Wide Awake Facial Reconstruction: A Literature Review, Cost Analysis, and Practical Guide
Aidan Shulkin, Yossi Cohen, Gabriel Bouhadana, Jordan Gornitsky, Daniel E. Borsuk · 2026
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Description
Aidan Shulkin and co-authors review facial reconstruction performed with the patient awake in a 2026 paper combining a literature review with cost analysis and practical guidance. General anesthesia has been the default for facial rebuilding, but it brings perioperative risks and resource use. Operating under local or regional anesthesia avoids those costs, yet the approach remains underreported and its best practices unsettled.
Thirty studies covering 1,249 patients and 1,262 flaps met the review's criteria, with forehead and nasolabial flaps the most common. Minor complications affected about ten percent of flaps and major ones under three percent, most patients reported little or no pain, satisfaction ran high, and nobody needed conversion to general anesthesia. A forehead flap done awake cost about 1,280 dollars against roughly 6,647 dollars under general anesthesia, a saving above five thousand dollars per case. The authors supply a guide to patient comfort and argue the technique deserves a wider role.
Catalog record
| CREATOR | Aidan Shulkin, Yossi Cohen, Gabriel Bouhadana, Jordan Gornitsky, Daniel E. Borsuk |
|---|---|
| YEAR | 2026 |
| COLLECTION | PAPERS |
| FORMAT | TXT |
| FILE SIZE | 31 KB |
| VERSION | 1.0 |
| LICENSE | CC BY 4.0 |
| RIGHTS | CC BY |
| SOURCE | Europe PMC |