Lidocaine is a very old and safe anesthetic drug that allows 90 min of numbness. Its standard dose is 7 g/kg, or 25 ml of 2% lidocaine (500 mg) for a 70 kg person, but it is known that this dose can be augmented many times; some papers mention about
seven times the maximum recommended dose  (Fig. 23.1).
Bupivacaine is a long-lasting anesthetic that is largely used in block anesthesia. Its dose is 1.25 mg/ kg, 25 ml of 0.50% bupivacaine for a 70 kg person and its action lasts 6 h.
The standard concentration of adrenaline is 1:1,000 and it can be diluted in 100 or 500 ml, obtaining a dilution of 1:100,000 to 1:500,000 . This drug's vasoconstrictive action lasts 5-7 h and causes brief side effects like tachycardia and hypertension.
If the patient is awake and the surgeon needs to neutralize the acid anesthetic solution, then the addition of bicarbonate is indicated. If the patient is under deep sedation, bicarbonate is unnecessary.
For a coronal lift, I use approximately 200 ml, for a facelift 150 ml and for the neck 150 ml depending on the size of the head and neck of each patient.
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