I am allergic to lidocaine (without preservatives). Is there an effective alternative to lidocaine for facelift surgery. I don't want to have general anesthesia if at all possible.
Is There a Local Anesthetic for Lower Facelifts Besides Lidocaine?
Doctor Answers (9)
Lidocaine sensitivity during Facelift
The incidence of true lidocaine allergy is extremely rare. Several additives in lidocaine solution may lead to a hypersensitivity reaction but, an allergic reaction is still rare. I would ask the provider who administered your lidocaine during your previous procedure what they had used as the local anesthetic. Your dentist would likely also have knowledge of these issues. Prior to any further administration of lidocaine, even with a resultant negative history, I would get tested for allergies to the entire caine family of analgesics.
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.
Local anesthetic allergy
As stated by other surgeons, the allergy you describe is extremely rare. First, I suggest you have the appropriate tests to confirm this problem. Please reconsider your desire to avoid general anesthesia. A very low level of general anesthesia is used in cosmetic surgery, making the surgery safer, more pleasant , and easier for patient and surgeon.
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Local anesthetic for lower facelifts
True lidocaine allergy is extremely rare. Nevertheless, if there is a high risk that you are truly allergic to lidocaine, you do not want to take unnecessary chances.
Although you do not want general anesthesia, it is the best way to have the surgery in your case. Injection of the skin with a dilute epinephrine solution can be administered to reduce bruising and potential bleeding.
Alternative to Lidocaine Anesthesia for Facelift
Yes, there are alternatives to Lidocaine for facelift anesthesia. The real question is, why not consider general anesthesia? Over the years, I have converted from doing almost all cosmetic procedures under local anesthesia to using general anesthesia almost exclusively. My patients are happier, the postoperative recovery is faster, there is less nausea, and, I believe, the general anesthesia is safer.
Local anesthetic options
There are a number of different options for local anesthesia, but lidocaine is by far the most common since adverse reactions are so rare. In fact, the issue of allergy has to be a bit suspect because the documented cases number in the single digits despite many millions of doses. In any case, you surgeon will be able to provide alternatives since there is no point in risking it.
Local anesthetic for lower facelift
I agree with Dr Placik. A true lidocaine toxicity is extremely rare. There are other caines to act as anesthetics. I would see an allergist for a skin test to find which caine can be used. Regards.
Lidocaine alternatives in facelift
In facelift we often blend our local with another local medication from a different medication group called marcaine. This medication does not share allergy with lidocaine. The numbing produced is slower though we use it because the block is more lasting.
Facelift could also be performed under a general anesthesia, using just the epinephrine alone. With skill and adjustment of technique, you should be able to complete facelift with either the modified local sedation, or general anesthesia with safety.
Best of luck,
Peter E Johnson MD
Local anesthetic allergy
A true allergy to amide anesthetics (i.e., lidocaine) is truly rare but can be life threatening. Most reactions are to additives such as methylparaben or metabisulfite. In a study of 208 patients that clamed to have allergies to local anesthetics, only 197 truly had an allergy when fully tested at a clinic.
You should seek evaluation by an allergist to find out if you have a true allergy to amide local anesthetics
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.