Local Anesthesia Toxicity?

I would never perform a facelift or neck lift with only local sedation for a patient. These surgeries are serious and require many medical professionals to ensure your safety. Full medical clearance should be required (Chest X-ray, EKG, bloodwork, urine analysis, letter of clearance from your doctor). A board-certified anesthesiologist should be in the room at all times, monitoring your blood pressure, oxygenation levels, heart rate, body temperature, respiration etc. Patients and surgeons try to cut corners and end up in dangerous situations. Think, for example: what would happen if you sneezed while a scalpel is near any number of vital nerves or veins or arteries? Is this a risk worth taking? In addition, in my practice, I insist that my postop patients when having a face or neck lift must have a postoperative nurse with them for the two following days/nights to ensure safety. Please do not try to save money by having local anesthesia. It's better to not have the surgery than to take such safety risks.

First of all, it it absolutely possible to do this procedure under local anesthesia safely. The tumescent technique has been done for over 30 years and is very safe, including for liposuction, mini tummy tucks, neck lifts, etc. However, you should still expect to be monitored by a nurse during the procedure for safety and the center should have what we call life safety equipment just in case of emergency, which should be rare but still possible. The question you should ask is, "can I handle being awake for the procedure?" as there will be some mild pain and discomfort while getting the areas numb (shots). If you are an anxious person or have a low pain tolerance then don't do it without IV sedation, which is what I prefer. Hope that helps!

What you are describing is a way to perform a facelift more or less "awake" but under heavy sedation, meaning there is no general anesthetic utilized. There are many surgeons, especially older surgeons, that have done this in the office for many years without any issues and with patients extremely comfortable (and, might I add, with excellent results). The surgeon that is warning you is correct that when performed incorrectly, or by an inexperienced or poorly trained surgeon, local anesthetic toxicity is a major concern. In the end, if this is the option you choose to pursue, I would ensure that your surgeon is well trained and has extensive experience performing these types of procedures in this manner.