Does every facelift need to be done under general anesthesia?

This is a very common question for patients seeking facelift surgery. The level of anesthesia that is necessary is enough that you are compliant enough to allow the steps of surgery to proceed while not in pain or anxious, while still breathing for yourself. When more extensive neck work needs to be performed, it is best to have an airway placed, necessitating a deeper form of sedation. I prefer to have he least amount of sedation necessary to perform the task at hand, but sometimes general anesthesia is a better and safer option.

This is a common question that many of my facelift patients have. I favor deep sedation to general anesthesia for facelift surgery as it gives the patient the most comfort to allow me to execute surgery and give a perfect result. I understand the allure of avoiding general anesthesia, however, with a deeper understanding of the spectrum of anesthesia, I find patients prefer this approach over other types when weighing risks and benefits.

Anesthesia is best understood in the context of a spectrum of sedation. There are four levels of sedation: 1. Minimal, 2. Moderate, 3. Deep and 4. General anesthesia. The same types of anesthetic medications are used with each level of sedation---just varying amounts and combinations. Think of minimal sedation as taking a xanax prior to a minor procedure. This is common in dentistry and other fields. The patient can follow verbal commands, but may have some cognitive and functional impairment (i.e., don't drive yourself home!). With minimal sedation, you still feel pain, so your surgeon would inject numbing medication in your face while you are awake so that you don't feel surgery.
At times you may still feel pressure or uncomfortable sensations similar to having a cavity drilled and filled while you are awake. Moderate sedation is the next level of sedation where consciousness may be impaired, but you are still able to make purposeful responses to verbal and tactile stimulus. Similar to minimal sedation, the surgeon is relying on injecting local anesthesia to avoid you feeling the surgery. The next level, deep sedation, is where an anesthesiologist uses medications (usually through an IV) to decrease consciousness to the point where you may not respond to limited painful stimuli, but may still be able to breathe on your own. This is a common level of sedation used in colonoscopies and other similar procedures. In general anesthesia you do not feel painful stimuli. You may still be able to breathe on their own but often requires assistance from the anesthesiologist.

My preference for facelift surgery is the spectrum between deep sedation and general anesthesia. Once asleep, I comfortably inject local anesthesia into the surgical field so that you don't feel painful stimuli and the anesthesiologist may limit the amount of anesthetic medication (and therefore the level of sedation) is required. This not allows you to be comfortable during your procedure without experiencing pain, but also minimizes the untoward effects of anesthesia such as nausea and vomiting and speeds recovery.

I typically perform all of my face and neck lifts under local anesthesia (no general / no sedation). My Trl-Harmony lift is a mini deep plane, lower face and neck lift that uses advanced techniques to naturally lift the skin and deeper tissue of the face and neck (SMAS and platysma) - correcting the effects of aging and weight loss. This results in natural looking refresh of the face with minimal downtime and no anesthesia issues. This is often combined with CO2 skin resurfacing, neck liposuction, and fat grafting in the same procedure.

Check out the link below for more info on the Tr-Harmony Lift.

A detailed examination will help delineate the best surgical option and provide you a custom plan for your face and goals. Check out our "Instant" Consults at the link below.

Hello Thank you for your question.
As far as I can understand from your question, It is absolutely not possible to have this operation outside of general anesthesia.
It would be better face to face consultation.
Best regards!

Thank you for your question. Facelift and neck lift surgery are commonly carried out under twilight anaesthesia including the deep plane techniques for both face and neck.
This is a point that you should with several surgeons and get an understanding of what they would offer.
Twilight anaesthesia is a well-established approach these days for facelift interventions.

I would highly recommend doing it under general anesthesia. I have done both under local anesthesia and general anesthesia. Your surgeon can be far more aggressive under general anesthesia without having to be worried about your comfort level.

Not necessarily. Facelifts can be done with sedation or local only. It just depends on what you and your surgeon are comfortable with.

You can have a facelift under deep sedation. This involves an IV that will give you medication to drift off to sleep, but a breathing tube will not be placed. Your body is still able to regulate its own functions. This is similar to what people have when they get their wisdom teeth out, but possibly a little deeper. You wake up much faster and can go home sooner than with general anesthesia.

Ga is the most convenient way for both the surgeon and patient if you want to have a through surgery.
Please discuss with your potential anesthesia doctor what they are going to use; you can always have a better experience with better agents & better anestthesia coctails and better adjustment
Although in my experience I dont suggest there are surgeons who do surgery under sedation + local anesthesia coctail. But I would question the depth/extend/ throughness of the surgery
Hope this answer helpsGood luck, Doctor Be+ Clinic

Hi @Phenomenal294687, thank you for your question! In my opinion, Facelift surgery is best performed under general anesthesia. However if you begin to feel anxious or panicky during the procedure, it is crucial that you communicate your concerns to your surgeon or medical team. They can offer additional support and guidance to help you feel more comfortable and alleviate any fears you may have. Best of luck!

Alan Gonzalez MD, FACS. Member of the American Society of Plastic Surgery (ASPS), Member of the International Federation of Adipose Therapeutics and Science (IFATS), Member of the American Society of Plastic Surgery (ASPS), Member of the Colombian Society of Plastic Surgery (SCCP).