Facial plastic surgery is conceptually divided into aesthetic and reconstructive disciplines. Indications for aesthetic plastic surgery include the sequelae of facial aging: rhytidosis, facial and cervical skin laxity and redundancy, brow ptosis, dermatochalasis and generalized periorbital aging, soft tissue atrophy, and cervical fat excess. Additional indications include the desire for nasal refinement and correction of malformed ears, a weak or prominent chin, and cheekbone or lip enhancement. Reconstructive procedures are indicated for correction of nasal airway obstruction and reconstruction following facial trauma, cancer therapy, and birth defects. The operations vary in complexity and duration based on the indications and goals of the surgical procedure. Regardless of the indication, facial plastic surgery is most often an elective procedure done to improve the patient's quality of life. Blood loss from aesthetic and reconstructive procedures is usually minimal with cases requiring transfusions the rare exception. Medications with antiplatelet activity such as salicylates and non-steroidal anti-inflammatory agents as well as vitamin E and herbal products known to increase bleeding such as ginkgo, ginseng, and supplements of ginger and garlic must be avoided in the perioperative setting. Facial surgery should reinforce the need to make sun protection a lifelong habit.
The choice of anesthetic techniques for these procedures is evenly divided between general anesthesia and a combination of local anesthesia with intravenous sedation. Patient's preference, surgical expertise, and expected duration of the procedure are all considerations in anesthetic decisions.
Usual postoperative course
Expected postoperative hospital stay
Most patients undergo operations on an outpatient basis.