What Type of Anesthesia is Available for a Mini-facelift or S-lift?

Mini facelifts are now done under local tumescent anesthesia and are almost painless with the great techniques of administering the local now a days.  Cost is roughly $6-8500 and recovery is so much easier as well.  Sincerely,

David Hansen,MD

The short answer is, YES, a facelift can be safely done under local anesthesia.  The bigger question is, why would someone want to do that?  Most the time, those offering facelifts under local don't have sedation privileges granted by hospitals and state boards.  In other words, it's the family practice doctor who goes to a weekend course on facelifts and calls himself a "cosmetic surgeon", or the oral surgeon who doesn't have hospital privileges to do facelifts because he can't demonstrate appropriate training.  Just because a facelift under local is possible doesn't mean it's wise.  It hurts to do the injection, it hurts if even a tiny spot is missed with the injection during the incisions.  The sounds of surgery are disturbing.  Finally, the pulling and pressure sensation of the operation don't go away with local anesthesia.  Conversely, facelifts can be done under general anesthesia or under "twilight" sedation.  I prefer twilight anesthesia.  No breathing tube is necessary, the patient forgets 99-100% of the experience and it is very, very safe.  The medications used cause euphoria and make it an almost pleasant experience.  Finally, a certified nurse can administer the medications.  This means the cost of anesthesia is usually in the low hundreds of dollars.   

Great question.  It really comes down to preference.  Either local anesthesia, sedation, or general anesthesia are possible.  Some patients are anxious and would do better not hearing or seeing anything, others are confident and would rather have a quicker recovery with a local anesthetic.  Conscious sedation or IV sedation is a middle of the road approach where an anesthesiologist is still involved and there is still sedation to relieve anxiety but the downtime is improved since there is not a general anesthetic.  

Some patients will do better with general anesthesia while others with local alone. The tolerances of the patient, their medical history, and past experience with anesthesia are some of the factors we consider. There are pros and cons with either choice, and the best choice is the one that will give a given patient the best experience possible. Good luck!

Thank you for your question



I have pioneered my Concept Facelift, which targets the SMAS muscle and skin, therefore giving the same longevity as a traditional facelift, however is performed under local anaesthetic.  This ensures a significantly reduced recovery period, with minimum swelling and bruising, therefore patients returning to their daily routines within 5-7 days. My reasons for pioneering this were because patients did not want the health risk of going under general anaesthetic (especially as is it not a necessity procedure), local anaesthetic or twilight sedation would be a great alternative, not only for health reasons but your recovery period will be shorter.  It will depend on the technique used from surgeon to surgeon as too whether they will use local anaesthetic or general anaesthetic.



Please make sure you find a reputable and qualified plastic surgeon who can assess you properly to give you a realistic idea of what outcome you can achieve. 



All The Best 

#Facelifts and ancillary procedures are usually performed as #outpatient in a surgery center. A one night stay in post-operative care facility may be advisable in some cases. But, local #anesthetic combined with intravenous sedation is usually used. This will allow the patient to sleep through most of the procedure. General anesthesia is available upon request however is usually not necessary.The Lite-lift™ is generally performed with a local anesthetic and medication by mouth, which will keep you comfortable during the procedure and allow for an easier recovery.For more information about Lite-lift™, I welcome you to visit my website link provided below.

Great question Angie, I have performed
well over 2,500 facelifts under local anesthesia with oral sedation for the
past ten years. Without doubt it is safe and well tolerated by patients.
Compare to the traditional facelift procedures that are performed under general
anesthesia, the post operative complications associated with local anesthesia
cases are lower and risk of bleeding is minimized. The key to a successful
facelift procedure using local anesthesia is selection of the right patient by
the surgeon and his or her comfort doing these cases.

Hi and thanks for your question.  I offer both local and general.  There are advantages and disadvantages to each.  Local anesthesia avoids the expense of an anesthesiologist and the surgicenter fee, but there is some pain involved with the local anesthesia injections.  Once the injections are completed, there is no pain at all.  General anesthesia avoids the pain associated with the injections, but there is a very,very small risk associated with going to sleep.  Some patients have personality types that make them good candidates for local anesthesia and some for general anesthesia. I give my local anesthesia patients Ativan before surgery to relax them, but surgery can still be stressful.

This is a great question, as there are multiple options available for anesthesia during elective cosmetic procedures. What it boils down to, or should boil down to, is patient safety, comfort, and last: surgeon preference and comfort, which definitely plays some role.I was fortunate enough to do my cosmetics training with an incredibly wide breadth of surgeons in different cosmetic specialties within the core four: dermatologic surgery, oculoplastic surgery, facial plastic surgery, and plastic surgery. During that time, I did a large number of procedures under many different types of anesthesia, and developed my preferences from there.That being said, I prefer to do most of my cases with oral sedation and local anesthesia. This eliminates the need for general anesthesia, which often times is the most dangerous portion of the procedure, and it eliminates the long term cognitive issues with repeated bouts of general anesthesia. To boot, it allows the patient to return home immediately after the procedure to recover comfortably and safely there. There are no issues with blood pressure changes as there are after general anesthesia, which makes the postop recovery course less worrisome and less dangerous for getting a collection of blood, or hematoma.This type of anesthesia also completely eliminates the need for an anesthesiologist. From a financial standpoint, eliminating the need for an anesthesiologist makes the cost of the procedure last daunting.Again, you'll find multiple opinions and types of physicians doing the exact same procedure with different types of anesthesia, and this often boils down to surgeon comfort. Some surgeons just like their patients asleep. This tends to stem mostly from what their prior training was before cosmetics: someone who may have been a general surgeon or ENT and is now doing plastic surgery may prefer general anesthesia, as that is what they are comfortable with. I tend to find that the younger, more progressive and more recently trained surgeons are the ones most comfortable with local anesthetic procedures. It is interesting though, if you ask your surgeon who wants to put you under general anesthesia, it is likely that they use local anesthesia as well after you are under general already. Patients often ask, why? The answer to that is, it makes the dissection easier when you are doing a facelift or similar. I prefer to reserve general anesthesia only for when it's absolutely necessary necessary, which is not usually the case for an elective cosmetic procedure. This is not inappropriate, but general anesthesia should be justified by the procedure and safety, not surgeon comfort. To ensure you are receiving the highest level of care, seek out a dermatologic surgeon, oculoplastic surgeon, facial plastic surgeon or plastic surgeon who is board certified and fellowship trained in one of these "core four" cosmetic specialties.

Thank you for this great question. In my practice, this is a choice given to the patient. Local anesthesia is appropriate for patients having shorter procedures and those with good pain tolerance. Sedation is the most common option, and involves some medications to make you sleepy and control pain, but does not require a breathing tube. Finally, a small percentage of patients will request general anesthesia in order to be completely asleep for the surgery. As a final note, your overall health should be taken into account when making this selection and also when deciding on the appropriate setting for the procedures (office, surgery center, or hospital). Best of luck!

Thanks for posting your question. I have performed thousands of facelifts, neck lifts, mini lifts, blephs, lasers and chin implants all under local anesthesia and oral sedation (valium). Done properly, patients are comfortable and have an easier recovery both mentally and physically. There is an art and science to this local anesthesia technique to acquire a high level of patient comfort. My patients do not even require a narcotic prior or during their their procedures thus reducing nausea caused by narcotics. The risks, both short term and long term, of general anesthesia are eliminated. Please consult with several board certified surgeons experienced in facelifting and also in local anesthesia techniques.