Face Lift Anesthesia Options

Actual Patient

More and more people each year make the decision to pursue cosmetic surgery to rejuvenate their appearance. As a result of this demand, plastic surgeons in Orange County have begun to offer a variety of anesthesia options for face lift patients. It was once the standard to address each patient with a “one size fits all” approach, meaning each patient had a full face lift performed under general anesthesia.  Over the years there has been an evolution of tailoring face lifts to meet the needs of each individual patient. At Cruise Plastic Surgery in Newport Beach, CA a variety of factors are taken into consideration when determining the best surgical plan.

The Most Important Factors

Patient preference. Interestingly, this can go both ways. One patient may feel there is no way they would have a face lift without being completely asleep while another may not like the idea of being asleep.

Length of procedure. In general, longer procedures are better done under general anesthesia. Local procedures that last more than 2 ½ hours can become uncomfortable.

Thick vs thin faces. Patients with thin faces are much easier to perform under local anesthesia than heavier faces. This is because thin skin is much easier to numb and move around.

Patient experience. This has a lot to do with how well a person tolerates discomfort. If a patient has a low pain threshold and is squeamish,  it would be better to be put to sleep. However, for those who can tolerate discomfort well, they may be a good candidate for local anesthesia. Once the face is numb the procedure becomes much easier.

Interestingly, issues that do not contribute significantly to the decision making process are:

Health. Despite thoughts to the contrary, general anesthesia or at least twilight anesthesia has significant advantages for people with less than ideal health. The reason being is that an anesthesiologist is present which is always safer.

Cost. There is not a significant cost difference among busy plastic surgeons between local and general anesthesia. There reason is that local anesthesia takes the surgeon longer to perform the same procedure.

The most common face lift anesthesia options offered at Cruise Plastic Surgery in Newport Beach are:

Local Anesthesia

Local anesthesia means that the anesthetic is administered directly to the surgical area. It is similar to what you would receive when having a mole removed or when the mouth is numbed at the dentist prior to dental work. The anesthetic is given by a needle injections to the specified area. In most cases, an oral sedative is taken prior to the injections, which helps relax the patient. Depending on how the sedative effects the patient, they could be awake during the procedure or fall in and out of sleep. The area that is anesthetized will be completely numb and no pain will be felt during the face lift surgery. Some of the reasons why this option may not be suitable for some patients include: restless leg syndrome, anxiety issues, back problems, inability to lay still for periods of time, and health concerns. Local anesthesia is typically performed in office.

IV Sedation (“Twilight”)

This type of anesthesia is performed by administering the anesthetic medications through an IV, which is typically placed in the arm. Unlike general anesthesia, a patient will be breathing entirely on their own with no assistance from a endotracheal tube. IV sedation is given in combination with a local anesthetic in the area of surgery. Patients will generally be in a “light sleep” and unaware of their surroundings, however there can be times where they are more awake then other times. IV Sedation is typically administered by a registered nurse or anesthesiologist in an outpatient surgery center.

General Anesthesia

This most well known type of anesthesia is administered by an anesthesiologist through an IV placed in the arm and performed with the use of an endotracheal tube for breathing assistance. A patient is completely asleep and will at no time be aware of their surroundings. This is the best choice for face lift patients who have high anxiety or the inability to lay still for periods of time. This is also a safer choice for those who have airway issues, such as sleep apnea. General anesthesia is a “deeper” form of anesthesia that allows for more invasive procedures to be performed or for longer surgery times resulting from multiple procedures being done at the same time. General anesthesia is offered at hospitals and outpatient surgery centers.

Hybrid Anesthesia

In an effort to utilize the best qualities of all three types of anesthesia, Joseph T Cruise, MD and his board certified anesthesiologists have developed what can be considered the ideal blend of all of the above. It involves using Propofol, which depending on the dose can be a twilight or can be a general. During the beginning of the case the patient is in a deep sleep to avoid any of the discomfort of injecting the local anesthesia. Once the local anesthesia is administered, and the face is completely numb, the patient can go into more of a “twilight” depth of sleep. The major advantage is that much less anesthesia is given and the type of anesthesia is far less likely to cause nausea than traditional methods. The result is a pain and anxiety free procedure with a quick, nausea free recovery.

Once Joseph T Cruise, MD completes his evaluation of a prospective face lift patient, he provides his recommendation on which anesthesia option would be most suitable. In some cases, there may be more than one type of appropriate anesthesia. In those instances a patient can choose which they prefer. The most important principle is for the patient to have their surgery in a setting where they will have the best surgery experience possible. This means one in which comfort and safety takes precedence.

Schedule a Consultation

To learn more about your face lift and anesthesia options, schedule a consultation with Dr. Cruise. Call our Newport Beach, CA office at (949) 446-1421 or contact us online. Out-of-town patients can also follow our fast-track online consultation process to find out if they are candidates with Dr. Cruise.