A question about general v. conscious sedation during full facelift. How is it different for you when your patient is not out?

For cases with conscious sedation or twilight anesthesia, the patient is usually asleep but breathing on their own. The decision of which type of anesthesia to undergo has to do with the comfort of the surgeon, the surgery center or hospital and the anesthesiologist. From a surgeon's point of view, as long as the patient is appropriately asleep, comfortable and taken care of by the anesthesiologist, it does not make a big difference which type of anesthesia is administered.

I have done facelifts using conscious sedation for my entire career. I do, however, have an anesthesiologist involved in every case so that my patients receive the best care and the most skilled sedation during their procedures. Typically patients drift in and out as the level of sedation is varied according the stage of the surgery, and afterward have little recall. They typically report no concerns after procedures that often take 4 to 5 hours to complete. I like this method as patients bleed less than when general anesthetic is used, I don't have to work around the breathing tube, and we can avoid the coughing that often occurs following GA, and so decrease the early swelling and bruising. All the best.

I have performed well over 3,000 face and neck lifts under local anesthesia with oral sedation for over ten years. Without doubt it is safe and well tolerated by patients. Compare to the traditional facelift procedures that are performed under general anesthesia, the post operative complications associated with local anesthesia cases are lower and risk of bleeding is minimized. The key to a successful facelift procedure using local anesthesia is selection of the right patient by the surgeon and his or her comfort doing these cases. 

Face lift procedures can be performed under many different levels of anesthesia. I prefer MAC which is monitored anesthesia care, basically same as conscious sedation except that for a safety measure I have an anesthesiologist maintain the sedation rather than a nurse. It is extremely easy to perform any form of face lift under sedation, and general anesthesia is not necessary at all. I would not recommend local anesthesia only since that is very uncomfortable for the patient and the surgeon.

#Facelifts and ancillary procedures are usually performed as #outpatient in a surgery center. A one night stay in post-operative care facility may be advisable in some cases. But, local #anesthetic combined with intravenous sedation is usually used. This will allow the patient to sleep through most of the procedure. General anesthesia is available upon request however is usually not necessary. Being this is an outpatient surgery, you will be provided the proper surgical wear to abide by surgical protocols and sanitation practices. The Lite-lift™ is generally performed with a local anesthetic and medication by mouth, which will keep you comfortable during the procedure and allow for an easier recovery.For more information about Lite-lift™, I welcome you to visit my website link provided below.

Five hours is a long time for conscious sedation which is another name for "twilight sleep" - the feeling you have just as you drift off. Medications can be given through your IV to make you more comfortable. In my practice procedures over 4 hours are most often done under general anesthesia.#faceliftanethesia#faceliftanesthesiachoices

This question is an important one and should always be discussed before facelift surgery. I recommend to you to choose the mode of anesthesia preferred by your surgeon. There are some plastic surgeons who perform all surgeries under general. Then, there are others, who avoid general anesthesia. Personally, I belong to the latter group. Of the last 1000 facelifts, none was performed under general anesthesia and I find no reason to change this. 

I use IV sedation, also known as twilight anesthesia
or local mac. This technique, when combined with a Board Certified
Anesthesiologist, in my experience, is more comfortable than general anesthesia
for the patient, as there is less nausea and vomiting. Additionally, the
patients have less post-operative pain, as the surgical site is numbed prior to
performing the procedure. Patients also do not have a sore throat after their
operation, as this technique does not require a breathing tube during surgery
(intubation).

When patients have surgery with IV sedation, they go to sleep and wake up so
comfortably, that at the end of the procedure many patients often ask, when is
surgery going to start? I once had a patient ask me for a cheese burger while
she was waking up from IV sedation, highly unlikely with general anesthesia.
Look for a Board Certified Plastic Surgeon that works with a
Board Certified Anesthesiologist who are experienced in using IV sedation,
if you are considering a face lift with this technique.The cost for general anasethesia or consciousness sedation is the same in my surgery center, as  both techniques require an an anesthesiologist. Also, the cost of the drugs used for conscious sedation are more expensive then those used for general anesthesia. Many of my patients, who have had both general anesthesia and IV sedation,
prefer IV sedation.

Yours,

Jon M. Grazer, MD, MPH, FACSPlastic SurgeryNewport Beach, CA

I use oral sedation and local anesthesia for the majority of my facelifts and find it easy for the patient with very little trouble for me. With the proper mixture time will fly by, you will sleep and have very little memory of the event the next day. This includes the stings you will feel from the local anesthetic. You will not be bored but you will sleep. Make sure you have arranged a ride home and help for the first night you are home.Speak to your surgeon to get their experiences.Best of LuckDr. JA. Dean Jabs M.D., Ph.D.Board Certified Plastic SurgeonBethesda MD/McLean VA

I have done a number of faceless using both techniques. A general anesthetic in my opinion allows the operation to proceed more efficiently and for that reason I use it almost exclusively now my own practice.