Deep plane revision without general anesthesia, thoughts?

With local anesthesia and sedation almost any primary surgery can be accomplished. However, it mostly depends on the patient. If someone is calm and has minimal surgical complexity it makes sense. Revision cases where longer surgical times may be needed often times people are more comfortable and the surgery can be accomplished with less total time and anesthetic under MAC sedation or “Big MAC” which uses an LMA and avoids paralysis while also allowing the patient to stay shallow enough to protect their own airway. Not everyone is a candidate but it makes recovery faster and people feeling like themselves quicker. It also keeps everyone much more comfortable during the procedure.

This is a possible option. In my hands, it is much more comfortable for the patient to be asleep under general anesthesia.

Many providers use this technique for deep plane facelift surgery. Local and tumescent anesthesia is also used so there is no discomfort. We use intravenous sedation for the majority of our cosmetic surgeries.

In our practice, all deep plane face lifts, including deep neck lifts are performed under general anesthesia for patient safety and comfort. It's very difficult to undergo oral sedation procedure that takes 3 to 4 hours and be comfortable. In addition, you'll have conscious awareness of the entire procedure, including the numbing shots throughout the entire face and neck repeatedly. Choose your surgeon based on natural results, so study their facelift photo gallery carefully, not the type of anesthesia performed.

But, use general anesthesia. The local anesthesia stops nerves from working so some safety is lost. The surgeon will be less able to know if they are getting close to a nerve (as it will not be working and the muscles on the face won't twitch).
We do these procedures with propofol anesthesia (through an IV). It's safe, effective, and you wake up feeling good.

I’ve done facelifts under just Valium. It friends on the extent of work to be done and the patient’s willingness to have it done that way . For a limited revision it should be no problem

I do not recommend attempting a deep plane lift without general anesthesia because you will not have good pain control with just local anesthesia. I am not sure you will find a surgeon to do a deep plane with without a general anesthetic. I have done SMAS lifts with local and IV sedation and this works well for many patients.

Without posting photos to see what the issues are impossible to respond to this question most likely if you think you need to revision, it will be much more involved than just using local anesthesia but again must repost some photos before and after would be very helpful for a virtual consultation. Expect fees to range from $8000-$15,000