You may be surprised to learn that many procedures like eyelid surgery, liposuction, facelifts, and others can be safely performed under local anesthesia with or without intravenous sedation. Whenever possible, it’s usually best to choose local anesthesia instead of general anesthesia for several reasons:
1. Local anesthesia is safer.
While cosmetic procedures today are overall considered extremely safe, it’s noteworthy to point out that in the rare cases of malpractice suits or death, most of these problems involve surgeries performed under general anesthesia. For example, liposuction’s mortality rate when performed under general anesthesia is estimated to be between one in 40,000 cases to one in 5,000. The actual figure is probably toward the lower end of that range, which means it’s extremely unlikely that you’ll be so unlucky, especially if you choose an experienced and reputable surgeon. Then, when we look at the mortality rate for liposuction performed under local anesthesia, we find a mortality rate of only one in 300,000 cases. The lesson to be gleaned here is that while both methods are very safe, the increased dangers of general anesthesia make safe local anesthesia a better option, so why take a chance?
2. Local anesthesia enables the doctor and patient to communicate and obtain better results.
When the doctor and patient can communicate during the procedure, there is much to be gained. If you are having eyelid surgery, for example, your surgeon can have you open and close your eyes so he or she can see exactly how your body is responding to the surgery and you can obtain the most precise results possible. In cases like liposuction, your doctor will ask you to alert him if you begin to feel any mild discomfort. This ensures that nearby tissues are not traumatized during the procedure. If they are, you will be okay, but your recovery time will be longer. When you are conscious, you can listen to your doctor and tell him or her exactly how you feel, which means your results will be more individualized than they would be if you are “out” under general anesthesia.
3. Local anesthesia allows for faster recovery.
Fewer drugs means that you are less hung-over after surgery, so you return to normal much faster. Going back to our liposuction example, the compression garments worn for six weeks after general anesthesia are only needed for five to six days after local anesthesia liposuction. Since you are able to provide feedback to your doctor during surgery, the liposuction is accomplished with much less trauma which means a much faster recovery.
For these reasons, Dr. Steinsapir performs cosmetic procedures under local anesthesia whenever possible. Cosmetic surgeries under local anesthesia often cost more than they would under general anesthesia because your doctor needs to spend more time working gently and delicately to ensure your absolute comfort. The increased doctor-patient time does cost money, but this is also the reason why you heal so quickly and receive detailed treatment, along with fewer complications and health risks.
Which procedures can I have under local anesthesia?
This depends on your unique, individual health status and a personal examination. Usually, those in good health can safely and comfortably receive most of the treatments we provide under local anesthesia. Nonsurgical treatments like BOTOX, fillers, the chemical peel, and fotofacial of course are routinely administered under local anesthesia. Cosmetic surgeries like the endoscopic forehead lift, facelift, midface surgery, liposuction, and eyelid surgeries are best performed under local anesthesia or local with intravenous sedation. It is especially important to receive eyelid surgery under local anesthesia so your doctor can instruct you to open and close your eyes so that he or she can monitor and adjust the effects of the surgery for optimal results.
When is it best to have surgery under general anesthesia?
Generally procedures that are likely to run more than an hour benefit from sedation. Body wall surgery including tummy tucks and breast surgery should be performed under general anesthesia. Procedures that are likely to take more that 4 hours are often best performed under general anesthesia but this is something that should be discussed with the individual surgeon.
How do I find a doctor who will treat me under local anesthesia?
As always, we encourage you to be direct with your doctor. Simply ask your potential cosmetic surgeon if he or she prefers to work under general or local anesthesia, and what he or she thinks will be best for you. If your doctor prefers general anesthesia for you, find out why. Is it because of your unique health situation? Local anesthesia should be the default answer with general anesthesia functioning as an exception. Yes, this will require your doctor to spend more time treating you, but in the end you will have peace of mind knowing that you’ll receive the safest care, as well as experience the fastest recovery time and the best results.
Dr. Steinsapir specializes in performing procedures that improve the face and body contours under local anesthesia. He believes the extra time this requires is well worth the safer, superior results and satisfied recipients. Dr. Steinsapir emphasizes the importance of minimally-invasive, detail-oriented treatments on a comfortable outpatient basis, while maintaining the expertise and safe resources needed for general anesthesia and inpatient treatment for individuals with unique health needs. If you have any apprehension about anesthesia, Dr. Steinsapir can answer your questions, offer advice, and create solutions during your individualized consultation. Contact us today to see how we can help.