Is There a Local Anesthetic for Lower Facelifts Besides Lidocaine?

I am allergic to lidocaine (without preservatives). Is there an effective alternative to lidocaine for facelift surgery. I don't want to have general anesthesia if at all possible.

Doctor Answers 9

Lidocaine sensitivity during Facelift

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The incidence of true lidocaine allergy is extremely rare. Several additives in lidocaine solution may lead to a hypersensitivity reaction but, an allergic reaction is still rare. I would ask the provider who administered your lidocaine during your previous procedure what they had used as the local anesthetic. Your dentist would likely also have knowledge of these issues. Prior to any further administration of lidocaine, even with a resultant negative history, I would get tested for allergies to the entire caine family of analgesics.

Chevy Chase Facial Plastic Surgeon
4.8 out of 5 stars 34 reviews

Lidocaine Sensitivity

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I always do my facelifts under general anesthesia but use local anesthesia in addition to allow the anesthesiologist to keep the amount of general anesthesia to a minimum. There are many alternatives to lidocaine but I think that Gen is the way to go for a facelift.  The patient is comfortable and I can focus on the surgery and the outcome.

Local anesthetic allergy

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As stated by other surgeons, the allergy you describe is extremely rare. First, I suggest you have the appropriate tests to confirm this problem. Please reconsider your desire to avoid general anesthesia. A very low level of general anesthesia is used in cosmetic surgery, making the surgery safer, more pleasant , and easier for patient and surgeon.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 43 reviews

Local anesthetic for lower facelifts

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True lidocaine allergy is extremely rare. Nevertheless, if there is a high risk that you are truly allergic to lidocaine, you do not want to take unnecessary chances.

Although you do not want general anesthesia, it is the best way to have the surgery in your case. Injection of the skin with a dilute epinephrine solution can be administered to reduce bruising and potential bleeding.

Alternative to Lidocaine Anesthesia for Facelift

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Yes, there are alternatives to Lidocaine for facelift anesthesia. The real question is, why not consider general anesthesia? Over the years, I have converted from doing almost all cosmetic procedures under local anesthesia to using general anesthesia almost exclusively. My patients are happier, the postoperative recovery is faster, there is less nausea, and, I believe, the general anesthesia is safer.

Robert T. Buchanan, MD
Highlands Plastic Surgeon

Local anesthetic options

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There are a number of different options for local anesthesia, but lidocaine is by far the most common since adverse reactions are so rare. In fact, the issue of allergy has to be a bit suspect because the documented cases number in the single digits despite many millions of doses. In any case, you surgeon will be able to provide alternatives since there is no point in risking it.

Richard Baxter, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 59 reviews

Local anesthetic for lower facelift

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I agree with Dr Placik. A true lidocaine toxicity is extremely rare. There are other caines to act as anesthetics. I would see an allergist for a skin test to find which caine can be used. Regards.

Lidocaine alternatives in facelift

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Lidocaine allergy fortunately is very rare, and often when patients tell me that they are allergic or sensitive to lidocaine they are referring to the side effects of the epinephrine in the lidocaine. The epinephrine is combined in the local anesthetic to prolong the effect, and to reduce bleeding during the procedure by constricting the blood vessels. The epinephrine also increases the heart rate and patients associate this feeling with 'allergy'. A true lidocaine allergy can be dangerous, though there are alternatives.

In facelift we often blend our local with another local medication from a different medication group called marcaine. This medication does not share allergy with lidocaine. The numbing produced is slower though we use it because the block is more lasting.

Facelift could also be performed under a general anesthesia, using just the epinephrine alone. With skill and adjustment of technique, you should be able to complete facelift with either the modified local sedation, or general anesthesia with safety.

Best of luck,
Peter E Johnson MD

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 44 reviews

Local anesthetic allergy

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A true allergy to amide anesthetics (i.e., lidocaine) is truly rare but can be life threatening. Most reactions are to additives such as methylparaben or metabisulfite. In a study of 208 patients that clamed to have allergies to local anesthetics, only 197 truly had an allergy when fully tested at a clinic.

You should seek evaluation by an allergist to find out if you have a true allergy to amide local anesthetics

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.