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Anesthesia Used During a Facelift?

My doctor said he could perform my facelift under local anesthetic and just give me some sedation. I am 42, would general anesthesia be safe for me? I don’t know what is worse – the general anesthesia, or not being fully knocked out.

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anesthesia facial plastic surgery

Facelift anesthesia depends on your tolerance for discomfort

Almost all modern facelifts are performed with local anesthesia. The question then is only what sedation you administer in addition to the local anesthetic, and who administers it. The options are no sedation, oral sedation alone (i.e. valium), deep intravenous sedation, or a light general anesthetic. When the airway may be compromised, for example by bleeding during surgery, or in a patient with reflux disease, it is usually better to have the patient asleep with a tube protecting their... more

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Brent Moelleken, MD

Beverly Hills Plastic Surgeon

ASAPS ASPS

Depends on your health, type of facelift, anxiety level of patient.

Having used both techniques for more than 30 years I only use local anesthesia for the following patient: 1. patients who only require a" minilift " and the idea of surgery does not make them anxious. 2. Patients who medically cannot have general anesthesia, but can have local anesthesia. In these patients I always have an anesthetist to give IV medication to make the injections totally without pain. 3. Someone who absolutely refuses general anesthesia because of fear. For all other patients... more

Toby Mayer, MD

Beverly Hills Facial Plastic Surgeon

Local anesthesia is best and you are still "knocked out" with deep sedation

I perform all facelifts under deep sedation with local anesthesia even though our office surgical facility is also accredited to perform general anesthesia. With local and sedation, you are completely unconscious and it is safer. I don't have to work around a tube in your throat and you wake up more smoothly. For example, a large recent study showed that the only facelift patients who developed pulmonary emboli (very, very few) were those who were done under general anesthesia.So, for... more

George J. Beraka, MD

Manhattan Plastic Surgeon

ASAPS ASPS

Long Lasting Results & Patient Comfort / Safety with Local Anesthesia

I agree with the excellent and comprehensive advice given here. As a Surgeon who has performed over 1,000 Facelifts with local anesthesia (with mild sedation as requested) I wanted to add a few comments. In my experience long lasting and natural looking results are easily accomplished with local anesthesia. I have found over the years that in patients with mild to moderate aging changes, in their 40s and 50s and good overall medical health, equivalent results can be acccomplished with local... more

Kamran Jafri, MD

New York Facial Plastic Surgeon

Local with IV sedation yes!

Having performed thousands of facial plastic surgery operations with both general anesthesia and IV sedation I can say with confidence that IV sedation has all the advantages of general anesthesia (patient comfort) and very few of the side effects of general. The main advantages of IV sedation anesthesia are: It does not require putting a breathing tube in the throat It does not require a breathing machine The recovery is much faster There is much less "hang-over" from... more

Sam Naficy, MD

Seattle Facial Plastic Surgeon

Type of anesthesia best for facelift surgery

General anesthesia and local anesthesia with sedation are both good options for facelift surgery. You should probably stick with your surgeon's preference. When the sedation choice is used, I prefer that a board certified anesthesiologist be present for safety issues. The more important question in my mind is appropriateness of facelift surgery in someone your age. I suggest you attain a second opinion before embarking on surgery.

Maurice M. Khosh, MD

New York Facial Plastic Surgeon

Local with IV Sedation is the best compromise

The great thing about this website is that a prospective patient can ask a question and receive educated opinions. My opinion is that local anesthesia with sedation provides the best compromise of pain control, relaxation, and safety while allowing the surgeon to work efficiently. I use this technique for most cases (using a CRNA or Anesthesiologist), with the exception of rhinoplasty, where general anesthesia is employed. Can general anesthesia be performed safely? Absolutely. However,... more

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Stephen Prendiville, MD

Fort Myers Facial Plastic Surgeon

Both are O.K., my preference is sedation.

Advantages of general anesthesia: No pain with injections Ease for the surgeon Disadvantages of general anesthesia: Higher risk (arguably) Higher cost in some practices where an in office procedure can be done with sedation but not general anesthesia More nausea associated with general anesthesia Blood pressure can increase on waking which can lead to hematomas The procedure can be done either way and I have and do both. My preference is excellent local anesthesia with sedation for the... more

York Jay Yates, MD

Salt Lake City Plastic Surgeon

ASPS

Local anesthesia with sedation is excellent for facelift

Facelift can be safely and comfortably performed under both sedation, and general anesthesia. Safely is the fey word. My own preferrence has been a local anesthetic with sedation for facelift procedures. The sedation our center provides is a deep or twilight sleep. The medication is "dissociative" or in other words the patient is breathing and responsive though unaware. We have preferred this technique because we have had less nausea than we have with general anesthesia and our... more

Peter E. Johnson, MD

Des Plaines Plastic Surgeon

ASAPS ASPS

Type of anesthesia depends on the type of facelift and your general health

The term “facelift” used generally, has many different degrees of surgical intervention. A lift that is treating only the skin and superficial fat and tissue, with generally smaller incisions may be reasonably performed with local anesthetic and sedation. In the interest of safety, which should be everyone’s primary concern, the sedation should be delivered by an appropriate anesthesia provider. In contrast a more complete facelift, one that addresses the entire facial... more

Robert Singer, MD

La Jolla Plastic Surgeon

ASAPS ASPS

Anesthesia used during a facelift?

Hello, While age is a factor, the real key is your health regarding the type of anesthesia. If you are medically cleared by your primary care doctor then you can either form of anesthesia. It is very common to have a Facelift using IV sedation. Some doctors feel that there is less post operative nausea using IV sedation vs. a general anesthetic. Some of this may be related to medication sensitivity. A general anesthetic usually requires an anesthesiologist so your cost may be higher via... more

Michael Kulick, MD

San Francisco Plastic Surgeon

ASAPS ASPS

It depends on the person and current situation

Face lifts can be done under local anesthesia and general anesthesia. It really depends on the person and how they can handle being slightly awake or not during the procedure. Also, a particular person’s pain tolerance plays a major part. I In my experience, IV sedation is the best way to do the procedure. You can have the person in a deeper or lighter state depending on the situation during the procedure that can help both the surgeon and the patient. Sometimes, cooperation by... more

Philip Young, MD

Bellevue Facial Plastic Surgeon

Sedation and general anesthesia both safe if done on a healthy person

Sedation and general aesthesia are both accepted ways to do surgery. If you are a nervous person then likely better to go under general. Sedation is sometimes administered by the Surgeon. My preference is always to have a trained anaesthesiologist do it.

Michael Weinberg, MD

Toronto Plastic Surgeon

Choose the best anesthetic for you

Your choice of anesthetic depends on several factors: Extent of the procedure If your procedure is more than 2 hours, sitting still for that long is a long time Your health Forty-two is young by todays standards but there are other factors that contribute to your "real age" as opposed to your chronological age. We have criteria by which we rate an individuals risk of undergoing general anesthesia (Called ASA class). You surgeon can discuss this with you. Your tolerance... more

Otto Joseph Placik, MD

Chicago Plastic Surgeon

ASAPS ASPS

General anesthesia is safe

A general anesthetic performed by a Board Certified physician anesthesiologist is safe and effective for the proper performance of a facelift. A well done facelift takes time and some patients are better off asleep for this. This is also true if they have an anxious personality and are difficult to sedate. Also realize that there are non-plastic surgeons doing facelifts out there and they typically can't get a physician anesthesiologist to work with them because this is beyond their proper... more

Richard P. Rand, MD, FACS

Seattle Plastic Surgeon

ASAPS ASPS

Anesthesia for facelift

Most facelifts require anywhere between 2-4 hours of operative time with frequent turning of the head and manipulation of the jawline. I have found that this can be quite uncomfortable under local anesthesia. In order to attain long lasting and aesthetically pleasing results, I like to perform my facelifts with some sort of sedation. This can be general anesthesia or conscious sedation. Seek other opinions if you are skeptical.

Etai Funk, MD

Houston Facial Plastic Surgeon

Extent of Neck Rejuvenation dictates Extent of Anesthesia

For facelift surgery in Houston, TX, I offer a wide variety of facelift procedures. I believe in an individualized approach to facial rejuvenation. Based on my recommended procedure, I will give the patient options to anesthesia that allow for a safe procedure with minimal risk and downtime. Typically, the more neck correction that is necessary, the more anesthesia I recommend. if a patient needs significant correction of excess neck skin and platysmal... more

Paul S. Gill, MD

Houston Plastic Surgeon

ASPS

Facelift with local/sedation or general anesthesia

The anesthesia used for facelift can be local with sedation or general. Please know that there is a rainbow-like spectrum of anesthetic 'depth' between these two. Some surgeons perform 'twilight' anesthesia that is in some cases as deep as a general anesthetic. In some cases, a 'light' general anesthetic without any inhaled anesthetic can have a quicker, less drowsy recovery than an iv/sedation anesthetic. It all depends on the anesthetist's experience and... more

Sam Most, MD

Bay Area Facial Plastic Surgeon

A Face Lift without General Anesthesia is better

A face lift can be performed with a sedative or twilight anesthesia that is not general anesthesia. It is usually administered with an IV and you are not aware of anything during the surgery, no pain, no discomfort. This avoids you having to be under general anesthesia, there is less bleeding and bruising, and you will not wake up feeling nauseous and ill. A skilled anesthesiologist who performs twilight anesthesia is most important.

Andrew Jacono, MD

New York Facial Plastic Surgeon

Anesthesia for Facelift Procedures

I would not suggest having a full facelift procedure under local. In my practice my preferred anesthetic is IV sedation (not general) with Local infiltration monitored by board certified anesthesiologist.

Vivian Hernandez, MD

Boca Raton Facial Plastic Surgeon

ASAPS

Facelift anesthesia

Anesthesia for a facelift can be sedation or general. It really depends upon your comfort level and your health. I just want the patient to be comfortable so that I can provide the best result for them.

Steven Wallach, MD

Manhattan Plastic Surgeon

ASAPS ASPS

Facelifts can be done under a variety of anesthetics

Facelifts can be done under a variety of anesthetics. Depending on the extent of your facelift, it can be done under local, iv sedation or general anesthesia. If you are in otherwise good health, the risk from anesthesia at an accredited center where they use either anesthesiologists or supervised nurse anesthetists is extraordinarily low. Generally speaking facelifts are not a type of procedure that keeps you from moving around after surgery like breast augmentation or abdominoplasty... more

Scott Trimas, MD

Jacksonville Facial Plastic Surgeon

Anesthesia choices

I have used both General Anesthesia as well as Monitored Anesthesia Care with excellent results. There are advantages and disadvantages to both techniques, depending on the surgeon or patient's perspective: The presence of either a Laryngeal Mask or Endotracheal tube ensures a secure airway for delivery of oxygen, however its placement and removal can cause a sore throat, or in the worst scenario a chipped tooth. For patients who have heavy necks, management of the airway is a shared... more

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Lavinia Chong, MD

Orange County Plastic Surgeon

ASPS

It's up to you

The is the preference of the patient and the surgeon. Here's my take on this. A facelift usually takes several hours to complete. Operating rooms are like a second home to us but are very foreign and often unsettling for patients. In addition people are taking and there sounds and smells, from cautery, that definitely do not put patients at ease. Today, anesthesia is very safe and with the new LMA tubes the patient doesn't have to be on a ventilator. Meaning the tube sits in the back of... more

Christopher L. Hess, MD

Fairfax Plastic Surgeon

ASPS

Facelift can be done safely with both anesthesia types

Facelift surgery can be performed equally safe under a general anesthetic or local anesthesia with sedation. An important factor to consider is that the procedure be performed in an accredited facility. Advantages to local anesthesia with sedation is that it usually costs less, and doesn't require intubation. It is also easier for the surgeon not having to deal with a tube in the operative field. General anesthetics are advantageous for people with cardiac problems or hypertension, since it... more