What Are the Options for Local Anesthesia During a Brow Lift?

As stated by others the 2 types of local anesthetic used are Lidocaine and Bupivacaine and it is very unlikely to have an allergic reaction to these.  We perform all of brow lifts with local anesthesia plus IV sedation (no general anesthesia)

It would be rare to perform a brow lift under local anesthesia only - without some IV sedation or anesthesia.

Certainly, the major sensory nerves in the brow area can be blocked easily with local anesthesia, to improve post-op comfort.  I do this routinely during the brow lift surgery.

Most surgeons use lidocaine or marcaine.  True allergies to these are rare - have you had some type of reaction previously?  Did you see an allergist for a work-up?  If you think you might have one of these rare reactions, I'd suggest getting an allergist to comment on your situation prior to surgery.

 

All the best,

 

Without a history of a bad reaction to a local anesthetic, skin testing is not indicated or necessary.  The local anesthetics used during surgery are very close to the ones used during dental procedures, suturing cuts and lacerations, ect.  It a patient has a true allergy, which is very rare, it is typically discovered early in life.


Hope this helps

 

it is rare to do skin tests although it is siimple and easy to do ...  most doctors use lidocaine, marcaine or a combination

In selected patients, certain variations of brow lifts can be done under local anesthesia, sometimes with the addition of a little sedation (example, a Valium pill).

One good example is when performing a brow lift through the hairline. Local anesthesia is used to do a "nerve block" on the nerves just above the eyebrows. Then, the incision area is injected and the area between the brow and incision is injected. The local anesthetic (Lidocaine, Marcaine or a combination) will have some epinephrin (adrenalin) to minimize bleeding and bruising (this may make you feel a bit anxious, like having too much coffee). After about 10 minutes, the area should be numb and ready to go.

Unless you have a known allergy to local anesthetics (very rare), a skin test is not done.

Local anesthesia is easy for a brow lift since the sensory nerves are easy to block. No one worries about doing a skin test for allergy to the local, since a true allergy is extremely rare. If you know or suspect you have an allergy to a specific local anesthetic, there is another family of local anesthetics that can be used instead. Most of what people think are allergies to local are, in fact, normal reactions to a component in them to reduce bleeding. This is usually first appreciated from a dental injection, since they use very concentrated epinephrine in their injections. Most Plastic Surgeons use a dilute concentration that prevents the reaction. With the local you will generally need sedation so you do not care what is going on over your head. I generally prefer a gas rather than IV meds since the gas wears off faster. (This, of course, would be general anesthesia, but I believe it is safer, wears off faster and causes less nausea postoperatively. Very little is used since we use the local even with general anesthesia. All the general is for is so you do not feel the local injection and are comfortable otherwise.)

  You can always have a skin test for local anesthetic allergy at an allergist if you suspect you might be allergic although this is quite rare.  Local anesthesia can be used for any procedure but in my 20 plus years of performing Brow Lifts, I haven't used it for a single one.  Coronal Brow Lifts are IMHO, the gold standard of Brow Lift procedures for hiding the incisions, reliabilty and duartion of results.  During the procedure the scalp is placed completely forward over the eyes and patients under local anesthesia would freak out IMO.  Have a general anesthesia and the proper Brow Lift for the best results IMO.   

 

 

 Yes, a brow lift can be done witha local anesthetic, chosen by the surgeon. In the past 35 years I have not done a skin test for a possible allergic reaction unless a patient gives me a history of previous reactions or there is a family history of problems.