Can you really perform a SMAS lower face and necklift as an in-office procedure with just a local anesthetic?
Doctor Answers (20)
SMAS facelifts under straight local anesthesia, no thank you
It is amazing how anxious even the calmest patient becomes on their day of surgery, even for a tiny mole removal. It is a truly rare person who could have a real facelift done completely comfortably under straight local. So, the best plan is not to look for someone who will do this if you ask but to go to the very best facelift surgeon, ask how they prefer to do it and why, and let them do their thing and take great care of you. It is your FACE and needs to be done right, once.
True Facelift under Local Anesthesia
Local Anesthesia Facelift
First, a true facelift, not some sort of "mini" version is an extensive operation that takes at least two hours. I usually spend 2.5 to 3 hours on a lower facelift. This can seem like a very long time while you lay there.
Second, the infiltration of the local anesthetic is painful. In other words, it is a lot of shots to get you numb at the beginning, but it is definitely do-able and it only takes about 5 minutes. With some gentleness and a few tricks, it doesn't hurt that much.
Third, just because you are not under anesthesia, a proper operating room is still a must. A facelift should only be done in a properly accredited operating room regardless of anesthesia. The facility should be certified by either AAAHC, AAAASF, or JCAHO.
Having said that, I offer all of my patients the option of local anesthesia. Not surprisingly, I get very few takers. But I still do sometimes.
I perform the vast majority of my facelifts with the patient under IV sedation. This is a strong sedation that keeps you asleep, but you still breath under your own power without a tube in your lungs or gas anesthesia. I consider it to have most of the best qualities of local and general anesthesia while avoiding most of the undesirable issues.
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Can you do it? Yes. Would I recommend it to my Mother? No
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Full facelift - local anesthesia
Prior to face lift or any other facial cosmetic surgery all of us infiltrate into the cheeks and neck local anesthetic for 1. numbing and 2. assistance with blood vessel constriction. IV sedation or general anesthesia are not needed for the analgesic effect (pain control) but instead are needed to improve your tolerance of the entire procedure. Patients who undergo inadequate numbing due to discomfort of the injections and patients who are anxious tend to have unpleasant experience. That is why some of the patients who undergo surgery with minimal or no sedation give such negative reviews about their experience. Just keep on doing your research on line, and be careful in your selection.
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