Do Most Surgeons Draw Pre-Op Surgical Markings on Your Face While You Are Unconscious?

When is the pre operative surgical markings done for a face lift and blepharoplasty. It is before the surgery while you are awake and sitting up or after you are sedated and lying down?

Doctor Answers 32

Face Lift Markings

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I always mark my patients in the sitting/upright position and awake.  I may make some adjustments while the patient is asleep or sedated, but for the most part follow the pre-op markings.

Marking the face for a face lift

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Markings are important prior to a facelift.  If you look into a mirror and then look into that mirror again while you lay down you will see a marked difference.  Enough said.  I always mark my facelifts in the standing position.  It is better for predicting a final result.

Wishing you all the best,

Tal Raine MD FACS

Do Most Surgeons Draw Pre-Op Surgical Markings on Your Face While You Are Unconscious?

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I prefer to make any necessary markings with the patient awake in pre op holding. That minimizes the time in the operating room and allows for some conversation between me and the patient. I find it a valuable time to remind the patient and family of what to expect after surgery, and a time to answer last minute questions.

Mark Preston, MD
Columbus Plastic Surgeon

Markings the road map for great surgery

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Markings are the road map for great surgery. I like to mark  the patient in the upright position while they are awake so they can see exactly where the incisions are. Then while the patient is asleep I like to refine the markings. This allows me to see the effect of gravity in different dimensions. The most important thing is that you understand the procedure and you are on the same page as your surgeon. Hope this helps, good luck.

Ritu Chopra, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 33 reviews

Standards for Pre Operative Facelift Markings. What are they?

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The best answer is both.  II almost always do markings with the patient upright in the receiving area and then often add some markings  in the O R when the patient is asleep.   Each surgeon has their own technique just as they do in operting on  the patient.  If a surgeon feels they can judge things in the OR it is okay.  I just find it easier to do both.  My best.

Markings for facelift surgery

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Hi Cerro Gordo-

Every surgeon has a different routine. Most surgeons, however, prefer to have the patient in a sitting position when doing the surgical markings, so they can take into account the effects of gravity on the face.


Tom Kaniff

Pre op markings for Facelift and Blepharoplasty are best done with you awake and sitting up

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Most surgeons typically do pre op markings for Facelift and Blepharoplasty when you are awake and sitting up.

This allows the surgeon to evaluate how the tissues lie and fall on the face and enables the surgeon to place the skin in the desired post operative location and make appropriate marks to guide him/her during the surgical procedure.

It is particularly important to make pre operative Facelift and Blepharoplasty markings before any local anesthesia is injected which can distort the skin and make accurate markings nearly impossible.

Markings for Facelift and Blepharoplasty

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I, like many of my colleagues, prefer to mark patients in the awake, upright, and dynamic position.  Preoperative marking is done to highlight anatomic landmarks and to give the Surgeon a general reference point during the procedure.

When do facelift surgeons perform their surgical markings?

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Personally, I perform the markings while the patient is sitting upright and looking straight ahead. This step is a very important step in the overall planning process of the procedure.

But I do know very good facial surgeons who mark only after their patients went asleep...

Frank P. Fechner, MD
Worcester Facial Plastic Surgeon
4.6 out of 5 stars 50 reviews

Typical Markings before surgery

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The vast majority of surgeons will mark their patients awake and upright.  This serves several purposes. 

First, it is part of the consent process.  The patient knows exactly what is going to be cut.

Second, with upper eyelid surgery there is an important functional component.  You must have the patient awake and moving to determine the safe amount of skin for removal.

Third, with faces a lot changes when you lay down.  The incisions won't change, but the other markings that guide me during surgery do and need to be made with the patient in the upright position.  Furthermore, I use that time to study the subtle shapes of the face and create the mental image of the procedure I am embarking upon.

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.