Regional Nerve Blocks in Plastic Surgery

facial sensory nerve branches and nerve blocks

Facial sensory nerve branches and their corresponding blocks.

Local anesthesia is used during many plastic surgery procedures. When procedures are performed on facial structures, regional nerve blocks with Lidocaine (Xylocaine) and Marcaine (Bupivicaine) are easily and frequently utilized. Here are some common nerve blocks used in my practice:

1) Supraorbital Nerve: Much of the forehead can be anesthetized by infiltration of the supraorbital nerves.  This nerve is exits the frontal bone at a point several centimeters above the pupil.

2) Infraorbital Nerve:  This nerve exits the maxillary bone at a point several centimeters just below the pupil. Accurate block of this nerve will anesthetize the cheek, the nasal sidewall and a portion of the nasal tip, one half of the upper lip, as well as some of the upper teeth.

3) Mental Nerve: This nerve exits the lower jaw bone (mandible) about 1-2 cm above the lower bony rim in the region of the canine and premolar teeth. Accurate block of this nerve will anesthetize the corresponding half of the lower lip, teeth and cheek in that area.

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