Facelift with Xanax and local?

My doctor performs a facelift with Xanax and local anesthesia. Will I be awake (I don't want to) or feel any pain?

Doctor Answers 23

Facelift under local anesthesia and oral sedation

Thanks for sharing.  I have performed thousands of face and neck lifts under local anesthesia and oral sedation. In the properly trained and experienced hands it is very possible to do a facelift this way.  There are limits in terms of length of procedure and underlying patient anxiety. Once the local anesthesia and meds have taken effect you do not usually feel pain and are actually likely sleeping.  This is a nice alternative to being under general anesthesia or iv anesthesia especially for someone who wants less risk and less cost.  Make sure your doctor has performed his facelifts hundreds of times this way and has great patient testimonials attested to this method

Orange County Facial Plastic Surgeon
5.0 out of 5 stars 86 reviews


Dear luchaboo, I would never perform a facelift with xanax and local anesthesia and this is not really the normal protocol for this procedure. I would ask myself why does he perform this under local anesthesia and the answer will probably be that the surgeons operating facility is not accredited which means the only anesthesia they are allowed to use is local. I perform all procedures in my private fully accredited operating facility with a board certified anesthesiologist and facelifts always under general anesthesia. Regardless of the patients discomfort that may be involved in a local face lift there are safety issues which should be addressed. Remember the great Joan Rivers decided not have an anesthesiologist present and had her surgery performed under local and the results did not go well. I have no doubt that had she had an anesthesiologist caring for her, the outcome would have been very different. You do not want a patient having multiple injections of xylocaine on a table for three to four hours in discomfort. Many patients who are undergoing face lift procedures are in their late forties to early fifties and could have underlying issues with blood pressure or other concerns that could be problematic with the xylocaine injections. It is best to have the patients safety and comfort in mind at all times. Best regards, Michael V. Elam, M.D.

Michael Elam, MD
Orange County Facial Plastic Surgeon
5.0 out of 5 stars 208 reviews

Facelift under local

I used to observe the renowned Lawrence Robbins do face/neck lifts in under two hours under local anesthesia with only MINOR sedation. That is a surgeon with THOUSANDS of facelifts under his belt. In most instances, in my 26 years experience, the facelift results of patients done under local anesthesia were limited and temporary at best. IF....someone has minimal changes, it could be a more reasonable option.I do not know your surgeon so cannot peak specifically about her/him.

Robert H. Hunsaker, MD
Miami Plastic Surgeon
4.5 out of 5 stars 79 reviews

Facelift with local anesthesia & Xanax

For the right patient, an "in office" facelift with local anesthesia and Xanax can be a completely safe option. You will feel some pain from the anesthesia injections and although some patients sleep through the procedure, others are awake though relaxed. Given your anxiety, I would encourage you to get a second opinion from another board certified plastic surgeon in your area to determine if this is really a good option for you.


Kouros Azar

Kouros Azar, MD
Thousand Oaks Plastic Surgeon
4.9 out of 5 stars 33 reviews

"awake" facelift

Dear Luchaboo:Many facelifts today are indeed done with oral sedation and local anesthesia -- with safety and patient comfort. I have done many of these (though usually with a bit more medication than just Xanax), and have always encouraged this approach over surgery under general anesthesia, as there is clearly less risk with local anesthesia, and certainly costs our patients less. I have never purported the procedures can be "painless", telling my patients that they will be "sleepy", but not "asleep", and, if there is pain, more local anesthetic can be injected in that specific area, and work done in another part of the face and neck until comfort returns to the site, and then the area is addressed; in my experience with hundreds of these procedures, this approach has been well-tolerated. The only way to "feel nothing" is to be put under a general anesthesia (and incur the attendant risks of being "out" --and this can be significant, especially if it is for multiple hours, as when facelift, eyelids, browlifting and/or laser resurfacing  combinations are performed in a single sitting). Talk to a board-certified plastic surgeon experienced in the "awake" facelift process to discuss these factors. Good luck!Sincerely, James H. Scheu, M.D.

James H. Scheu, MD, FACS
Saint Louis Plastic Surgeon
4.4 out of 5 stars 24 reviews

Facelift with Xanax and local?

A facelift can be performed with local anesthesia. However, this means that the patient is awake. It is like a prolonged dental procedure. An experienced surgeon can make a patient relaxed and comfortable but some discomfort especially with the injections of the local anesthesia is expected. It is not for all patients for sure. Many prefer to be asleep for the procedure. Some patients are afraid to be asleep with anesthesia and others are worried about possible risks in addition to nausea some experience. For some patients local anesthesia may be the preferred method. For others, general anesthesia works best.

George Volpe, MD
Newton Plastic Surgeon
4.8 out of 5 stars 26 reviews

Facelift and Local Anesthesia

It is becoming more common for Plastic Surgeons to perform facelifts under local anesthesia with mild sedation. Having personally performed all of my facial procedures this way for ten years, I can say that it is both very possible and has numerous advantages for the patient. The first advantage is the safety. By not having to undergo general anesthesia, you avoid all of the real risks of damage to your heart, lungs, brain etc. Secondly, when performed in this manner, the overall cost to the patient should be less since there is no anesthesiologist or facility fee to pay.That said, there truly is a learned skill when it comes to making the experience comfortable for the patient. There are numerous little things (ie the amount of light in the room, the size of the needles, the music playing, the energy of the doctor etc etc) that add up in making the experience of local anesthesia placement and the actual surgery successful.So long as you trust your surgeon, all you need to be sure of is that he/she does most of his/her procedures in this manner. If they only perform an occasional procedure under local, then I would possibly reconsider since this method is something that takes a bit of practice to perfect. Hope this helps, and best of luck to you! Doc L.

Paul Lanfranchi, DO, FAOCO
Las Vegas Facial Plastic Surgeon
4.9 out of 5 stars 64 reviews

Local Anesthesia

Certain lesser facelifts can be performed under strictly local anesthesia and oral sedation.  You will likely feel some of the anesthetic shots as it takes many.  You will also "hear" the sounds of cutting by your ear. 

Keith Denkler, MD
Marin Plastic Surgeon
5.0 out of 5 stars 18 reviews

Wide awake surgery is increasingly popular but that doesn't mean it's appropriate for you

"Wide awake" cosmetic surgery has been promoted recently.  Its proponents suggest that breast augmentation patients can actually participate in their surgical outcomes.  Like the other consultants, I rely on BC Anesthesiologists to take care of our patients experience during procedures such as facelifts.  For the properly selected patient, upper eyelid lifts can be offered  but this is a shorter procedure, which will generally not stress the patient unduly.  If you don't want to be awake or experience any pain, choose either IV sedation or general anesthesia, administered by a BC Anesthesiologist in an accredited surgical center. 

Lavinia K. Chong, MD
Orange County Plastic Surgeon
4.8 out of 5 stars 58 reviews

Facelift under local anesthesia

Thank you for your question. The answer depends on your comfort with a local facelift as well as the surgeon's comfort and experience with the procedure. Some of the best facelifts I have ever seen have been under local anesthesia, with less bleeding, bruising and a therefore, a quicker recovery. Admittedly, these were done by surgeons with an exceptional level of skill and experience with facelifts under local anesthesia, usually with some form sedation. These particular surgeons have done so many of these procedures that they have become extremely efficient, with average operative times under two hours. They have also tailored the local anesthetic solution so that they are long lasting with little discomfort on injection. Most surgeons are more comfortable with facelifts done under general anesthesia. I would ask your proposed surgeon what he or she is most comfortable with, as well as their level of experience. Unlike most other types of plastic surgery, there is a wide variation in experience level for this procedure. Then base your decision on what you are comfortable with.

Ben Lee, MD
Denver Plastic Surgeon
4.5 out of 5 stars 25 reviews

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.