Can an endoscopic facelift be performed under local anesthesia?

Doctor Answers 7

Endoscopic facelift & local anesthesia

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Yes, an endoscopic facelift can be performed under local anesthesia. It's going to depend on your surgeon and your tolerance for discomfort.


Kouros Azar

Thousand Oaks Plastic Surgeon
4.9 out of 5 stars 38 reviews

Endoscopic facelift

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Endoscopes are used in midface lifts to lift the cheek soft tissues of the face via a temporal incision.  This usually involved dissection against the cheek bone to release these tissues and a suture fixation of these tissues up to the temporal muscle fascia.  This usually requires much more than local anesthesia.  In addition, swelling of the area from injection of local may impair your surgeon's ability to judge the symmetry of the results.  Probably best to do with at least sedation or general anesthesia.  Best wishes, Dr. T. 

Endoscopic procedures under local anesthesia

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Endoscopic procedures can be performed under local anesthesia with the appropriate nerve blocks and local infiltration of the tissues. Whether you can tolerate it is another matter, as is the comfort of the surgeon with such procedures under these circumstances. You won't feel pain, but you may experience pulling that may be uncomfortable, and you may hear sounds and feel vibrations you are not entirely comfortable with. It all boils down to whether you are comfortable with this and whether your surgeon is comfortable with surgery under these circumstances.

Ben Lee, MD - Account Suspended
Denver Plastic Surgeon

Can an endoscopic facelift be performed under local anesthesia?

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 Hi, I have performed many facelifts over the past 30 years.  Whether the Facelift Surgeon performs the facelift under a local anesthetic is a personal choice often based upon the individual patient and the length of the procedure.  I have included information about my minimally, invasive SMAS facelift that I often perform under local anesthesia in 90 minutes or less.  It's important to mention that endoscopic procedures typically do not allow for removal of excess skin (require incisions around the front of the ears) and often use suspension of SMAS folding techniques that do not last.  Non smiling photos of your face from the front and side would help in the evaluation. I have performed facelifts for over 30 years and have performed many minimally, invasive type facelifts. Following the beauty principles outlined in my book on face and body beauty, women look the most feminine, youthful and attractive with heart shaped faces.  Heart shaped faces have cheeks that are full and round in the front.  Cheek augmentation with a dermal filler or using cheek implants for a permanent enhancement will create full, round cheeks that will feminize the entire face. If the chin is weak, this creates an imbalance making the nose appear larger, the mid face top heavy and the lower face look short that de-emphasizes the lips and allows early formation of a double chin.  Chin augmentation using a chin implant will add projection to the chin creating harmony and balance to the lower face.   I have found that placement of a silastic chin implant, through a small curved incision under the chin (also allows excess skin removal) to be very safe, quick and highly effective.

 If you have "jowls” these are sagging facial tissues and an indication for some form of a SMAS facelift.  The underlying SMAS layer, of the face, must be dissected, lifted, trimmed and re-sutured (not merely folded or suspended with threads or sutures that will not last).  The excess skin is then removed and the facelift incisions closed.

My most popular facelift is the minimally invasive, short incision facelift that has all the benefits of more invasive facelifts (traditional, mid-face, deep plane, cheek lift and subperiosteal facelifts) but with these added benefits:
  • very small incisions
  • minimal tissue dissection = less bruising and swelling = rapid recovery ( several days instead of weeks or months with the more invasive type facelifts mentioned)
  • can be performed in 90 minutes or less, with or without general anesthesia
  • no incisions within the hair = no hair loss
  • excess fat can be removed
  • excess skin removed
  • cheeks, chin and jaw line can be augmented with dermal fillers (I prefer Restylane Lyft) or facial implants
  • most patients fly back home to parts all over the world in as little as 3 days post-op
I combine facial shaping with every facelift procedure.  When jowls are present, these should be done in concert and not alone or separately in order to create a naturally, more attractive face.

Hope this helps.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 28 reviews

Endoscopic face lift - under local?

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Thank you for asking about your endoscopic face lift.
  • It depends on what is being done and how longer the surgery takes.
  • The purpose of anesthesia is for it to keep you comfortable during surgery -
  • So your surgeon can do the best work and you get the best result.
  • General anesthesia is the standard - because local anesthesia may not be enough and when iv sedation is added for comfort, it makes surgery more hazardous than with general anesthesia.
Always see a Board Certified Plastic Surgeon. Best wishes  - Elizabeth Morgan MD PHD FACS

Endo brow lift under local

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While it probably can be performed using a good local block in key spots, you are probably better off with some sedation to relax you and to allow the surgeon to perform the procedure without having to also worry that the procedure is hurting you in anyway. This could distract from the result.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Endoscopic facial surgery and local anesthesia

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There is not one singular definition for endoscopic facelift. Depends on what the surgeon does. Remember that the type of anesthesia used is designed for the patient to be comfortable while the surgeon accomplishes the desired goals. This is determined for each patient with you surgeon.

Thomas Romo, III, MD, FACS
Manhattan Facial Plastic Surgeon
4.8 out of 5 stars 58 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.