When having a facelift/neck lift, is local anesthesia the best way? And do you feel any pain?

Personally I believe that the best, safest, and most cost-effective way to perform a face and neck lift is under local anesthesia with oral sedation. In my hands, there is no compromise whatsoever in the quality of results with this technique. I want to emphasize that there are many excellent surgeons with great results who prefer other forms of anesthesia. I have a great deal of respect for all of my colleagues, especially those who excel in facelifts. But in my hands, with my experience, the procedure is best performed under local anesthesia with oral sedation. To answer your question about pain, there is no pain during the procedure. If there were any pain, the patient would be complaining and would simply be wiggling around too much for the procedure to be performed.  Obviously, such a situation is not an option - and so every patient is perfectly comfortable and pain-free during facelifts performed under local anesthesia.

Hi there, 
Every surgeon has techniques they feel comfortable with but in our practice we find patients are most comfortable with twilight anesthesia (IV sedation). This allows the patient to have no memory of the procedure and allows us to provide the procedural details and level of precision our patients expect.
Hope that helps and best wishes, 
Dr. Donath 

Hello, I generally don't recommend anyone have a facelift under local anesthetic unless there are medication allergies or medical issues involved. While surgeons can use local anesthetic to numb the area, some pain, tugging feeling can be felt. Also, when only local anesthetic is used, the patient can see, hear, and smell what is going on in the OR...which could be unpleasant and lead to a spike in blood pressure for the patient, etc. The biggest risk is if the patient moves while this is being performed, it could cause permanent damage or result in less than ideal results. It's better to just receive general anesthesia. Hope this helps. Best Wishes, Dr. Lane Smith Las Vegas, NV 

I prefer my patients to be sedated with local anesthesia. Some patients need general anesthesia and do better when completely asleep for the procedure. In the 34 years I am performing facelifts, neck lifts, Z lifts, with or without SMAS, the decision for which type of anesthesia is very important. Some physicians cannot perform the procedure with conscious sedation, they can only do it under general anesthesia. See a board certified ASAPS plastic surgeon in consultation. Good luck...

Dear entireworldpurple5, Thank you for your question. Doing a facelift/necklift under local anesthesia is not the most ideal way to perform this procedure, due to patient discomfort. This is a lengthy surgery. I suggest setting up a consultation with a Board Certified Operating Surgeon to explore your options. Best of luck to you!

I’ve performed almost all my cases under local anesthesia and these cases are the full face and neck lifts and not the mini or s lifts. There no reason not to perform Facelifts in this fashion. There is minimal pain associated with the procedure once anesthesized.

The best way to answer this is to consider that a facelift is really 3 procedures, the left and right side of the face and the neck.  Depending on the amount of surgical site factors like oozing, etc. a deep plane facelift with platysmaplasty takes 3 to 4 hours of operative time.  The question I ask patients is: how long they like to sit on a recliner by the pool? The average answer is 30-45 minutes, not enough time to perform a facelift properly.  Although it is less expensive to avoid sedation, the real reason for having this procedure is to obtain the result you are happy with, not to have the least expensive possible procedure.  Anesthesia techniques are very safe for healthy patients in professional hands (CRNA or Anesthesiologist).  So, in my opinion, local anesthesia is a way that the procedure can be performed, but certainly not the preferable way.  

Local anesthesia is a part of every face lift surgery regardless whether it is done in general, twilight or local anesthesia. It provides perfect loss of senasation and completely painless surgery even if done as  the only anesthetic. The only pain patient is going to fill in pure local anesthesia is the injection of the anesthetic in the face and neck; for that reason most convenient anesthesia for face/neck lift is twilight anesthesia, which is combination of sedation and local anesthesia. You should discuss type of anesthesia with your surgeon or anesthesiologist before surgery. Good luck.

Most surgeons, myself included, perform a facelift/necklift under general anesthesia for patient comfort and safety. There are many different types of facelifts/necklifts and the extent of surgery and technique influences whether or not the operation can safely and comfortably be performed under local anesthesia (which is always accompanied by some sort of sedation, though). Please note that the operation takes multiple hours and laying in a certain position without moving is not overly comfortable. Best wishes,Thomas Walker, MD, FACS

No, facelift/neck is a major surgical operation, and in my opinion- should be performed under General Anesthesia in a Professional setting. It is the safest and most reliable Anesthesia. I surge that you seek an experienced Board Certified PS for in person exam