Is it possible to have facelift without general anesthetic?

I was set to have a facelift, laser resurfacing, cheek implants, and upper and lower eyelid surgery. Then, six days before my surgery, I was told by my surgeon that the anesthesiologist said that my EKG made using general anesthesia too risky. I'm only 62 and have inherited my mother's "turkey neck." I cannot accept the fact that I will have to live with this for the rest of my anticipated long life. Is any procedure available with local anesthetic to help me? Sorry...I don't know how to attach photos.

Doctor Answers 35

Yes, you can; but patient safety still must be paramount.

Thank you for your excellent question.

You certainly can have a facelift done under local anesthesia +/- intravenous sedation that does not require general anesthesia.  Over the last 20 years, I have grown to prefer local anesthesia + IV sedation for performing facelift/neck lift procedures.

That may be a good option for you.  I think it is still very important to have a cardiologist to get your heart/EKG worked up and cleared for surgery, even if it is done under local anesthesia.  Local anesthetic agents can still cause heart rate to raise. So abnormal EKG changes would make me nervous even for a pure local procedure.

We all want you to be happy with your cosmetic result.  More importantly, we want you to have a safe perioperative course without any cardiac incidents.

You should seek out a board certified cosmetic, facial plastic, and/or plastic surgeon who is interested in working with you on your anesthetic choice to have your procedure done in the safety of a accredited surgical facility.

Happy New Year and Best Wishes!

Orange Facial Plastic Surgeon
5.0 out of 5 stars 23 reviews

Facelift Under Local Anaesthetic

Thank you for your question
I have pioneered my Concept Facelift, which targets the SMAS muscle and skin, therefore giving the same longevity as a traditional facelift, however is performed under local anaesthetic.  This ensures a significantly reduced recovery period, with minimum swelling and bruising, therefore patients returning to their daily routines within 5-7 days. My reasons for pioneering this were because patients did not want the health risk of going under general anaesthetic (especially as is it not a necessity procedure), local anaesthetic or twilight sedation would be a great alternative, not only for health reasons but your recovery period will be shorter.  My patients will experience slight discomfort when injecting the local anaesthetic, then will feel very relaxed and calm throughout the procedure (please watch video).
Please make sure you find a reputable and qualified plastic surgeon who can assess you properly to give you a realistic idea of what outcome you can achieve. 
All The Best 

Procedures may be performed under local anesthesia in experienced hands

Thanks for posting your question. I have performed thousands of facelifts, neck lifts, mini lifts, blephs, lasers and chin implants all under local anesthesia and oral sedation (valium). Done properly, patients are comfortable and have an easier recovery both mentally and physically. There is an art and science to this local anesthesia technique to acquire a high level of patient comfort. My patients do not even require a narcotic prior or during their their procedures thus reducing nausea caused by narcotics. The risks, both short term and long term, of general anesthesia are eliminated. Even under local anesthesia, I do choose to perform the procedure in an accredited surgery center (AAAASF). One final note, performing all these procedures will be too much to do under local.  I would consider doing these procedures in two phases. Please consult with several board certified surgeons experienced in facelifting and also in local anesthesia techniques.

Raymond E. Lee, MD
Orange County Facial Plastic Surgeon
5.0 out of 5 stars 86 reviews

Is it possible to have facelift without general anesthetic?

Yes a facelift can be done under local anesthesia with IV sedation. Combining a full SMAS facelift with cheek implants and 4 lid blepharoplasty would in my opinion be too much at once under local.

However, if Anesthesia will not clear you for general anesthesia they may not be willing to do IV sedation.

Facelift without General Anesthesia

Many plastic surgeons are quite comfortable doing facelift procedures without general anesthesia.  Local anesthesia with IV sedation is commonly used for providing anesthesia  for facelifts. Be certain that your surgeon is experienced in this approach and that you are operated in a facility in which you are fully monitored both in the operating room and the post-surgical area.

David N. White, MD
Palo Alto Plastic Surgeon

Great Facelifts without general anesthesia

I perform most of my facelifts with sedation and local anesthesia.  General anesthesia is needed for long surgeries, surgeries involving big muscles (like a tummy tuck) and surgeries that are very painful (like liposuction).  With a skilled surgeon, a full facelift or any variation can be easily performed without general anesthesia.  This significantly lowers your risk for complications due to anesthesia and shortens your recovery time!

Andrew Jimerson, MD
Atlanta Plastic Surgeon
4.4 out of 5 stars 542 reviews

Facelift under local and sedation

It is possible but you have to discuss this with your surgeon and anesthesiologist and make absolutely certain it can be done.

Michael Constantin Gartner, DO
Paramus Plastic Surgeon
4.7 out of 5 stars 137 reviews

Facelift is often done under local anesthesia with appropriate sedation


Facelift is often done under local anesthesia, with appropriate sedation, and I do almost all of my facelifts that way, avoiding fluctuation in blood pressure, and also limiting costs without compromising safety. Nonetheless, if you have an abnormal EKG, that requires further information, and likely the input of a cardiologist, as facelift is a totally elective procedure, and best done in patients with acceptable medical risks.  Also, any procedure done under local anesthesia requires both skill and patience on the part of the surgeon, as thorough knowledge of how to provide the local anesthetic, coupled with appropriate level of sedation are the keys to maintaining a comfortable experience.  Also, the procedure must be done in a certified ambulatory surgery setting, and not merely in a room set aside in the doctors office for procedures
I hope that this helps.

Thomas M. DeWire Sr., MD (retired)
Richmond Plastic Surgeon
4.3 out of 5 stars 35 reviews

Facelift under local

Yes, it is possible to have a facelift without a general anesthetic.  Generally speaking, mini facelifts, or in the case of my practice, the MACS lift is done under local anesthetic.  This lift is less extensive and less invasive than my standard facelift and is very easy to tolerate once the local is in (that part hurts though).  The key however is not avoiding general anesthesia.  The key is finding the surgeon who can do the best thing for your face and do it safely.  Good luck!

Scott K. Thompson, MD
Salt Lake City Facial Plastic Surgeon
4.9 out of 5 stars 107 reviews

Is it possible to have facelift without general anesthetic?

Yes, it is possible. But is it safe for you? Make certain local anesthesia/IV sedation are safe for YOU. Have your cardiologist clear you for any procedures involving any type of anesthesia/sedation. Hope this helps.
Best wishes.

Gary Horndeski M.D.

Gary M. Horndeski, MD
Texas Plastic Surgeon
4.6 out of 5 stars 222 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.