Awake during facelift and I felt everything; is this acceptable?

I was awake during facelift+ Facial surgery. I told the Dr I was awake and he did not do anything. I felt every injection, slice of skin, and stitches. It was horrible. After the procedure, I told them of my ordeal. No person on the surgical team nor Drs had any remorse nor cared. They had hoped the Versed eliminated my memory but it did not. I am in agony over this, I have panic attacks and nightmares every night. Is this acceptable? I can not get past this without therapy. Please advise.

Doctor Answers 15

Awake during facelift

I am so sorry that you had such a horrible experience. While it is perfectly safe to do a face/neck lift under local anesthesia, it sounds as if your surgeon did not get it right. There is simply no excuse. Obviously, you need to speak with your surgeon about this. In the meantime, continue with therapy. It should definitely help with the panic attacks. 


Kouros Azar

Thousand Oaks Plastic Surgeon
4.8 out of 5 stars 21 reviews

Aware of pain during procedure

This is truly every patient's worst nightmare. It's obviously a problem with the administration of local anesthetic. The only thing more nightmarish is being aware of everything but being unable to talk or move...I've never seen this happen, but patients ask about it often. There just isn't an excuse for either scenario in contemporary plastic surgery. Therapy may be a good idea.  I presume you've spoken to your surgeon about it.

Norman Leaf, MD
Beverly Hills Plastic Surgeon

Local Anesthesia and Facelift

I am so sorry you had to experience such a traumatic experience. Let me first say that it is perfectly acceptable to perform a full lower facelift and necklift under local anesthesia with conscious sedation. It makes the process generally safer and cost effective. That said, there certainly is an "art" to doing it in this manner. Placing the anesthetic initially requires a few pinches to get started. The rest of anesthesia placement is technique. Some surgeon's are gifted at it, others not so much. Certainly it is not ideal to have you totally uncomfortable for this initial part, let alone the entire procedure. Versed and that class of medications can sometimes have different effects on different patients. Obviously you did not have amnesia. I would seek your PCP for some advice and perhaps some temporary sleeping medication to help you through the night. 

Paul Lanfranchi, DO, FAOCO
Las Vegas Facial Plastic Surgeon
4.9 out of 5 stars 53 reviews

Pain during Facelift Surgery

I am very sorry to hear about your experience. Its often a good idea to review all the medication you received during the procedure and if an anesthesiologist was involved. 

For my surgery, any surgery over 1 hour of if I am concerned, I have an anesthesiologist involved to ensure patients have no pain or negative experience with the surgery.

James P Bonaparte 

James Bonaparte, MD, MSc, FRCSC
Ottawa Facial Plastic Surgeon
5.0 out of 5 stars 17 reviews

Awake during the facelift

Thanks for the question.  I am sorry to hear about your experience.  I do about 75% of my facelifts under oral sedation and tumescent anesthesia (a numbing solution injected into the area of planned surgery).  It sounds like you were not adequately numbed for the procedure or the medications were not given ample time to take effect before beginning the procedure.  Either way this is not really acceptable.  Perhaps it is time to seek services with another board-certified plastic surgeon. 

Bad experience with IV sedation and local with a facelift

This really should not of happened to you. Facelifts can be done with sedation and local but most patients fare better with the general anesthetic. If you were complaining of discomfort during the procedure the medication should have been increased.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.9 out of 5 stars 32 reviews


Clearly your reaction and pain are unacceptable.  Sedation during facial surgery is highly recommended. General anesthesia is often necessary for longer (3-4 hrs) procedures. You should not be having pain now. Since it is already done there isn't much you can do. I'm sorry this happened to you.

Talmage Raine MD FACS

Talmage J. Raine, MD, FACS
Chicago Plastic Surgeon
4.5 out of 5 stars 8 reviews

Awake During Facelift

First of all, I am very sorry that you had a bad experience.  The reason I perform 100% of my facelifts under sedation is to avoid the scenario that you had to endure.  In my opinion, a several hour OR experience is beyond the capacity of most people.  The analogy I use is the "lounge chair by the pool".  How long is this comfortable for you? For most patients, one hour is plenty and most well performed facelifts far exceed one hour. Secondly, if you had this experience and you actually paid for anesthesia, you may want to discuss this again with your Surgeon.  Versed alone, which is very short acting, is an insufficient way to sedate most anxious patients. 

Stephen Prendiville, MD
Fort Myers Facial Plastic Surgeon
4.8 out of 5 stars 82 reviews

Awake with pain during facelift

Dear CINZIA77:

Sorry you had this experience! This would be most unusual with today's medications and monitored anesthesia care!

There are so many issues and concerns that are not made available in your post. My recommendations is to:

  1. Request a copy of your records including your operative note and anesthesia record.
  2. Arrange a second opinion by a Board Certified Plastic Surgeon who performs cosmetic facial surgery routinely
  3. Arrange a consultation with a psychologist to review your concerns

Certainly, anesthesia affects each patient uniquely and I feel terrible for your experience. Beyond this, your description of the Dr. and surgical team are worrisome. Maybe your Primary Care Physician can be of help.

I hope this is helpful and I wish you well.

Dean P. Kane, MD, FACS
Baltimore Plastic Surgeon
4.8 out of 5 stars 70 reviews

Face lift - felt the surgery. Is this acceptable?

Thank you for asking about your face lift.

  • I am so very sorry you had such a bad experience.
  • Without knowing all the facts, one can't take a definite stand but this is the usual expectation.
  • You may be awake and aware and feel pressure + movement during an iv sedation/local anesthesia face lift.
  • You may feel the injections
  • You may feel pain at intervals, requiring additional injections to control the pain.
  • This approach would not usually cause panic attacks and nightmares.
  • On the other hand, having surgery while feeling the pain of surgery throughout the procedure will give most people panic attacks and nightmares - and their pain will be evident to the surgeon.
  • The only justification for such surgery would be an inability to numb the area combined with an inability to stop the surgery, e.g. significant bleeding.
  • Otherwise, surgery would usually be terminated and done later, under general anesthesia.
  • The problem with awake face lifts is that sedation sufficient to stop pain may be sufficient to stop the patient from breathing - needless to say, a major emergency.
  • But in any situation in which you are subjected to severe pain by a doctor, you are entitled to an explanation, acceptance of responbility by the doctor and an apology.
  • Always see a Board Certified Plastic Surgeon. Best wishes  - Elizabeth Morgan MD PHD FACS

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.