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Do Most Surgeons Draw Pre-Op Surgical Markings on Your Face While You Are Unconscious?

asked 1 year ago by July4 in USA
Latest answer by Sam Naficy, MD
Question viewed 631 times
Tags: female, marks

When is the pre operative surgical markings done for a face lift and blepharoplasty. It is before the surgery while you are awake and sitting up or after you are sedated and lying down?

32 answers to Do Most Surgeons Draw Pre-Op Surgical Markings on Your Face While You Are Unconscious?

+1

Pre-Surgical Markings Before or After Anesthesia

I always mark the patient sitting up and awake before facelift or blepharoplasty surgery. Facial contours are different when a person is sitting up or lying down. Take a mirror and look at yourself in those two positions. Occasionally some additional marks are made after the patient is asleep.
Richard W. Fleming, MD

Beverly Hills Facial Plastic Surgeon

www.bevhills.com

+4

Face Lift Markings

I always mark my patients in the sitting/upright position and awake.  I may make some adjustments while the patient is asleep or sedated, but for the most part follow the pre-op markings.
Douglas L. Gervais, MD

Minneapolis Plastic Surgeon
+3

Marking the face for a face lift

Markings are important prior to a facelift.  If you look into a mirror and then look into that mirror again while you lay down you will see a marked difference.  Enough said.  I always mark my facelifts in the standing position.  It is better for predicting a final result. Wishing you all the best, Tal Raine MD FACS
Talmage J. Raine, MD

Chicago Plastic Surgeon
+3

Do Most Surgeons Draw Pre-Op Surgical Markings on Your Face While You Are Unconscious?

I prefer to make any necessary markings with the patient awake in pre op holding. That minimizes the time in the operating room and allows for some conversation between me and the patient. I find it a valuable time to remind the patient and family of what to expect after surgery, and a time to answer last minute questions.
Mark Preston, MD

Columbus Plastic Surgeon
+3

Markings the road map for great surgery

Markings are the road map for great surgery. I like to mark  the patient in the upright position while they are awake so they can see exactly where the incisions are. Then while the patient is asleep I like to refine the markings. This allows me to see the effect of gravity in different dimensions. The most important thing is that you understand the procedure and you are on the same page as your surgeon. Hope this helps, good luck.
Ritu Chopra, MD

Beverly Hills Plastic Surgeon
+3

Standards for Pre Operative Facelift Markings. What are they?

The best answer is both.  II almost always do markings with the patient upright in the receiving area and then often add some markings  in the O R when the patient is asleep.   Each surgeon has their own technique just as they do in operting on  the patient.  If a surgeon feels they can judge things in the OR it is okay.  I just find it easier to do both.  My best.
George Commons, MD

Palo Alto Plastic Surgeon

www.pacfps.com

+3

Markings for facelift surgery

Hi Cerro Gordo- Every surgeon has a different routine. Most surgeons, however, prefer to have the patient in a sitting position when doing the surgical markings, so they can take into account the effects of gravity on the face. Sincerely, Tom Kaniff
Thomas E. Kaniff, MD

Sacramento Facial Plastic Surgeon

www.facialcosmeticsurg.com

+2

Pre op markings for Facelift and Blepharoplasty are best done with you awake and sitting up

Most surgeons typically do pre op markings for Facelift and Blepharoplasty when you are awake and sitting up. This allows the surgeon to evaluate how the tissues lie and fall on the face and enables the surgeon to place the skin in the desired post operative location and make appropriate marks to guide him/her during the surgical procedure. It is particularly important to make pre operative Facelift and Blepharoplasty markings before any local anesthesia is injected which can distort... more
Brooke R. Seckel, MD

Boston Plastic Surgeon

www.drseckel.com

+2

Markings for Facelift and Blepharoplasty

I, like many of my colleagues, prefer to mark patients in the awake, upright, and dynamic position.  Preoperative marking is done to highlight anatomic landmarks and to give the Surgeon a general reference point during the procedure.
Stephen Prendiville, MD

Fort Myers Facial Plastic Surgeon

www.drprendiville.com

+2

When do facelift surgeons perform their surgical markings?

Personally, I perform the markings while the patient is sitting upright and looking straight ahead. This step is a very important step in the overall planning process of the procedure. But I do know very good facial surgeons who mark only after their patients went asleep...
Frank P. Fechner, MD

Worcester Facial Plastic Surgeon

www.drfechner.com

+2

Typical Markings before surgery

The vast majority of surgeons will mark their patients awake and upright.  This serves several purposes.  First, it is part of the consent process.  The patient knows exactly what is going to be cut. Second, with upper eyelid surgery there is an important functional component.  You must have the patient awake and moving to determine the safe amount of skin for removal. Third, with faces a lot changes when you lay down.  The incisions won't change, but... more
Louis W. Apostolakis, MD

Austin Facial Plastic Surgeon
+2

Facelift marking

I agree with other authors here that preoperative marking is the most important step in planning any cosmetic surgery. Generally, when patients look in the mirror or are being looked at by others, they are in the upright position. What matters most in a a cosmetic outcome is how the patient will look to the casual observer in the routine social setting. Things change considerably after being placed in a supine position, and especially after the injection of medication to anesthetize the skin... more
Tim Abou-Sayed, MD

Palm Beach Plastic Surgeon
+2

Surgical marking - and decision making - is best done preop

In my opinion, the best time to make final plans, and mark/measure, is in the preoperative area, with the face animated, the patient awake and giving input, and with gravity pulling the right direction on the face.
Laxmeesh Mike Nayak, MD

Saint Louis Facial Plastic Surgeon

www.nayakplasticsurgery.com

+2

Preoperative markings.

I always mark my incisions while the patient is awake and sitting upright in a chair. I feel that it is important to see your face, eyelids, and eyebrows in their natural position in order to accurately determine what needs to be done. When you are lying done, the perspective is affected and this can lead to over correction and possible problems in the healing period.
Gregory J. Vipond, MD

Pasadena Facial Plastic Surgeon
+2

Pre-Op Surgical Markings on Your Face

Dear Cerro, I always mark my patients when they are awake and in a sitting position.  This gives them the opportunity to see my surgical plan, and to ask any questions that they may have, as well as see where their scars will be.  I believe most surgeons do the same.
Amy T. Bandy, DO

Newport Beach Plastic Surgeon
+2

Facelift Markings before surgery

Most surgeons make markings on the patient while the patient is awake and sitting up before surgery.  However, depending on the surgeons' technique, these markings may be made after the patient is under anesthesia while skin prepping is being done, ie. shaving of hair.  The most important aspect of choosing your surgeon is that you trust and feel comfortable with your surgeon.
Kristin Egan, MD

Manhattan Beach Facial Plastic Surgeon
+2

Facelift incisions

I mark my patients before and during surgery for facelift.  I mark the upper eyelid incisions and the forehead incisions for endoscopic brow lift as well as the chin incision.  I then mark the actual incisions in front of the ear for the facelift one the patient is asleep because I don't need the patient standing to do that.   Samer W. Cabbabe, M.D. Board - Certified Plastic Surgeon Saint Louis Plastic Surgery Consultants
Samer W. Cabbabe, MD

Saint Louis Plastic Surgeon
+2

Facelift and blepharoplasty markings

There is no standard for marking the patients either awake or asleep it is simply a personal preference of the surgeon. Some physicians who do not own their operating facilities will do it prior to going into the operating room as it saves on expenses and time. Others like to mark the patients in the preoperative room and discuss the incisions with the patient. Since I have my own surgical center and time is not important to me cost wise my preference is to sit the patient upright in the... more
Michael Elam, MD

Orange County Facial Plastic Surgeon
+2

Marking the face before facelift

Almost all facelift surgeons mark patients in the pre-op area while the patient is sitting upright.  I feel that it is important to have the patient upright since that is when the skin sags most and how patients will be seen by others.
P. Daniel Ward, MD

Salt Lake City Facial Plastic Surgeon
+2

Preoperative Facelift and Eyelift Markings

I think it is a wonderful idea to mark the patient prior to surgery such that I can visualize the natural skin creases in the upright position around the eyelid and ear.   This allows me to maximally camouflage the scars.  I also like to mark the vectors of SMAS pull on the cheek fat pad, jowls, and lax platysma of the neck.    By marking the patient in the upright position, I gain alot of information during surgery that can help provide optimal shape and symmetry in the... more
Paul S. Gill, MD

Houston Plastic Surgeon
+2

Markings should be done before surgery

Although some surgeons prefer to mark their patients after they have fallen asleep, I prefer to mark my patients while they are sitting and awake. This allows me to make accurate assessments of how the patient will look afterwards, since the face (and eyelids) look very different when sitting up as opposed to lying down. 
Jen Yuan Chow, MD

Pasadena Facial Plastic Surgeon
+2

Surgeons differ with preoperative markings

Preoperative markings prior to any surgery are very variable from surgeon to surgeon.  I can state that I like to make my markings with the patient awake and sitting upright to clearly see what shadows, and lines I can hide any incisions in.  Furthermore, the upright posture is the "face" that we publicly present.  I hope this helps.  This is not to say that other types of markings are wrong.  This is just the way I do it and my rationale. more
Raghu Athre, MD

Houston Facial Plastic Surgeon

www.athresurgical.com

+2

Markings before surgery.

While either way works, I prefer to mark my patients awake and sitting up, so I can visualize the effects of gravity on their skin and  facial form. Patients usually look at themselves in a vertical position so it makes most sense to mark them in this position. This also allows patient input during the markings without the effects of sedation. 
Jeffrey M. Darrow, MD

Boston Plastic Surgeon
+2

Surgical Markings Vary with Surgeon Preference

Hi, When to mark the patient is generally based on personal preference and training. There really isn’t a right or wrong way to do it. I personally like marking my blepharoplasty and facelift patients while they are awake and sitting up. Once they are sedated and lying down, I verify my measurements and adjust or make additional markings as needed. I prefer to do the markings with the patients sitting up because that is how the patient is going to see herself/himself most of the... more
Sarmela Sunder, MD

Beverly Hills Facial Plastic Surgeon
+2

Pre operative markings for facelift, etc.

I always do this with the patient awake and sitting BEFORE the go to sleep. In that way they can see exactly what I'm going to do and comment on it before surgery.
Toby Mayer, MD

Beverly Hills Facial Plastic Surgeon
+2

Marking for a Blepharoplasty and Facelift

Hi, Markings are always made with the patient sitting up and awake. The surgeon may reinforce the markings during surgery but these are always made before the surgery. Best, Dr.S.
Oleh Slupchynskyj, MD

New York Facial Plastic Surgeon

www.facechange.org

+2

Pre-operative marking are usually done with the face upright and the patient awake

Usually most surgeons will mark the patient prior to surgery with the patient in the seated position and the patient awake.  This allows them to see the look of the face with the effects of gravity and muscle tone.  However some surgeons  make detailed notes at a preoperative visit and then mark the patient accordingly at the time of surgery. Both techniques work. Dr. Mayl Fort Lauderdale
Nathan Mayl, MD

Fort Lauderdale Plastic Surgeon
+2

This varies with each surgeon.

Dear Cerro There is no standard for this.  Rather, there are just personal preferences.  My personal preference for eyelid surgery is to make a surgical plan preoperatively.  Depending on the individual situation, I am mark my patient's eyelids in the presurgical holding area.  Additionally I remark the eyelids on the table after reconfirming the measurements.  Faces are different.  For faces, I like to have 8X10 photos from different angles available... more
Kenneth D. Steinsapir, MD

Los Angeles Oculoplastic Surgeon
+1

Pre-Op Surgical Markings

Each surgeon has their preference but most of us will do our markings on an upright and awake patient
Sam Naficy, MD

Seattle Facial Plastic Surgeon
+1

I do while patient is awake and sitting upright

Can be both depending on the surgeon's preference. I like to do it before surgery while patient is upright see video
Babak Azizzadeh, MD

Beverly Hills Facial Plastic Surgeon
+1

When are markings for a facelift done?

Each plastic surgeon has his or her own technique, most including myself prefer to have the patient awake and sitting up as gravity can change the features. Also this gives me time to discuss with the patient what I am doing and how and get any additional feedback from my patient. The video below shows marking of a patient before surgery. see video
Miguel Delgado, Jr., MD

San Francisco Plastic Surgeon

www.dr-delgado.com

+1

Face Lift, Beverly Hills Face Lift, World's Best Face Lift, Los Angeles Face Lift

I have been performing Face Lifts for over 20 years and have taught Face Lift techniques to resident surgeons for quite a few years. The markings associated with a Face Lift could be done either way...with the patient sitting up which is the way I saw plastic and Cosmetic Surgeons do when I was training over 20 some years ago. I have always allowed my Face Lift patients to relax, lay down on the O R table before I do the facial marking as I feel it allows them to relax more. IMO, if... more
Francis R. Palmer, III, MD

Beverly Hills Facial Plastic Surgeon

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