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Sedation for the Advanced Mini Facelift

Nowadays, we perform virtually all our facelift surgery under a combination of sedation and local anaesthesia. In fact, for many patients, this is a very powerful deciding factor when they choose to have an Advanced Mini Facelift. Sedation not only works extremely well but it is also significantly more cost effective for patients.


What is sedation and how is it different to general anaesthesia?

Sedation involves the administration of drugs which make you sleepy but not unconscious. Nowadays this involves giving a combination of drugs which will make you relaxed or sleepy enough to undergo a procedure under local anaesthesia without feeling any discomfort or being stressed by events. In fact, almost all of our patients report positively enjoying having their Advanced Mini Facelift under sedation.


What are the advantages of sedation over general anaesthesia for a facelift?

The main benefit of sedation is that you tend to feel much better both during and after your procedure than if you have a general anaesthetic. It is extremely unusual to feel sick or to feel at all unwell after treatment under sedation – the recovery profile is much better. Sedation is also safer than general anaesthesia, although this is a marginal benefit as nowadays general anaesthesia is very safe. Almost everybody can tolerate sedation safely, which can be important if you have a significant medical condition that might preclude having a general anaesthetic.


Is there anything I should do before having sedation?

There are a few simple safety precautions you will need to take. You may have a light meal and drink (non-alcoholic) drinks up to two hours before your surgery. It is important that you do not eat or drink anything for at least two hours before having sedation. You should also have made arrangements to be escorted home as you will be unable to drive for 48 hours following sedation. We will send you full written instructions when we confirm the date for your surgery.


What happens when you have sedation?

You will need to prepare yourself prior to sedation by following a few simple instructions, which may be seen here. Before the procedure your Consultant Anaesthetist will talk things through with you and address any concerns you may have.

In practice, you will have a small plastic cannula inserted into the back of your hand. The sedative drugs are administered by infusion and can thus be turned up or down at will. In the initial stages, we make you very sleepy while the surgeon numbs the tissues with a local anaesthetic solution. After this, there is no reason to be deeply sedated as you will not experience any pain. Thereafter the anaesthetist will typically lighten the sedation so that you remain relaxed and comfortable but fully able to cooperate.


What drugs do you use for sedation?

The mainstay of the technique we use is an anaesthetic agent called propofol, although we do use some additional drugs. Propofol is very widely used in anaesthetic practice and has an extremely good safety profile when used in trained hands and the correct environment. It has the advantage of rapid, clear-headed recovery with no associated post-operative sickness.


Will I be asleep? I don't want to know anything at all about events.

This is a question that we are often asked. If you think carefully about things, you will realise that the only stimulating part of the whole surgical procedure is when the local anaesthetic is administered and we do in fact make you very sleepy for the first few minutes. After that, because the tissues are completely numb, you will not feel any discomfort and therefore there is no reason to be deeply sedated throughout the entire procedure. In fact, there are very good reasons not to be deeply sedated throughout the procedure.

The main reason we (and our patients) prefer light sedation is that people feel much better under light sedation – in fact, they feel great! This may be likened to drinking alcohol. When you have had one glass of wine you typically feel slightly elated, relaxed and positive but when you have had one bottle you tend not to feel quite so good! We tend to aim for the 'one to two glasses of wine' level of sedation during most of the surgery. Furthermore, deeply sedated patients can sometimes become somewhat restless, which makes the surgeon's job much more difficult.

You will be able to talk to us during the procedure and if at any stage you wish to be less or more deeply sedated this can be arranged 'at the flick of a switch'. Very occasionally people insist that they 'want to be asleep' and we can always do this if this is important to you. Of course, general anaesthesia is always available as a last resort.


Will I remember anything?

Typically patients have no clear recollection of their surgery and any recollections are usually pleasant. The drugs we use are powerfully amnesic and it is common for people to remember nothing at all, despite the fact that they chatted through most of the procedure!


Will I feel sick after sedation?

Usually not and this is a major advantage compared with treatment under general anaesthesia. Any post-operative nausea or sickness is typically related to the use of painkillers or a drug we sometimes use to help with blood clotting after a facelift.


How quickly will I recover after sedation?

You will be 'awake' almost immediately after surgery. You may feel slightly drowsy for a few hours, especially if you have had an early start or deeper sedation than normal, but sometimes this is not such a bad thing! You will be effectively 'back to normal' by the next morning (although there are some precautions you need to observe for 48 hours after sedation).


How much does sedation cost? Is it cheaper than having a general anaesthetic?

The costs for sedation can be found on our price list. In general terms, you are paying for the Consultant Anaesthetist's time and expertise so there is little cost differential in that respect. However, if you elect to have a general anaesthetic rather than sedation for your Advanced Mini Facelift you will need to pay significantly higher hospital fees – somewhere in the region of an extra £1500. This relates to the hospital pricing structure, not the anaesthetist's fees, and is outside of our control.


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