News & Features

Stay Awake Facelift Doc

Zachery E. Gerut, M.D.
1245 Colonial Road
Hewlett, N.Y. 11557
Visit Dr. Gerut's Website
Zachery E. Gerut, M.D.
So many plastic and cosmetic surgery patients are telling their surgeons they don't want to go under general anesthesia, it has become an official trend. Even when getting that long- awaited facelift, many just don't want to be put to sleep. Actually, it's not whining -- experts say being under general anesthesia is fraught with risks. Breathing problems can develop while some suffer nausea, vomiting and sluggishness for days afterwards. Those who have been there say recovering from a general is like being hit by a Mack Truck.

So Long Island, New York, plastic surgeon Zachary Gerut, M.D., wondered if he could skip the general while doing facelifts and use local anesthetics instead, allowing the patient to stay awake and enjoy a much kinder and gentler post-op experience. Dr. Gerut had observed that many liposuction patients remain awake during their procedures, so why couldn't facelift patients also stay conscious?

One of the key techniques in liposuction has become what is known as "tumescent" or "wet liposuction." Surgeons overfill the area to be suctioned with lidocaine, saline, epinephrine and Marcaine, a type of Novocain often used by dentists. The tumescent technique is now known to reduce swelling and bruising while staunching bleeding.

About ten years ago, Dr. Gerut started applying the tumescent technique - little by little -- to the kissers of his facelift patients. In the process, he found that pumping in so many liquids caused the face to swell two to three times its normal size. Currently, it takes about a half an hour to infuse the medications into the typical patient's face. Later, Dr. Gerut learned the hardest part of the stay awake facelift was seeing in his mind's eye what the finished, healed face would look like amidst the swollen flesh and bloated features. "Then one day, two M.D. sisters came in for a facelift," Dr. Gerut says. "They knew all about general anesthesia and wanted none of it."

So Dr. Gerut used the tumescent technique on both. Outcome? The physician-sisters hopped off the table and sauntered out of the building as merrily as if they had been at a picnic. The thought shot through Dr. Gerut's mind that perhaps he had really hit on something.

"Patients today have busy lives," Dr. Gerut says. "So the beauty of what is now known as 'The Gerut Lift' is that it usually requires only about three days to recover from a full surgical facelift."

However, similar patients under general anesthesia can require one to three weeks for returning to normal activities. Says Dr. Gerut, who now has two and one-half years of stay awake facelifts under his belt: "Using the Gerut Lift, patients can talk to me while I operate, request more or less anesthesia or valium or - like some - just get bored and go naturally to sleep while I operate."

Even though general anesthesia is not used, an anesthesiologist attends each facelift, just in case things go awry and some serious gas must flow.

The actual facelift operation proceeds like any another with deep lying muscles and skin being pulled up and trimmed. Another technique that makes the operation popular: speed. The doctor says his Gerut Lift requires about two and one-half to three hours at most while many other full facelifts need up to six hours to finish. Dr. Gerut has found most awake patients can't tolerate holding still for much longer than three hours. Moreover, when a patient is under deep sedative or general anesthesia and the surgery goes on for five hours, one component of the anesthesia wears off which causes bleeding and bruising to "markedly increase," in the words of the surgeon.

"After a Gerut Lift, the typical patient leaves my surgical suite with stitches only - no dressing, gauze masks nor compression garments required," says Dr. Gerut. "Many go out to dinner that evening and later report they felt fine."

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