Face lift without general anaesthesia. Is local anesthetic possible?

Question

I have been given a very thorough medical and given clean bill of health but hiatus hernia precludes general anaesthesia for elective surgery. Could local anaesthetic be offered?

Semih Yildiz, MD, FEBOPRAS · Answer

A facelift can sometimes be done with local anesthesia plus oral or IV sedation, especially if the procedure is limited, but it is not the safest or most comfortable plan for every patient. The decision depends on the extent of lifting, expected operating time, your ability to remain still, airway and reflux risk, and whether the surgeon has a qualified anesthesia team available.

A hiatal hernia does not automatically rule out facelift surgery, but it should be discussed directly with an anesthesiologist because aspiration risk and medication choices matter. I would choose a board-certified facial plastic surgeon or plastic surgeon who can coordinate with anesthesia and offer a plan based on your medical clearance, rather than promising "local only" before an exam.

Stephen Prendiville, MD · Answer

To answer your question, a facelift under local anesthesia is possible and is the preferred method for some Surgeons.  Many of my patients prefer having anesthesia.  I am unsure why a hiatal hernia would prevent you from having elective anesthesia when otherwise healthy.  Appropriate preoperative treatment of gastric acidity and appropriate timing of being NPO should address concerns.

José Eduardo Telich Tarriba, MD · Answer

Dear janieengland, thank you for your question!
Yes, a facelift can be safely performed without general anesthesia in many cases. Local anesthesia combined with sedation (also known as “twilight anesthesia”) is commonly used . This technique allows you to remain relaxed and comfortable while avoiding the deeper effects of general anesthesia, which is particularly useful in patients with specific health considerations.
It’s important to choose a board-certified plastic surgeon who is experienced with facelifts under local or twilight anesthesia. They should work alongside a qualified anesthesia provider to ensure a smooth and safe procedure tailored to your needs. Be open during your consultation about your medical history so the team can plan accordingly.

John Michael Thomassen, MD · Answer

Most facelift procedures can be comfortably performed under local anesthesia.  This includes deep plane lifts and SMAS lifts.  Endoscopic lifts would require at least some IV sedation to keep the patient comfortable.  Deep neck procedures require IV sedation or General Anesthesia.

Adam D. Stein, MD · Answer

Great question!
Absolutely- at my practice I exclusively perform facelift procedures under local IV sedation. The "twilight" sedation approach ensures that patients are comfortable and relaxed, but breathing on your own.
While some surgeons may choose to only utilize general anesthesia, a facelift does not have to be performed with it.

Anil R. Shah, MD · Answer

Hello,
Yes, a facelift can be performed under local anesthesia. In many cases, local anesthesia is combined with nitrous oxide (commonly known as laughing gas) to enhance patient comfort and relaxation throughout the procedure. This approach can be a safe and effective alternative to general anesthesia, depending on the extent of the surgery. It is always best practice to consult with a skilled facial plastic surgeon.

Jeffrey M. Darrow, MD · Answer

A full facelift and neck lift can be accomplished under local anesthesia alone. It is common to give some oral medication for sedation so patients can relax during the procedure and it is a positive experience. The medication‘s used for the local anesthetic last approximately four or five hours so this is ample time for the procedure to be done.  Speak with your plastic surgeon about whether they offer this option. Best wishes.

Oliver Chang, MD · Answer

Short answer is yes, you can do a facelift under local anesthesia - the real question is can you handle that though? There will be times where you feel things, things might hurt or sting, and it will be many many hours of trying not to move or scratch / touch something on your face. 
More commonly, light sedation can be done where there is no ET tube (breathing tube) and only oxygen via canula is given while you are being monitored with pulse oximetry. Local anesthesia is given here as well, and sleeping during the procedure. 
But if the hiatal hernia is of issue, that should be addressed first prior to any elective cosmetic procedure. That way, there is one less risk to deal with even undergoing light sedation or local anesthesia.

Matthew Tamplen, MD · Answer

Hello,Yes a facelift can definitely be done under local anesthesia. Sometimes we can give some oral medications to help with pain and relax you for the procedure. In the right patient the procedure can go very smoothly. 
Best,Matthew Tamplen MD

Michael I. Echavez, MD · Answer

A facelift can be done without general anesthesia, but it would be up to the surgeon as to which type of anesthesia to use.  Some surgeons may not do a facelift without general anesthesia, but some may.  You would need to discuss this with your particular surgeon.

Face lift without general anaesthesia. Is local anesthetic possible?

Answers (12)

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