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

why do some doctors do mini or s-lifts with local and others more asleep anesthesia?

Doctor Answers 44

Mini Facelifts are done under local anesthesia and are much safer than general.

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

Beverly Hills Dermatologic Surgeon
4.7 out of 5 stars 42 reviews

I prefer to do my face lifts with local anesthesia and...

I prefer to do my face lifts with local anesthesia and oral sedation.

Instead of sending heavy medication into the IV line to keep you asleep or sedated throughout the procedure, tumescent anesthesia uses only local anesthesia injected into the face to control pain, and Valium pills to relax you. The term "tumescent" (meaning swollen or puffy) comes from the appearance of the area immediately after injection, before the medicine is absorbed into the surrounding tissues. The medicine that is injected is a solution of saline (salt-water), epinephrine, and Lidocaine. Saline helps to separate the tissues, making the dissection less traumatic for the face. Epinephrine causes the tiny blood vessels in the area to constrict, minimizing bleeding and bruising. Lidocaine numbs the area to provide pain control, similar to what the dentist uses before filling a cavity in a tooth.

The procedure is performed without heavy medication and without a long post-operative recovery. Most patients are comfortably and safely on their way home about an hour after surgery. Since most of the medication used with tumescent anesthesia in The Awake Facelift is eliminated from the body within a few hours, there is no "hangover" effect such as is often experienced after general anesthesia. This also translates to less post operative nausea and vomiting.

Having the patient awake throughout the procedure enables the surgeon to maximize the aesthetic result with the least risk of complications. Nerve function can be continually assessed during surgery by having the patient raise the eyebrows, smile, or perform other facial expressions. Checking nerve function is critical to avoiding the rare complication of facial nerve damage, but this important precaution is impossible using general anesthesia or heavy sedation.

In some cases, patients might not be good candidates for the Awake Facelift, such as if they are tolerant to anesthetics (have a hard time getting numbed up at the dentist), take a lot of pain medications regularly, are very anxious or nervous, or have contributing medical concerns such as cardiac history. These patients are better suited for IV sedation.

Jonathan Hoenig, MD
Beverly Hills Oculoplastic Surgeon
5.0 out of 5 stars 40 reviews

Anesthesia concerns

I have done all my facelifts and necklifts ( along with blepharoplasties and liposuction if needed ) with simple, easy, and safe oral sedation and local anesthesia for the past 10 years. There is much less bleeding , much less swelling , and a simpler recovery period. The cost benefits and safety benefits are enormous. I do this for large facelift procedures, minilifts , S-lifts and all other facial cosmetic work. All experienced and qualified facial cosmetic (plastic) surgeons should long ago have adopted this approach for the safety, ease, and benefit of their patients..

Richard Galitz, MD, FACS
Miami Facial Plastic Surgeon
4.6 out of 5 stars 11 reviews

Anesthesia for facelift

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.

Kevin Sadati, DO
Orange County Facial Plastic Surgeon
4.9 out of 5 stars 204 reviews

Anesthesia for a Mini-Facelift

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.

Jonathan Pontell, MD, FACS
Philadelphia Facial Plastic Surgeon
4.8 out of 5 stars 103 reviews

It depends upon the patient

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!

Anand D. Patel, MD
Brookfield Facial Plastic Surgeon
5.0 out of 5 stars 19 reviews


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 

Anesthesia Used During a Facelift

#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.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 109 reviews

Anesthesia for cosmetic procedures

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.

Cameron Chesnut, MD, FAAD, FACMS
Spokane Dermatologic Surgeon
4.9 out of 5 stars 104 reviews

Anesthesia for Mini-Lift or S-Lift

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!

Evan Ransom, MD
Bay Area Facial Plastic Surgeon
4.9 out of 5 stars 110 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.