Surgical time with general anesthesia?

I have consulted with a plastic surgeon in Frankfurt, Germany, near where I live to have a neck/face life (SMAS) and lower bleph. She anticipates the surgery will last approximately 7 hours. Is this length of time typical? Carol

Doctor Answers 7

Is 7 hours too long to do a facelift and eyes

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Your main concern should be the skill and experience of your plastic surgeon.  There are excellent surgeons who can take 7 hours to do this procedure and get good results.

In my experience under ideal circumstances the combination of a facelift and eyelid surgery most commonly takes 3-1/2-4 hours.

I do believe that the longer the time under general anesthesia the more common postoperative problems such as nausea and vomiting occur.

Please don't equate "fast" with good, or deliberate and precise with "bad." But 7 hours . . .

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Slow is still slow, and not always a sign of more careful or better-performed.

Surgical speed is one of those things that capture surgeons' attention like little else. This is evident when we see colleagues who schedule a facelift for 2 hours and routinely take 3 or 3 1/2 hours. Why? Because 2 hours looks good on the surgical schedule that lots of people read (other doctors--referral sources, nurses--patients and referral sources, etc.)!

Some might put more hours on the list because it makes them look deliberate and thoughtful, or somehow using new and special techniques that the (increased) time might infer.

Mostly, it just screws everybody else's schedule up, and we all learn who the chief offenders are. Ask any scrub nurse--THEY know!

I would schedule 4 hours for full SMAS facelift, necklift, submental fat excision, anterior platysmaplasty (as needed), and lower belpharoplasty with lateral canthopexies. If things go well, as they usually do, I would complete the surgery in just over 3 hours, leaving time for induction of anesthesia, prepping and draping prior to the incision, and hair-wash and bandaging after the last suture was placed. This keeps me (and my colleagues) on schedule, gives me time to dictate the operative report, and perhaps grab a sip of water before my next case.

All that being said, 7 hours indicates (perhaps) inexperience or something out of the ordinary. Ask your surgeon directly why it is scheduled for this length of time.

One other consideration I hesitate to bring up, but feel I should, is cost. I assume your elective surgery is self-pay, and operative and anesthesia costs are related to time. If your surgeon finishes in 3 1/2 hours, did you "overpay" for OR and anesthesia time? Do you get a refund? How is this accounted for? Again, as my colleagues here all agree, unless there is some compelling reason your surgeon is taking this long, this is quite a bit longer (and therefore unnecessarily costly) than what I assume a 4-hour operation by the same surgeon in the same surgical facility with the same anesthesia provider would be.

Your surgeon should be able to justify the time quoted, without defensiveness or evasiveness. If any of this is detected, I would consider other surgeons. Something is rotten in Denmark (Germany). Best wishes! Dr. Tholen

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
4.9 out of 5 stars 263 reviews

SMAS facelift

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Surgical time varies considerably, even among experienced surgeons.  However, seven hours does seem like a long time for these two procedures.

When you undergo any facial surgical procedure, be sure to select a board-certified facial plastic surgeon or board-certified general plastic surgeon who is experienced in the procedure being carried out.

The results from this particular procedure are typically excellent, long-lasting, and yields very natural results.

William Numa, MD, FACS
Boston Facial Plastic Surgeon
5.0 out of 5 stars 7 reviews

Time for a facelift

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I find that surgical time for facelifts vary the most when it comes to different plastic surgeons.  It is a complex procedure that requires a lot of attention to detail. The quality of the work is what matters most.  You can best assess this with your surgeon's before and after photos and maybe even talk to previous patients.  That being said, it typically takes me around 3 1/2 hours.  When I first came out of residency this took me closer to 6 hours. 

Surgery time and results

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Every surgeon is different. The surgeon I trained with almost 20 years ago used to take a long time, but would tell patients that it was because he was very precise with his closures(which he was!).  Go for the good result not the speed with which a surgeon can operate.  

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Surgical time with general anesthesia

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The length of time needed for a surgical procedure can depend on the surgeon.  Some surgeons need more time and some need less time.  I would say that for a face/neck lift and lower blepharoplasty, that 7 hours would be on the longer side of the spectrum.  

Michael I. Echavez, MD
San Francisco Facial Plastic Surgeon
4.5 out of 5 stars 18 reviews

General anesthesia time

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We perform a comprehensive lower face and neck lift and lower blepharoplasty in approximately 3-3-1/2 hours under general anesthesia. For many examples, please see  the link below

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 158 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.