar patients that demonstrate the agging face changes you see in the mirror. I would not use the type of anesthesia or place of the procedure as primary decision point.

Daniel J. Leeman, MD

Austin Facial Plastic Surgeon

General anesthesia allows the surgeon to focus only on achieving the best facelift

The most important factor if facelift is the skill and experience of your surgeon. The advantage of local anesthesia is that you are less likely to have nausea post op and you will "bounce back" quicker. However, I prefer general anesthesia because it allows me to focus entirely on achieving the best possible facelift result. Often, the most important technical details of the facelift occur near the end of the operation, and often after the time taken for dissection and... more

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Brooke R. Seckel, MD

Boston Plastic Surgeon

ASAPS ASPS

Anesthesia considerations for facelift

There is no single correct answer to this. I use a CRNA (nurse anesthetist) and would be very comfortable having her give me anesthesia. It is more a matter of preference than any demonstrable safety issue. Recovery after anesthesia may be a little bit faster with IV sedation than general. In either case the experience should be a comfortable one for you so go with the surgeon you think will do the best job.

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Richard Baxter, MD

Seattle Plastic Surgeon

ASAPS ASPS

Anesthesia for facelift.

Hi! 1) The most important point about anesthesia for facelifts is that it be given by a board certified anesthesiologist (an MD) experienced in cosmetic surgery anesthesia. The blood pressure has to be maintained low and stable, and you have to wake up very smoothly. 2) In our office surgical suite in New York, I prefer deep intravenous sedation and local anesthesia. But general anesthesia is fine too. 3) If general anesthesia is used, then you need an endotracheal tube. An LMA... more

George J. Beraka, MD

Manhattan Plastic Surgeon

ASAPS ASPS

Decision making for a facelift

It sounds as though you've done your homework! As long as you're comfortable with your surgeon, you like his/her before and after pictures, and you're comfortable with how your post-operative care will go you should be in good hands. Don't let price dictate your surgeon choice as you may be disappointed in the end. Good luck!

Jeffrey E. Schreiber, MD

Baltimore Plastic Surgeon

ASPS

Facelift Anesthesia

This is a good questions that there may not be a perfect answer for. First you should decide on the surgeon not the anesthesia. But having said that, you need to make sure that there is an anesthesiologist and that they are board certified as well. Then I would say take it from there. The issue I have with IV sedation for such a long procedure is that the risks increase for problems because the anesthesiologist is leaving the breathing up to you, who is going to be sedated. So there is... more

Farbod Esmailian, MD

Orange County Plastic Surgeon

ASPS

IV Sedation vs. General Anesthesia for Facelift

Nowadays there is a fine line between IV sedation. IV sedation means that no tube is in your throat and you breath on your own. In addition local anesthetic is infiltrated into the tissues to help with pain control and bleeding. Many surgeons have an nurse anesthetist do the sedation as they perform the surgery. The surgeon is then the physician responsible for both the surgery and the anesthesia. General anesthesia for cases like this is different then it used to be. In the past an... more

Christopher L. Hess, MD

Fairfax Plastic Surgeon

ASPS

Facelifting

Dear Anonymous The type of anaesthesia is usually surgeon preference. They have similar risk and the same potential for nausea- the most dredded aspect. There are arguments for both and in the end the surgeonhas to be happy to do your surgery and you have to like your surgeon. With Warm Regards, Trevor M Born MD

Trevor M. Born, MD

Toronto Plastic Surgeon

ASAPS

IV or general anesthesis for facelift

My personal preference is general anesthesia but I am willing to perform the procedure under IV sedation. My general recommendations are that if a procedure is less than 2 hours then either is acceptable. However, it is difficult for anyone to remain still for more than this and therefore I recommend general anesthesia for longer cases.

Otto Joseph Placik, MD

Chicago Plastic Surgeon

ASAPS ASPS

Anesthesia Type For a Facelift

Facelift surgery, like most cosmetic surgery can be performed under a wide selection of anesthesia types. These can range from local anesthesia only, light IV sedation, deep IV sedation to general anesthesia. There are risks and benefits with each type of anesthesia. Most importantly the anesthesia provider should be comfortable and competent in which ever type of anesthesia is needed. In my Naples, Florida cosmetic surgery center, my board certified registered nurse anesthetist... more

Kent V. Hasen, MD

Naples Plastic Surgeon

ASAPS ASPS

General anesthesia vs iv sedation for facelift

Both methods are safe. The most important thing in my opinion is that the person administering the anesthesia is a board certified anesthesiologist. Some surgeons use a nurse anesthetist. This is personal preference but I prefer a board certified anesthesiologist to administer the anesthesia. Make sure the facilities are accredited by either JACHO, AAAA or AAA. Assuming you have no medical problems, either method of anesthesia is acceptable. Do not make decisions based on price; you... more

Tracy Pfeifer, MD

Manhattan Plastic Surgeon

ASAPS ASPS

Facelift: General or Sedation

Dear Anon Either one is fine. I decide which type of anesthesia to use depending upon the patient and my anesthesiologist. I have some patients who insist on general while other want only sedation. Some doctors prefer one way or the other. What I don't understand is the 3000.00 price difference. That's the most expensive anesthesiologist I know of. Usually anesthesiologists are paid based on a time basis and very often in office cosmetic surgery on a flat rate. My anesthesiologist board... more

Steven Schuster, MD

Boca Raton Plastic Surgeon

ASAPS ASPS

Decisions, decisions

One of the great values of the internet is the ability to gather a large amount of information in a very short time regarding any practice, doctor etc. First, you might already know the board status, training etc.. of each of your plastic surgeons. The next step is to look at the pre and post pictures, even talk to previous patients. The last and most important is to have a good "gut feeling " this is a long term relationship and it is important to feel safe and comfortable. Small... more

Hisham Seify, MD, PhD

Los Angeles Plastic Surgeon

ASPS

Factors to Consider when thinking about Facelift

The important issue is how good your health is and how your recovery will be? This is usually best answered by a good physical exam by your surgeon and a medical clearance exam from your primary care physician. There are always risks and dangers with surgery, but the type of anesthesia used is also an important factor. I believe that general anesthesia allows the surgeon to focus on the details and completness of the results without having to worry about the... more

Erez Sternberg, MD

Jacksonville Plastic Surgeon

Facelift Surgery with General Anesthesia

For the past 25 years I have used general anesthesia for all my facelift surgeries. My primary reason is to have you relaxed and not moving during the operation. I only use board certified anesthesiologist who are there to monitor your vitals and to have antibiotics and anti-nausea in your IV. I often participate on reviewing other surgeons work for our state medical board and find the use of local anesthesia can add substantial risk to your procedure. You do not... more

John Ward, MD

Phoenix Plastic Surgeon

ASPS

Factors to Decide with a Facelift

The most important factor to decide with a facelift is the surgeon. As a patient, some factors to look for in a surgeon are the following: Type of lift performed How many procedures has the surgeon performed Board certification (Either Facial Plastic Surgery or Plastic Surgery) Incisions planned Before and afters Scientific articles written on facelift surgery Postoperative Care Plan Comprehensive facial rejuenation plan... more

Anil R. Shah, MD

Chicago Facial Plastic Surgeon

General anesthesia is preferred

It sounds as though the $3,000 difference in the procedures has to do with the surgeon performing both the surgery and the anesthetic simultaneously. The anesthesia team charges the same amount of money whether it is for I.V. sedation or general anesthesia. They are a service provider, and their charge is based upon the amount of time. It is important to have an anesthesiologist present for safety purposes in case there are any heart or lung problems during the procedure. General... more

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William Portuese, MD

Seattle Facial Plastic Surgeon

First and foremost consider facelift surgeon quality

Anonymous53: Since you have consulted with 4 surgeons, you are obviously doing reasearch in person. As for those secondary considerations: (1) costs should be appropriate for the surgeon's results, the facility used, the staff's experience, etc.; (2) the anesthesia method is that which your surgeon chooses to provide you his best results; and (3) the facility should be accredited, and preferably regularly doing cosmetic surgery cases. In our situation, we prefer our office aesthetic... more

Sutton Graham II, MD

Greenville Plastic Surgeon

ASAPS ASPS

Both are fine!

We have done facelifts for more than 30 years and unless we are doing a minilift, we find that most patients prefer general anesthesia, especially if the surgery is that long. It should not be that much of a difference in the anesthesia cost. The time is the same and we charge the same for both. You should discuss this with the surgeon,