Is 73 too old for a facelift? What about 78? What about 85? All of these are ages of patients who had rejuvenation surgery, including facelift, by me over the last several years. And it was done safely and successfully. I would have never done a multi-hour cosmetic surgery on a septuagenarian six years ago. What has changed?
The answer is Gentle Sleep Anesthesia. It was developed here at the Appearance Center and SCARS Center over the last six years by our senior Hoag anesthesiologists and myself. This revolutionary technique, instead of putting patients into an anesthetic state, induces a sleep state. It requires the anesthesiologist’s knowledge of the technique and advanced local anesthetic numbing performed by the surgeon. This collaborative effort, a fine dance between the anesthesiologist and the surgeon, allows safe multi-hour surgery.
How is this achieved? Modern anesthetic medications allow us to induce stage 2 to 3 sleep along with minimal sedation. The minimal sedation is turned off every 1 to 1 1/2 hours leaving the patient in this light sleep. In this state, the patient can follow commands and answer questions without ever remembering the events. They are asked to do what they would normally do during sleep. They move their legs, they thrust up their hips, they shrug their shoulders, they take deep breaths and clear their throats, and they tell us if anything is uncomfortable. We also ask if they’re hot or cold. After all of this is performed, and patient safety is reestablished, the light sedation is restarted, and the patient drifts off back to stage 2 or 3 sleep, only to be awakened again in another 1 to 1 ½ hours. This is what happens during normal sleep – we shift our body, take deep breaths, clear our throat, cover or uncover the blankets if we are too warm or too cold, and go back to sleep. We mimic physiologic normal sleep, during which we perform cosmetic surgery. And the recovery results are incredible. There is no hangover and no mental cloudiness within a few hours of surgery. Lung function is not affected. Leg circulation is maintained, avoiding risk of blood clots.
Here a couple of real patient stories.
85 year woman had her second facelift. At 2 weeks and 3 days after surgery, she was on a cruise. Her life was not disrupted – time is precious.
A 77-year-old, 1 day after her facelift, briskly walked into the office from the parking lot. When I saw her walking in the courtyard all wrapped up, I asked her where her husband was. “I left him in the car. He is fine!”
These are real patients with real stories. And Gentle Sleep Anesthesia opens a world of possibilities for those over 70 who are generally healthy, active, and enjoying life.
