I have had more and more patients asking me if they can have their facelift under local. While I do perform many procedures (including facelifts) under local, this trend has surprised me. Maybe it is due to the many advertisements for such procedures such as Lifestyle Lift, Sono Bello Lift, Biltmore Lift, Quicklift and many other latest, greatest trademarked procedures. Whatever the reason, I think it is important to keep a few things in mind.
First, general anesthesia is very safe for most patients. Over the past several decades, innovation and training have greatly improved anesthesia. I often hear anesthesiologist tell patients that that the took more risk driving to the surgery center compared to the risk of their sedation that day. In addition, most reputable surgeons would agree that they can do more work, in a more efficient manner, with better results for the average patient under anesthesia, than they can under local. An additional important question to ask your surgeon is, “can you get the same result for me under local as you could if I were asleep?”
On the other hand, with today’s outstanding topical numbing creams we can do procedures much more comfortably under local than we could in the past. For instance, our patients will apply a 23% Lidocaine/7% Tetracaine cream one hour before the procedure to numb the skin, and then in the procedure room, we will carefully and slowly inject areas being treated with a tiny needle. The procedure is almost the same as those under anesthesia from here. With many of our patients, we talk during most of the procedure. Following the procedure, patients are able to drive themselves home if they wish and typically have few complaints of discomfort.
In is important to keep in mind that for local anesthesia patients must hold still and cooperate for at least a few hours while the procedure is performed. In addition, they do have to be comfortable with us injecting local anesthesia as we go and feeling some pulling of the skin during the procedure. Patients really have to decide if this is for them or not. If you have trouble at the dentist, then this is probably not the way to go for you.
Another consideration is that a lot of this depends on what type of procedure you are having. If a patient has minimal laxity and needs minimal work, a mini-lift may be appropriate. For these patients, a procedure under local is much more reasonable. If a patient has extensive muscle and skin laxity as well as submental adiposity, a more advanced facelift procedure will probably be required. In my opinion, few patients can do well with this type of procedure under local.
Our techniques for performing facelifts under local have improved dramatically, and this is a great option for many patients – exploring your options begins with a consultation to investigate the possibilities.