Conscious sedation for a facelift
I find some of the comments from Dr Commons below extraordinary. "if you are foolish enough to choose being awake" " too many patients experience discomfort during a facelift" etc...
These, I suggest, are the words of a clinician that doesn't know how to give local anaesthetic properly. I perform facelifts, only facelifts and lots of them. Of the last 200 full (not mini) facelifts I have performed under conscious sedation alone, not one has experienced discomfort during the procedure or would appreciate being called foolish. Of the 26 revision facelifts I have performed in the last 4 months, all of whom had previously had a general anaesthetic, none of them would prefer the process or recovery of their previous experience, All of them expressed how much more pleasant sedation was.
I am strongly of the opinion that conscious sedation is the ONLY way to lift a face. Our faces are the most dynamic and expressive parts of our body, so why lie them flat, stick a breathing tube in them, paralyse them and then guess on the vector of lift? Sure general anaesthesia is a gift for the surgeon to work on your tissues as he has a recumbent asleep patient whose blood pressure has been artificially lowered to minimise bleeding. The patient can't feel anything so local anaesthetic infiltration is a quick half hearted process. Result? a rebound hypertension and pain on awaking, sore throat and cough from the ET tube, drains to drain off the inevitable resulting fluid accumulation.
Conscious sedation enables real time assessment of the facial nerve " smile, raise your brow etc" during surgery. It enables assessment of lift vector and tension whilst sitting upright to see how gravity affects the lift. It is PAINLESS, if local anaesthesia is infiltrated meticulously and with care. During deeper dissection the sedation can be increased so that the patient is asleep.
General anaesthetic was the norm and convention in the past. 1970's, 80's and 90's facial plastic surgery. It is 2015 now, I suspect sometime in the not too distant future General anaesthetic for facelifting will be seen as an archaic relic from times of old.
Price should not be a factor in your decision which method of anaesthesia to undertake, but you need to be informed about the various options. I always have an anaesthetist attending all cases where sedation is given.
Facelift Under Conscious Sedation or General Anesthesia
I now only conscious sedation for facelifts. It is the one thing that has been shown to shorten recovery. A lot of tumescent local anesthesia is used and this reduces the swelling and bruising after surgery and allows for much faster recovery. With conscious sedation you do not feel things and you are not necessarily awake either. The term conscious sedation says it all. You are conscious in the sense that you can respond to commands but you usually do not remember anything and generally sleep through most of the procedure but you are not completely out and in need of breathing support like you would if you were under general anesthesia.
I hope that helps.
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.
About the Facelift Procedure and Anesthesia
#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.
Facelift Anesthesia Choices
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.
General Anesthesia vs Conscious sedation
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.
General anesthesia vs conscious sedation
In over 30 years of cosmetic surgery I have performed 95% of the facelifts under conscious sedation. When properly administered the patient is asleep, does not remember anything and I don't have to deal with tubes coming out of the mouth obstructing my field. I always make a point of asking on the post op visit how the anesthesia was. The uniform answer is that they don't even remember going into the operation room. If a patient insists on general I will oblige, of course. Go with what your PS does. As far as safety both are equal. Good luck.
General vs. Conscious sedation during a full facelift
Thank you for your question. I give my patients the choice but insist on having a board certified anesthesiologist to administer the anesthesia. This enables me to concentrate on performing impeccable surgery and leaves the anesthesiologist to monitor the patients vital signs. Therefore, I really have no preference and I am comfortable with whatever the patient decides.
Facelift Anesthesia - Sedation vs. General
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.
With sedation, you will not be bored. You will likely not remember the case or the passage of time. Most doctors, such as myself, would not care - general vs sedation as long as the anesthesia doctor is present to make the experience a safe one where you have no pain and have stable blood pressure. Some surgeons do the sedation themselves and this is fine if they have a lot of experience with it and the patient is extremely healthy to begin with.