An uncomfortable subject… PART TWO

Many patients share with me their concerns about anesthesia. In a previous blog post, we discussed simple ways that we make our procedures comfortable. These include numbing cream and injectable numbing medicines which are used to provide patient comfort during our office-based facial procedures. For more complicated procedures, more advanced anesthesia techniques are required.

A typical anesthesia setup for facial surgery


For more involved procedures, we work with teams of highly trained, board certified professionals whose only responsibility is to keep you comfortable in an operating room. We also carefully screen our patients for health problems that might impact their anesthetic risk and consult with other specialists to ensure that we have done everything possible to keep you safe under anesthesia.

For advanced facial rejuvenation procedures like face lifts or lower eyelid surgery, I strongly recommend sedation anesthesia. A trained professional places an IV catheter and gives you medicines in your vein to keep you comfortable while they make sure that you’re safe during the procedure. This is the same kind of anesthesia that you would get if you had a colonoscopy.

Now, I have never had this kind of anesthesia. My friend, Dr. Greg Weiss, a professor of anesthesiology at the University of Colorado, describes it as a warm feeling that takes over your whole body. However, you usually totally forget the experience because the medicines keep you from remembering anything about the procedure! My wife experienced IV sedation when her wisdom teeth were removed. She tells me that she felt dizzy, then sleepy, then woke up at home a few hours later with no idea what unpleasant things had happened and no memory of how she had gotten there.

One benefit of sedation anesthesia is that you keep breathing on your own and you can move your legs and arms to help prevent blood clots. You may come in and out of awareness, but you wouldn’t feel any pain because we use injectable numbing medicine along with the sedating medicines. You also shouldn’t worry about being safe under anesthesia because all of the members of the surgery team work together to ensure your safety.

Sometimes we need to put you totally asleep for a surgical procedure. In my facial surgery practice, we reserve this for patients having rhinoplasties and septoplasties. While these procedures are not particularly painful, they can cause bleeding. We protect you by heavily sedating you, putting in a breathing tube, and breathing for you during the procedure. Aside from maybe a sore throat, this kind of anesthesia is very safe and well tolerated. Dr. Weiss pointed out that you’re much more likely to be in a car accident on your way to the surgery center than to have something go wrong under anesthesia.

Patients sometimes worry about feeling sick to their stomach after receiving anesthesia. Thirty years ago, this was a major concern! Now, we know to give you a couple of other medicines to prevent nausea while you receive anesthesia medicines. I also routinely prescribe medicine for nausea after any procedure requiring prescription pain medicine. In my opinion, being nauseous is the worst and I do everything in my power to prevent this feeling in my patients.

Anesthesia can be a an uncomfortable subject for many patients. Many patients fear losing control of their bodies and many more fear pain and discomfort. If you have concerns about anesthesia, please talk to your doctor! We can discuss all the options for managing pain and performing your procedure safely.

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