Anesthesia for facial plastic surgery is a broad subject encompassing many issues including use of specific anesthetic drugs, preoperative assessment and preparation, perioperative care, and personnel and facility issues. Although there have been significant advances and changes in the practice of anesthesia over the last 20 years, perhaps the most significant of these is the steadily increasing proportion of ambulatory surgical cases. Approximately 70% of all operations performed in the United States are done as outpatient procedures. Consequently, the number of ambulatory surgery centers (ASC) has increased dramatically. In addition, primarily due to convenience and economic factors, office-based surgery has also increased dramatically. Office-based surgery is unique in that few state regulations exist and the quality of care varies widely among facilities. Nevertheless, this venue will continue to remain a popular choice and every practicing facial plastic surgeon should be familiar with the advantages and disadvantages of such a choice.
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