Anesthesia Cheat Sheet

There are a variety of anesthetics used in conjunction with facial plastic surgery and facial rejuvenation procedures. Consult the following list to better acquaint yourself with those most commonly used.

Type: Topical anesthesia such as EMLA
(ectatic mixture of local anesthetics) cream

What happens: The cream is rubbed on the treatment area about an hour before the procedure.

Used with: Chemical peel, laser tattoo removal and injectables. Topical anesthesia is often used with other types of anesthesia.

Risks/concerns: Exceedingly rare. Medications could be absorbed by your body and cause a serious systemic reaction.

How you feel afterward: The pain may return once the cream wears off.

Type: Local anesthesia

What happens: Your doctor numbs the area to be treated, usually via an injection of the numbing agent lidocaine in combination with epinephrine, which stops excessive bleeding.

Used with: Nose surgery, eye surgery, face lifts and other facial rejuvenation procedures. Local anesthesia is often used in conjunction with other types of anesthesia.

Risks/concerns: You may still feel some pain during the procedure. Other concerns include bleeding and nerve injury.

How you feel afterward: The pain may return once the anesthetic wears off.

Type: Regional anesthesia (nerve blocks)

What happens: Your anesthesiologist injects medication to numb only the area of your body that requires surgery. Whereas a local anesthetic numbs the precise body part/area being treated, regional anesthesia treats the entire area and its nerve pathways. (This is the same type of anesthesia that many women get when in labor.)

Used with: Brow lift, lip reduction, lip augmentation or facial liposuction.

Risks/concerns: Numbness, weakness or pain, heart or lung problems, and/or infection.

How you feel afterward: You may feel nauseous or dizzy, and you may vomit. Some people report very bad headaches.

Conscious sedation or twilight sedation

What happens: Your anesthesiologist administers a cocktail of medications to help you relax and block pain. Essentially, you are awake, but not aware.

Used with: Many facial plastic surgery procedures, including some brow lifts, laser skin resurfacing procedures and neck lifts.

Risks/concerns: Breathing trouble.

How you feel afterward: Sleepy and nauseated; you may have a headache.

Type: General anesthesia

What happens: General anesthesia can be administered in liquid form via IV, inhaled via gas, or both. You are not conscious throughout the procedure.

Used with: Invasive procedures such as facelift.

Risks/concerns: Breathing problems, allergic reactions, increased blood pressure and (rarely) death.

NOTE: General anesthesia is considered the riskiest form of anesthesia. Make sure to tell your surgeon if you or any family members have had trouble waking up after general anesthesia.

How you feel afterward: Nausea and vomiting may occur. Some people report a "hangover effect" that lingers for days.

Discuss your anesthesia options and their risks with your surgeon and anesthesiologist before your facial plastic surgery procedure. Many will recommend a combination of anesthetics to manage pain and reduce the risk of any complications.

  • Halaas 58x57

    Yael Halaas, MD, FACS

    60 East 56th Street
    3rd Floor
    New York, NY 10022
    (332) 239-6439

  • P

    Cosmetic Surgery Associates of New York

    465 Columbus Avenue
    Valhalla, NY 10595
    (914) 421-0113

  • P

    Min S. Ahn MD

    The Aesthetic Wellness Center
    2 Connector Road, #2C
    Westborough, MA 01581