Picture of Dr. Andrew Jacono in Scrubs During Surgery

Plastic Surgery Under Twilight Anesthesia and Local

Info About Plastic Surgery Under Local and Plastic Surgery Without General Anesthesia

What Is General Anesthesia?

Plastic Surgery Under Local and Twilight Anesthesia

General anesthesia is a combination of medicines that places patients in a sleep-like state before a medical procedure. Anesthesiologists administer these medications, place a breathing tube in the mouth, and pump anesthetic gas into the body. This induces a state of unconscious paralysis. During surgery, patients are unaware and do not feel any pain. Some compare this experience to a state of deep sleep.

Although this is effective at inducing unconsciousness, many people are concerned with its associated risks. It tends to put significant strain on the body, causing patients to feel weak and nauseous after treatment. These effects can last for up to a few days. Such discomfort can pose serious issues for patients who are busy or have difficult daily obligations.

General anesthesia also causes blood vessels to dilate, which makes patients bleed more during and after surgery. It also causes bruising and pain during the recovery period. For these reasons, Dr. Jacono rarely administers general for surgical treatment. Instead, he uses either local anesthesia or twilight anesthesia. These options are much safer and more reliable.

The vast majority of plastic surgeons only perform surgery with general anesthesia. While Dr. Jacono agrees that serious complications related to general anesthesia are extremely unlikely to occur (less than .001% chance), he believes that its side effects are too disruptive. He prefers that his patients feel as relaxed as possible after treatment.

What Is Local Anesthesia?

If a patient undergoes treatment with local anesthesia, they are wide awake. First, Dr. Jacono gives patients a minor sedative in pill form for relaxation purposes. He then injects a series of shots to numb certain areas of the face.

Dr. Jacono specifically uses drugs called Lidocaine and Marcaine, both of which are longer-lasting and more effective than Novocaine. These local anesthetic injections can be painful, but Dr. Jacono uses a tiny needle that slowly spreads the medicine. This minimizes discomfort.

Because local can cause physical and emotional stress, Dr. Jacono does not suggest it for patients who are afraid of needles. He also does not recommend it for patients with low pain tolerance. After the first injections, however, patients are unable to feel anything other than the pressure on their faces.

Local anesthesia decreases the amount that patients bleed during surgery, especially when compared to general anesthesia. Patients also bruise less after surgery, and recovery times are quicker. What’s more, local anesthesia is significantly less expensive than general anesthesia.

What Is Twilight Anesthesia?

Twilight anesthesia, or propofol, is a medication that is used to sedate patients. It is administered through an intravenous injection, so anesthesiologists do not have to use anesthetic gas. Propofol is the same anesthetic medicine used during colonoscopies and is commonly used throughout the medical field. As soon as the anesthesiologist stops administering twilight, the patient will begin to wake up and will be conscious after a few minutes.

Twilight anesthesia has far fewer side effects than general anesthesia. It causes no nausea, headaches, or “hangovers” after surgery. It is therefore extremely safe to use, so much so that patients often feel well-rested after surgery.

For these reasons, twilight anesthesia is one of Dr. Jacono’s preferred methods of anesthetic sedation. He uses it during almost all of the surgeries he performs.

Can Plastic Surgery Be Done Under Local Anesthesia?

Dr. Jacono can perform a variety of surgeries under local anesthesia. These include mini facelifts, eyelid lifts, lip augmentations, rhinoplasties, and chin and cheek augmentations. Local anesthesia makes these operations quick and relatively painless.

Although patients are awake during an operation with local anesthesia, Dr. Jacono comforts them as much as possible. He employs music therapy prior to injections and during the surgery itself. Studies show that playing relaxing music lowers blood pressure, which limits bleeding during surgery and bruising after.

Dr. Jacono is an expert at performing surgery under local anesthesia, and his patients rarely experience complications. Staying awake for treatment may seem daunting, but many of Dr. Jacono’s clients have confidently undergone surgery while conscious.

What Procedures Does Dr. Jacono Perform Under Twilight Anesthesia?

Dr. Jacono is a dual board-certified facial plastic surgeon who performs the vast majority of his surgical procedures under twilight anesthesia. These include rhinoplasties, lip lifts, cheek augmentations, eyelid lifts, deep plane facelifts, neck lifts, and browlifts. He finds twilight to be the safest and most effective anesthetic for his practice, as it causes fewer complications than general. Patients also wake up from treatment feeling refreshed rather than groggy, nauseous, and unwell. 

In some cases, twilight anesthesia can be modified to better fit the surgical procedure. For example, during rhinoplasty, Dr. Jacono and his anesthesiologists place a dam in the back of the throat. This prevents blood from dripping into the windpipe. Because the patient is asleep, they cannot protect their own airway, which can become blocked with blood clots.

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