The most recent studies share the professional opinion that most, if not all, facial cosmetic surgery procedures, can be performed safely under local anesthesia with intravenous sedation. Despite this fact, a large percentage of people undergoing cosmetic surgery are still subjected to the risks of general anesthesia

When a patient is placed under general anesthesia, the patient is put on a respirator and a tube is placed in the throat to help them breathe. A combination of drugs causes a deep sleep during the procedure. 

Unfortunately, complication rates are greater under general anesthesia and the body is put at a greater risk. Following a surgical procedure, patients often have a sore throat from the tube that was in their throat, are very fatigued and more likely to feel nauseated. One recent study showed a higher incidence of post-operative cognitive decline in elderly women after general anesthesia, as opposed to their male counterparts. Recovery is considerably longer because the body has to recover from both the surgery and the anesthesia.

The primary characteristic of local anesthesia is its ability to numb a specific area of the body without impacting the consciousness of a patient. In contrast, general anesthesia renders a patient completely unconscious and insensitive to pain anywhere in the body. This type of anesthetic requires precise monitoring of breathing and heart function and maintenance in order to keep a patient stable and healthy. Because local anesthesia does not affect bodily systems to such an extreme degree as general anesthesia, local anesthesia provides a higher degree of safety for the patient. Through a variety of procedures, such as topical injections and nerve blocks, patients can be rendered insensitive to pain in only the area of the body affected by the surgery.

In general, patients experience faster recovery times after receiving local anesthesia rather than general anesthesia. One primary reason for the difference in recovery time stems from the fact that under general anesthesia, many of the body’s systems, such as the cardiovascular system, are seriously depressed by the anesthetic. In these cases, patients must be monitored carefully, sometimes for many hours after the procedure, as the body slowly regains control of all of its functions, including respiration and muscle movement. Thus with general anesthesia, the patient must recover not only from the procedure itself, but also from the effects of sedation. With local anesthesia, patients usually require less medication and remain alert and responsive throughout the procedure, giving them a head start on recovery following the surgery. Enhanced recovery times also generally mean that patients who undergo local anesthesia can return home sooner than individuals who required full sedation.

Another benefit of this type lies in the fact that the local anesthesia can act as a method of pain management, reducing the overall amount of painkillers necessary for recovery and usually even obviating the need for severe pain medication, such as morphine, altogether. When considering all of these facts, local anesthesia is often the better, and safer choice for plastic surgery patients. Facelifts, neck lifts, eyelid lifts (blepharoplasty), liposuction, chin implants, fat grafting, cheek reduction (buccal fat pad reduction), and fractional C02 laser resurfacing are procedures that can be performed under local anesthesia by a skilled and experienced facial plastic surgeon.

Article by
Orange County Facial Plastic Surgeon