Can Cheek Implants Be Done Under Local Anesthesia?

Q: Dr. Eppley, I don’t like the idea of losing consciousness under general anesthesia or IV sedation. Would it be possible to undergo cheek augmentation with malar cheek implants with only local anesthesia? I am very tough and I am not afraid of surgery or the sounds of surgical instruments at all, but I don’t want to feel any pain during the procedure. Is it possible to numb the midface area completely? Would you do cheek augmentation under local anesthesia if the patient is aware of the fact that this might be very uncomfortable?

A: While any type of procedure can theoretically be done under local anesthesia, that does not mean it is always a good idea. I have never done cheek implants under straight local anesthesia since it is a bone-based operation. I am sure one could get through it, but I could not promise that it would be completely pain-free. In addition, the most important aspect of the procedure is to get the implants into the correct position. You would not want anything to limit that objective. Always remember the purpose of the operation is about getting the best surgical result, not about how little anesthesia is needed. There are no rewards for seeing one ‘tough;’ one can be. In short, this would not be something I would advise or do… as I know well how this story would play out. To quote an anesthesiologist whose skill and experience I admire…‘the patient who states that will be just just fine under local anesthesia is exactly the patient who won’t be’. I would recommend that you do not have this operation unless you can come to the acceptance of doing it under sedation or general anesthesia.

Dr. Barry Eppley

Indianapolis, Indiana