Can I get full facelift under local anesthesia/twilight sedation as I have severe sleep apnea?

Question

Is it safer/possible to get a full facelift under local anesthesia or "twilight sedation" instead of general for severe sleep apnea? General anesthesia is not recommended, looking for other safe options. Thanks. 63year old female

Martin Jugenburg, MD · Answer

Hello, thank you for your question. Actually we perform all of our facelifts under local. Of course you are given some sedation and analgesics to help with pain. It is a safer method to utilize for facelifts.

Randal Haworth, MD, FACS · Answer

General anesthesia is usually safer because the endotracheal tube protects your airways during the procedure. Contrary to public perception, IV sedation relaxes the muscle around the throat and jaw which lead to obstruction of your airways. You also need more lidocaine which can be toxic.

Ozge Ergun, MD · Answer

The decision to undergo a full facelift under local anesthesia or twilight sedation depends on several factors, including your health status and the surgeon's preference. However, having severe sleep apnea can pose some risks during the procedure. General anesthesia may be preferred for patients with sleep apnea as it allows for better airway management during the surgery. It's important to discuss your sleep apnea and any related health concerns with your surgeon during your consultation to determine the best anesthesia option for you.

Donald Groves, MD · Answer

In short- every surgeon's practice is different. Although some surgeons prefer putting patients fully asleep under general anesthesia for this procedure, some perform it under IV sedation ("twilight sedation") with local anesthesia, or just under straight local sedation, as you are describing here. The severe sleep apnea is definitely a concern to bring up in both a conversation with your surgeon, and with your anesthesiologist. The last thing anyone would want is to do something unsafe in the setting of an elective surgery like this. Everything ultimately comes down to surgeon, anesthesiologist, and patient preference, so always have the conversation with your surgeon and anesthesiologist so you all know exactly what to expect, agree on the safest plan to proceed, and so everyone feels comfortable with how the procedure will be performed (if at all) prior to proceeding. I hope this helps!
Best, 
Dr. Donald Groves 
Plastic Surgeon

John Michael Thomassen, MD · Answer

With sleep apnea, your best option is local anesthesia with a light oral sedative.  This will keep you from obstructing your airway during the procedure.  You can get an excellent result this way.  If you are too anxious to do it awake, then a general anesthetic is needed.  Twilight will likely cause you to obstruct your airway during the procedure and is  probably not the safest option.

Gerald Minniti, MD, FACS · Answer

Whoever told you that general anesthesia is safer than sedation is incorrect. Twilight is an uncontrolled airway environment where you can obstruct. Under general anesthesia, your airway is secured and patent during the entire procedure. Afterwards upon emerging, it is 'twilight' anesthesia that might leave you more sedated compared to general anesthesia.

Zoran Potparic, MD · Answer

Our routine is twilight anesthesia for face lift patients. Very few are done under local only. However, in the case of sleep apnea, safest anesthesia is endotracheal general anesthesia since it provides safe airway through entire procedure. Hope this helps. Good luck.

Ahmad H. Ahmadi, MD · Answer

IV sedation in combination with local anesthesia for facelifts is my preferred way of doing the procedure. The combination produces relaxation and anesthesia to a greater extent than if used individually. Make sure that your surgeon is aware of your condition and concern. And always, follow your doctor’s recommendations.

Leland Webb, MD · Answer

In the setting of severe sleep apnea, twilight anesthesia could present itself as a significant risk to your airway and compromise safety. It may actually be much safer for you to have a facelift under general anesthesia under the guidance of a board-certified anesthesiologist and board-certified plastic surgeon. Furthermore, this would offer you possibly optimal results and given That you would be the most comfortable and safe in this scenario. This is a situation to discuss with your surgeon, who hopefully has a good relationship with his/her anesthesiologist, however, the airway is the most important, and when you have an anesthesiologist present, this person can focus on protecting your airway. Make sure that you choose the safest option for you.

Jyoshid R. Balan, MBBS, MCh · Answer

Hi good to hear from you It's absolutely safe to perform face-lift under local Anaestheisia and as a daycare procedure. RegardsDr jyoshid r balan

Can I get full facelift under local anesthesia/twilight sedation as I have severe sleep apnea?

Answers (10)

More Facelift Questions

No swelling or change after SMAS face lift

Please help me to get my old face back I have long moon face now and no idea how to correct it

Can one plastic surgeon do face and body well?

Why is it taboo to get a face lift under 40? If there is skin to lift, why not?

What could have caused my facelift scars to move to my face and ear? 9 months post op (photo)

Candidate for face/brow lift? (Photo)

WE SEND PRETTY
EMAILS