Dr. John Standefer of Fresh Image Cosmetic Surgery Center in Dallas, Texas addresses why he chooses to use local anesthesia with oral sedation instead of general anesthesia for all of his surgical procedures.

At Fresh Image Cosmetic Surgery Center in Dallas, Texas, we never use general anesthesia. Many patients are surprised to hear this, as a lot of surgeons in the area use general anesthesia, administered by an anesthesiologist. I received extensive training to safely and effectively administer local anesthesia with oral sedation, and I have successfully completed over 8,000 procedures with this method. My patients love their results and the benefits of not using general anesthesia.

There are several reasons to choose local anesthesia rather than general anesthesia for facial surgery. The first reason is safety. The risk of general anesthesia, albeit small, is obviously airway and/or circulation issues. What many people may not know is that decreased immunity occurs after general anesthesia. Any surgical procedure puts stress on the immune system. It takes a while to recover even without general anesthesia. With general anesthesia, the body has to detoxify all of the medications administered during general anesthesia. The depressed immune system can cause a decrease in your energy level, and can cause a feeling of malaise. The malaise  impairs our feeling of wellbeing. This can occur at any age. It is much more apparent as we age because our energy levels are generally less as we age, and our immune system is normally less active later in life.

The next obvious reason for using local anesthesia with oral sedation is that the chance for blood clots in the legs (deep vein thrombosis or DVT’s) is less. A study of over 175,000 facelift patients revealed a less than .0005% chance of DVT’s in patients having local anesthesia versus patients having general anesthesia.

Local anesthesia with oral sedation is also less expensive than general anesthesia. When you add an anesthesiologist or nurse anethesist to the surgical team, the cost of the facial cosmetic procedure is much greater than when done with local anesthesia and oral sedation. With local anesthesia and oral sedation, monitors are still important. In our certified surgical center in Dallas, Texas, the blood pressure, heart rate, EKG, and oxygen levels are monitored at all times, just like in hospitals. ACLS (advanced cardiac life support) certification is required of not only the surgeon, but the registered nurses as well.

Since general anesthesia is done in a hospital or day surgery center, there are additional costs associated with these facilities.

The risk of infection following facial surgery is very low. It is reported as less than .05% in a study of over 175,000 facial procedures. A certified surgical center that is office based is less likely to have ever been exposed to infections, as opposed to surgical centers and hospitals. Hospitals often deal with more acute and long term infections, especially when they have an ICU.

Finally, patients remain comfortable and pain-free throughout the duration of their procedures when local anesthesia with oral sedation is used.  Patients are so relaxed, it is common for them to fall asleep during their facial surgical procedure.

With over 8,000 facial cosmetic procedures performed under local anesthesia with oral sedation, and having no patient ever abort or stop the procedure due to pain and discomfort, and having no patient develop blood clots or DVT, I am a firm advocate of using local anesthesia for facial cosmetic surgery. At Fresh Image Cosemtic Surgery Center in Dallas, Texas, we take pride in providing safe medical care to address our patient’s facial cosmetic surgery needs.

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