Anesthesia Used During a Facelift?

Almost all modern facelifts are performed with local anesthesia. The question then is only what sedation you administer in addition to the local anesthetic, and who administers it. The options are no sedation, oral sedation alone (i.e. valium), deep intravenous sedation, or a light general anesthetic.
When the airway may be compromised, for example by bleeding during surgery, or in a patient with reflux disease, it is usually better to have the patient asleep with a tube protecting their airway.
In our practice, when a deep intravenous sedation or light general anesthetic are administered, these are performed by a board certified anesthesiologist (not the surgeon pushing drugs on his own) in an accredited outpatient surgery center or hospital.
For mini-lift type procedures in a compliant patient, a local anesthetic may be fine. For a patient having a full facelift with many ancillary procedures, deep sedation or a light general anesthetic may be preferable. Your doctor should be able to discuss with you all the options above. And remember, safety first!

The anesthesia that is used depends on the surgeon and the type of facelift that is being performed.  Local anesthesia to general anesthesia is performed for face and necklifts.  I personally do the majority of my facelifts under general anesthesia. This allows the patient to be as comfortable as possible for the procedure as it typically takes several hours for the surgery. 



General anesthesia also allows me to do a high lateral SMAS plication, platysma band plication and full facial fat grafting as part of the facelift.  The SMAS elevation allows me to restore volume to the mid – face while maximizing the longevity of the facelift.  The platysma band plication allows me to repair the neck muscles that have fallen. It also allows me to lift the neck improving the overall contour of the neck. 





Fat Grafting is a relatively new procedure that has dramatically improved the results of facelifts.  It restores the volume that patients lose over time.  The combination of restoring the volume, repositioning the soft tissue of the face and removing the extra skin of the neck and face is what gives patients an amazing but natural and youthful appearance to their face and neck after surgery.





Please discuss with your board certified plastic surgeon about you facelift options and what anesthesia is performed during your surgery.  

This is a very common question. Facelift surgery can be done under local anesthesia, IV sedation plus local injections, or general anesthesia and depends on several factors. These include the type of facelift being done, patient health and anatomy, and the surgeon’s experience and preference. All of this is typically discussed at your initial consultation. My preference for most patients is MAC anesthesia, which is a type of IV sedation that many people have for procedures like colonoscopy. You are not intubated during MAC anesthesia, you breathe on your own but you have little memory of what happens. The medications wear off very quickly at the end of the surgery and patients generally have few side effects. As always, I advise patients to choose a board-certified plastic surgeon experienced in facial surgery and find someone you connect with and trust. Good Luck!

Either way is a completely reasonable alternative in competent hands. General anesthesia is very very safe in healthy individuals, and is usually very well tolerated. Local anesthesia with sedation is often my preferred method though, as it allows for briefer recovery times overall, with oftentimes less swelling and bruising in my facelift practice. This is because many of the agents used to put you to sleep make the blood vessels dilate, contributing to that swelling and bruising.  Overall, I’d tell you that this question is pretty easily addressed with your surgeon. What are both you and he comfortable with? Are you ok at the dentist, or does even that require sedation? How long is the expected duration of the procedure? I think longer than three hours, you might consider general, mainly because some people get tired of laying on their back longer than that. Also, if you have any substantial medical issues, it may be best to have an anesthesiologist on the team.

I perform all of my surgeries at an accredited surgical center staffed with RN's, CRNA's and Anesthesiologists. My patients are given moderate sedation (just like a colonoscopy) they are completely unaware of what is happening, but they are not intubated and are breathing on their own. In my hands I think this is the best technique. 

Thank you for your question. Every patient is different. Every surgeon differs in their preferences. The only way to guarantee that you won't hear something, feel something, or experience something you may find distasteful, is to give you a General. The level of General required is less than if you broke a bone or were having intra-abdominal surgery. That being said my anesthesiologists give great "twilight" anaesthesia. Discuss with your surgeon. Your comfort is important in your experience.