Would you recommend a facelift revision without sedation?

Question

Would you recommend a facelift revision in the PS's office with local anesthetic and no sedation? The original facelift was done in office with oral meds for sedation. Is it reasonable to do a revision without the oral sedation?

Ben Lee, MD · Answer

Depending on the extent of the revision, it is entirely possible to do this under local anesthesia with or without oral sedation. In fact, entire facelifts can be done under local anesthesia under the right circumstances.

Paul Lanfranchi, DO, FAOCOO · Answer

Absolutely, 100% yes, a facelift revision can be performed under local anesthesia and oral sedation. Many surgeons, like myself, exclusively perform all facial cosmetic procedures under local. Probably the most important question to ask your PS is HOW OFTEN they perform procedures under this type of anesthesia. There certainly is an art to both administering the anesthesia, and actually performing the procedure this way. Surgeons who do this often usually can make the experience very comfortable with minimal discomfort.

Zoran Potparic, MD · Answer

Most of facelifts revisions in our practice are done in local anesthesia. Minimal pain during injection of local anesthetic is well tolerated  by patient. However, some revisions may be more extensive than original surgery. In that case it is best to follow surgeon's recommendations. Good luck.

Matthew Richardson, MD · Answer

Facelifts (or revision facelifts) can be performed under just local anesthesia, but this becomes a matter of patient and physician comfort and tolerance. If the patient is more comfortable, and more sedated, the procedure can be performed more quickly and possibly even more safely as the patient is less likely to move around during the procedure. Most patients (and their surgeons!) will enjoy the experience more if they are sedated (at least with oral medications if not intravenous sedation). 
In the case of revision facelifts, this may be a different scenario depending on how much of a revision is needed.  If only one small area is being addressed (such as a scar or some remaining fatty tissue), local anesthesia only may be adequate. However, if a patient needs a full facelift, I will generally recommend sedation for the reasons stated above.

Philip Solomon, MD, FRCS · Answer

You can undergo revision facelift surgery with local anesthetic and oral sedation.   The type of anesthetic required depends on the extent of the surgery planned and the individual patients needs.

Richard H. Tholen, MD, FACS · Answer

Local anesthesia can indeed numb up an area completely--so the answer depends on your pain tolerance (all those facial injections of local anesthesia do indeed hurt some), and how much of a revision you and your surgeon contemplate.Oral sedation (rather than IV sedation and monitoring by anesthesia personnel) does not make you very sleepy, but can "take off the edge" or make you forget your injection discomfort. Perhaps you don't need that for a little scar revision and minor additional tightening. Any more, and I would suggest more anesthesia.But that's just me! Best wishes! Dr. Tholen

Michael I. Echavez, MD · Answer

A revision facelift could be performed with just local anesthetic, but there are a few factors that would influence what type of anesthesia would be best for each patient.  First there is the preference of the patient.  Some patients really do want to be aware of nothing during the procedure or be totally put asleep with a general anesthetic.  Others may be comfortable with IV sedation being added to the local anesthetic.  And there may be some who are fine with just the local anesthesia.  The extent of the revision would also be important to know.  If it is a fairly minor revision, the local anesthesia alone may be fine but if it is more involved, it may not.  The surgeon may also have a preference which may influence the decision.  I would discuss your preference of anesthesia with your surgeon and come to a mutual decision.  In most cases, my preference would normally be to use at least some sort of sedation along with the local anesthesia.

Miguel Mascaro, MD · Answer

You certainly can do it.  It really is a matter of how comfortable you feel during the numbing process, as this is when things become most uncomfortable.  Painless, awake facelifts are becoming and more and more common each day.  It can take a little longer as ensuring patient comfort during the procedure is of utmost importance.  That being said, as long as your PS feels comfortable, and you feel comfortable with it as well, then there is no reason to be apprehensive.  I personally don't mind doing a face and neck lift under local.  It just has to be the right patient with the right motivation.  Best of luck.  I hope some of this helps.

Robert H. Woods, MD · Answer

There is no particular reason to do an office procedure without some oral sedation unless you dont tolerate it well or just dont like the way you feel on it. Local only procedures can be done without difficulty, but a little sedation helps take the edge off. If you are not particularly anxious, then you just need to get through the numbing process. If that entails a significant amount of anesthetic you may want to get some sedation. If it is less the a syringe, then it probably is not worth the bother.

Keith Denkler, MD · Answer

It seems your physician wants to adjust some more skin laxity and thinks it can be done under strict local anesthetic.Discuss the time of the procedure. If it is lengthy, you may want some oral sedation.

Would you recommend a facelift revision without sedation?

Answers (13)

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