Local Anesthesia vs General Anesthesia: Plastic Surgery Benefits and Risks

What is Local Anesthesia?

Local anesthesia is a pain prevention medication used during minor surgical procedures to numb a small area of the body without putting the patient to sleep. Local anesthesia only lasts a short period of time, so it’s typically used for minor outpatient procedures, where the patient can return home the same day. It can be used along with sedation to calm the patient and reduce stress levels. Combined, they allow a surgeon to perform a procedure without any pain or distress.

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Types of Local Anesthesia with Oral Sedation

There are two main types of local anesthetics. One of them is topical anesthetics and it is applied directly to the skin or mucous membranes, such as the inside the mouth, nose, or throat. It can also be applied to the surface of the patient’s eyes. Topical anesthetics come in the form of liquids, creams, gels, sprays, and patches. Some surgeons will use a combination of local anesthetics to provide a longer lasting effect. Some of the procedures local anesthesia can be used for are applying stitches, IV insertion, catheter insertion, and laser treatments.

Local anesthesia can also be administered through injections. Injectable anesthetics are usually used for numbing during procedures, as opposed to pain management. Local anesthesia injections are used for procedures like a root canal, skin biopsy, mole removal, rhinoplasty, and pacemaker insertion.

Local Anesthesia with Oral Sedation Plastic Surgery

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At our Aventura plastic surgery office, we use local anesthesia for a variety of procedures. Many of our patients who come to our office for rhinoplasty get local anesthesia. Some of our patients ask, “Can you have a facelift with local anesthesia?” The answer may surprise you, but yes, you can. We provide many of our clients who want a facelift with local anesthesia with oral sedation. 

Generally, our facial surgery patients will take a pill cocktail we provide for them and then rest in a recliner for an hour or so prior to their surgery starting. The greatest benefit to local anesthesia with oral sedation, other than lower costs, is the bleeding is very minimal and the recovery is quicker. 

Some of the more common procedures where we use local anesthesia with oral sedation for plastic surgery are:

Deciding Which Type of Local Anesthesia to Use

Several procedures can be performed using either injections or topical anesthetics, but Dr. Galitz will ultimately determine the best type for the patient based on factors like the length of the procedure, the size, and location of the area that needs to be numb, underlying conditions, and medication taken by the patient.

What is General Anesthesia?

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General anesthesia includes a combination of intravenous drugs and inhaled gasses (anesthetics) that puts the patient in an unconscious state, so they are unable to feel pain during a medical procedure. It is so much more than just being asleep; the brain doesn’t respond to pain signals or reflexes. The patient’s airway is secured with a tube or laryngeal mask. While unconscious an anesthesiologist monitors the patient’s vital functions and manages their breathing.

General Anesthesia Risks

General anesthesia can be administered safely, even to individuals with significant health conditions. Most of the time, the risk of complication is more closely related to the kind of procedure you’re having and your general health, rather than the type of anesthesia.

Elderly people or individuals with serious medical problems can be at an increased risk of postoperative confusion, pneumonia, stroke, or heart attack. Specific conditions that can increase the risk of complications during surgery include:

  • Smoking
  • Seizures
  • Obstructed sleep apnea
  • Obesity
  • High blood pressure
  • Diabetes
  • Medical conditions involving the heart, lungs, or kidneys
  • Medications, such as aspirin, that can increase bleeding
  • History of alcohol abuse
  • Drug allergies
  • History of negative reactions to anesthesia

Local Anesthesia vs General Anesthesia

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There are several instances where general anesthesia may be chosen over local anesthesia, but there are also some cases where the patient is asked to choose between the two themselves. This choice can depend on age, state of health, and personal preference.

Main reasons for choosing general anesthesia:

  • The procedure takes an extended period of time.
  • The patient can potentially lose a significant amount of blood.
  • Breathing may be affected.
  • The procedure will make the patient feel uncomfortable.
  • The patient is young and may have difficulty remaining still.

Recent studies show that the majority of all facial cosmetic surgery procedures can be performed safely under local anesthesia with intravenous sedation. However, a large percentage of people undergoing cosmetic surgery are still subjected to the risks of general anesthesia. When a patient is placed under general anesthesia, the patient is put on a respirator and a tube is put down their throat to help them breathe. A combination of drugs causes a deep sleep during the procedure.

Unfortunately, complication rates are higher under general anesthesia. After having a surgical procedure, patients tend to have a sore throat from the tube, they experience extreme fatigue, and are more likely to feel nauseous. Additionally, recovery time tends to be longer because the body must recover from both the surgery and the anesthesia.

One of the benefits of local anesthesia is its ability to numb a specific area of the body without the patient being put under. On the other hand, general anesthesia requires the patient to be completely unconscious and insensitive to pain on the entire body. This requires precise monitoring of breathing and heart function to keep the patient stable and healthy. Since local anesthesia does not affect bodily systems to the same extent as general anesthesia, local anesthesia provides more safety for the patient.

Patients usually recover faster after having local anesthesia instead of general anesthesia. One of the main reasons there’s a difference in recovery time is because under general anesthesia, many of the body’s systems, like the cardiovascular system, are depressed by the anesthetic. Patients who undergo general anesthesia sometimes must be monitored carefully for hours following the procedure, as the body slowly regains control of all its functions, including respiration and muscle movement. This means with general anesthesia, the patient must recover not only from the procedure itself but also from the effects of sedation. With local anesthesia, patients require less medication and remain alert and responsive throughout the procedure, giving them a head start on recovery after surgery. Most patients that receive local anesthesia can return home the same day, which is rare with general sedation. Another benefit is that local anesthesia can act as a method of pain management, reducing the overall number of painkillers for recovery and sometimes excluding the need for stronger pain medication like morphine.

Talk to an Experienced Miami Plastic Surgeon

When considering all these facts, local anesthesia is often better and a much safer choice for plastic surgery patients. Here at Aventura Plastic Surgery procedures like a facelift, neck lift, blepharoplasty, chin implant, cheek augmentation, and rhinoplasty can all be done using local anesthesia. Give us a call at (305) 974-0505 for more information and to schedule a consultation.

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