Is Nine Hours Under General Anesthesia Too Long?

Nine hours is a long time to be under general anesthesia for cosmetic surgery. You are young for a facelift so I would wonder what the surgeon proposes which would result in so long a procedure. Whenever the anesthesia time exceeds 5.5-6 hours, there is a documented increase in complications no matter how skilled the surgeon and anesthesiologist. I agree that, as a surgeon, you simply get tired past a certain point and it is important to recognize one's own limits and to create an operative setting with which both the patient and surgeon are comfortable.

Few would argue that your cosmetic surgery should not be life threatening.  Generally anesthesia is associated with a finite risk of death.  What is this risk?  It depends on one's overall state of health and the relative risk of the procedure being performed.  For a facelift, the risk of dying from having a general anesthesia is approximately one in 50,000 depending on the study.  Recognize that studies the provide these estimates are very imprecise.  Surgeries that go beyond 6 hours are associated with increased risks.  How do ethical surgeons deal with this risk: we limit how much work we do at any given operative session.  Rather than having one massive surgery-the Blue Plate Special, it is far safer to have two or three smaller surgeries.  This achieves several things.  First your cosmetic surgery does not push the bounds of survivability.  Secondly how fresh do you think your surgeon will be at the start of the 8th hour of surgery?  Finally, by having staged surgery, you can ease into your new look.  Please do not be seduced by the promise of cost savings by having everything done at one time.  I do also very much agree that additional opinions are warranted.