Wednesday, August 8, 2012

Your Anesthesia Options

I am often asked what type of anesthesia will be required for Facial Plastic Surgery.

The most appropriate option depends upon the surgery being performed and the underlying health of the patient. I've listed below the options that I frequently employ and a discussion of their pros and cons.

Local Anesthesia

Local anesthesia involves the infiltration of a numbing solution (Lidocaine and Marcaine) that includes some epinephrine (adrenaline) to constrict blood vessels and minimize bleeding. The area is numbed nearly instantaneously. You do feel a "pinch" or "bee sting" but the area that is infiltrated will remain numb during surgery and for three to five hours afterward. Local anesthesia can be combined with oral sedation (Xanax, Ativan, Valium) to provide relief for anxious patients.

This option is most appropriate for small soft tissue procedures:
  • Upper Blepharoplasty
  • Mole Removal
  • Scar Revision
  • Skin Cancer Reconstruction
  • Earlobe Repair
  • Laceration Repair

IV Sedation (Twilight Anesthesia, Monitored Anesthesia Care, MAC)

IV sedation uses safe doses of common intravenous medications to provide procedural sedation. Medications used include Versed and Fentanyl among others. This is often combined with local anesthesia to provide local relief of discomfort and minimize bleeding during the procedure. IV sedation allows a patient to "sleep" through the procedure without the need for a breathing tube in their airway. 

IV sedation is effective for nearly all facial plastic surgery procedures including:
  • Facelift
  • Necklift
  • Browlift
  • Upper and Lower Blepharoplasty
  • Rhinoplasty
  • Cheek Implants
  • Chin Implant
  • Liposuction
  • Otoplasty
  • Deep Laser Resurfacing

General Anesthesia

General anesthesia is what most people think of when they refer to "being under" or "being asleep." General anesthesia results in loss of consciousness that requires a breathing tube to be placed to assist the patient in breathing. When performing face or neck surgery, general anesthesia is only required for cases such as reconstruction of severe nasal defects where it is expected that some blood might enter the airway. In these cases, we need a breathing tube in place to protect the airway and maintain breathing. 

While many facilities will perform general anesthesia for Facial Plastic Surgery, this is not required as IV sedation is safe and effective in most cases. 

For further information about your options, call (303) 788-6632 or email .

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