Tumescent Anesthesia Face Lift?

Thanks for your question -
Tumescent fluid is a combination of local numbing medicine (typically lidocaine) with epinephrine (adrenaline) which helps constrict blood vessels to reduce bleeding. It was originally used for liposuction procedures but has also become an important part of face lift surgery.
The term tumescent refers to the feel of the tissue when it was injected with sufficient quantity of the medication to become somewhat firm. This is a bit of a left over description ... most plastic surgeons use super wet or wet tumescent techniques for liposuction at this point (the difference is the volume of fluid with the above drugs injected vs. the amount of tissue extracted.)
In this regard, "tumescent" is a bit inaccurate to describe the local injected for a facelift as there is typically minimal amount of liposuction involved. But the concept it the same, using a combination of lidocaine for analgesia + epinephrine to decrease bleeding.
Most facelifts have some degree of these two medications used even when general anesthesia is used.
I hope this helps.

Thanks for posting your question. I have performed thousands of facelifts, neck lifts, mini lifts, blephs, lasers and chin implants all under local anesthesia including (tumescent anesthesia) and oral sedation (valium). Done properly, patients are comfortable and have an easier recovery both mentally and physically. Tumescent anesthesia is basically diluted lidocaine.  This in addition to the regular local anesthesia provides very good comfort to the patient and also aids the surgeon in helping to separate the skin from the muscle layer to facilitate the surgery.  There is an art and science to this local anesthesia technique to acquire a high level of patient comfort. My patients do not even require a narcotic prior or during their their procedures thus reducing nausea caused by narcotics. The risks, both short term and long term, of general anesthesia are eliminated. Please consult with several board certified surgeons experienced in facelifting and also in local anesthesia techniques.

Tumescent Anesthesia for a facelift is a popular technique that I have used for the past 15 years or more. After local anesthesia is injected in the areas for incision, fluid consisting of a combination of dilute local anesthesia with epinephrine  which helps constrict blood vessels to reduce bleeding during the surgery. The word tumescent refers to the firm feel of the soft tissue when it was injected with this solution. I think it is a great technique.

Tumescent anesthesia evolved from liposuction surgery. It is particularly helpful when operating in the neck, face and scalp. The goal is to use a low concentration of lidocaine with epinephrine diluted in a large volume of saline. This minimizes lidocaine dose and also allows for excellent hydrodissection and hemostasis with the tumescent. I have seen this technique used alone but I use this in concert with sedation, as patients tend to be more comfortable. There are a few books on tumescent anesthesia for the face and I've found these to be pretty helpful.

Tumescent anesthesia is a wonderful tool used in facelifts and liposuction.  Tumescent anesthesia involves the placement of Lidocaine(numbing medication) and adrenaline  beneath the area of operation.  This does a couple of things: (1) It reduces the the amount of bruising after surgery; (2) reduces the amount of bleeding during surgery; (3) It help reduce the amount anesthesia required to keep the patient asleep and (4) It help in pain control after surgery.  It may opinion it should be used routinely in facelift surgery.

Dr. ES

I think you will find that quite a few plastic surgeons use tumescent anesthesia during facelift surgery. Tumescence implies that an anesthetic solution is infiltrated (or injected) under the skin surface to do numb the tissues. The solution also contains a certain concentration of adrenaline (epinephrine) that causes the blood vessels to contract thereby minimizing chances of bleeding. The tumescence also helps to 'pre-dissect' the tissue planes, which technically aids in lifting up the skin. Some plastic surgeons choose to do the entire facelift procedure under tumescence and a light sedative anesthetic. Others use tumescence as part of their normal routine for doing facelift surgery under a general anesthetic.

Dear M. Ahuja
Tumescent anesthesia is helpful with facelifting surgery in many ways
1 improves the plane of dissection
2 reduces post operative bleeding
3 decreases post operative pain
Technically it is easy to do and does not add time to the operation- actually reduces the operative time.
With Warm Regards, Trevor M Born MD

I always do my facelifts under general anesthesia but use local anesthesia in addition to allow the anesthesiologist to keep the amount of general anesthesia to a minimum. Tumescent anesthesia is dilute local anesthesia with another substance that helps reduce the amount of bleeding because vessesls stay constricted. Its the same cocktail used in liposuction. There are many alternatives to lidocaine but I think that Gen is the way to go for a facelift and most would use local anyway.

Tumescent anesthesia has been a significant important technique developed in the 80s by Dr. Joel Klein. It essentially allows for proper anesthesia to the specific area and overall there have been many studies that have shown it to be effective and perhaps even decreased bruising, infection, hematoma formation, recovery, etc. These studies have been with various other surgical treatments such as liposuction and laser resurfacing. For facelift surgery there are few physicians who do the traditional tumescent technique and most physicians do anesthesia under general for facelift surgery. Nonetheless I do think it is an excellent technique for facelift surgery and essentially I think that you will have to inquire as to whether the physician provides tumescent anesthesia on a regular basis. I’ve seen it in my practice to be beneficial in approximately 90% of my facelift patients.

I am not a big fan of tumescence for facelifting. First it may mask bleeders, and second it is more swollen with liquid and may distort the movement of tissues and skin redraping.