Can a complete neck lift be done under local anesthesia with ORAL sedation? Under the chin incision, does it help w/ lifting?

I have excess skin under my neck (a turkey waddle) and dropped muscles. I need to have a plastysmaplasty. I have consulted with two fine surgeons who have different approaches to this matter. One proposes the use of local anesthesia with oral sedation, the other, local anesthesia with IV sedation. Both have almost the same approach to neck lift--a cut in front to back ear, down the neck. One surgeon also recommends a small incision under the chin I am OK with this, better than drooping.

Doctor Answers 14

Facelift / neck lift under local anesthesia

Thanks for your question. A lower facelift with neck lift including liposuction and platysmaplasty can be done under local anesthesia + oral sedation or with iv sedation. That said, administering the local + oral sedation does involve experience and skill. I have successfully performed several thousands of lifts this way and is my preferred method as I feel I get a superior platysmaplasty result and an easier recovery for my patients. Many docs are not comfortable with administering it and would rather put the patient to sleep.  In my opinion I would pick the surgeon who you think can deliver the results and not strictly on the anesthesia  method. Note, the submental incision is needed to perform  proper neck Lipo and midline platysmaplasty.  

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

Local with oral sedation is safe and preferred

A face/ neck lift with a bit of cervical liposuction and a medial platysmaplasty is what the surgeon who is recommending the chin incision is planning. 
The other is planning face/neck lift and lateral platysmaplasty.
both work.
both safe.
i prefer local with oral sedation but  both are OK.
the real decision is who's before and after pictures give you confidence in the fact that you will get a good result.
look for someone with a neck like yours and their result!

Ritu Malhotra, MD
Cleveland Facial Plastic Surgeon
4.6 out of 5 stars 10 reviews

Planning a neck lift

Thank you for asking about your neck lift.

  • Depending on the severity of your problem, oral sedation + local anesthesia OR iv sedation + local anesthesia OR general anesthesia are acceptable.
  • The incision under the chin is to tighten the platysma muscle.
  • Each approach has its pros and cons.
  • With oral sedation + local, you are more awake and may feel pain which may limit how much can be done. Because severe bleeding is a risk of this surgery, your surgery needs to be done in a fully equipped operating room.
  • With iv sedation + local, you MUST have surgery in an accredited out-patient surgery center with a CRNA or anesthesiologist tending to you - otherwise you may stop breathing during surgery, creating a true crisis 
  • With general anesthesia, you feel no pain, your airway is controlled so it is safer but you have more recovery from the medicines.

Always consult a Board Certified Plastic Surgeon.
Hope you find this information helpful. Best wishes.

Elizabeth Morgan, MD, PhD
Atlanta Plastic Surgeon
4.6 out of 5 stars 43 reviews

Neck lift and local anesthesia

A neck lift can be done under local anesthesia. I prefer doing a neck lift procedure under general anesthesia but each surgeon will have their own rational for a type of anesthesia. I recommend a sub-mental or chin incision when I feel its appropriate to achieve the best result. In my opinion, you have to decide which surgeon you prefer and where you feel most comfortable. You will certainly have more awareness when having a neck procedure under local anesthesia and oral sedation. 

Jason S. Cooper, MD
Jupiter Plastic Surgeon
4.9 out of 5 stars 30 reviews

Neck Lift Under Local Anaesthetic

Thank you for your question.  Neck Rejuvenation (plastysmaplasty and neck lipo) can be performed under local anaesthetic with oral sedation and local anaesthetic with IV sedation, both which I frequently use (this will depend on your preference).  Local anaesthetic still giving the same longevity and results however meaning a significantly faster recovery time.  Local anaesthetic having minimal health risks compared to general anaesthetic.  There will be no dressing or drains afterward.  This is performed as a day case, walk-in walk-out procedure with minimal bruising and downtime.  I make small incision running from the top of the ear toward the bottom, slightly around the back of the earlobe.  After 3-6 months the scar is skin colour and almost invisible.  I would make an incision under the chin if neck liposuction is required.  This procedure if often combined with facelift, eyelid surgery, cheek lift etc Please find a reputable and qualified surgeon who can assess you properly to give you a realistic idea of what outcome you can achieve.  Ask to see before and after pictures to gauge past patients results to help you decide on a surgeon.   All The Best

Neck Lift Under Local Anesthesia

Yes, it is definitely possible to have your neck lift procedure under local anesthesia with the use of oral or intravenous sedation. Using this method, you will be conscious during your surgery but will be extremely relaxed and will not feel any sensations of pain. Some doctors and patients prefer this option as local anesthesia is generally associated with less feelings of nausea and an easier recovery from drowsiness associated with the administration of anesthesia. I recommend you to discuss all your anesthetic options directly with your surgeon, as he or she will be best able to guide you according to your goals and expectations

Julian De Silva, MD
London Facial Plastic Surgeon
5.0 out of 5 stars 142 reviews

Lower face and neck lift with local anesthesia and twilight sedation

I have performed well over 2,500 lower face and neck lifts under local anesthesia with oral sedation for the past ten years. Without doubt it is safe and well tolerated by patients. Compare to the traditional facelift procedures that are performed under general anesthesia, the post operative complications associated with local anesthesia cases are lower and risk of bleeding is minimized. The key to a successful facelift procedure using local anesthesia is selection of the right patient by the surgeon and his or her comfort doing these cases.

Kevin Sadati, DO
Orange County Facial Plastic Surgeon
4.9 out of 5 stars 204 reviews

Anesthesia Concerns and Options for Neckline Improvement

Dear beachgirlca,

You are not alone in your concerns with anesthesiology. Keep in mind that a board certified anesthesiologist is monitoring your anesthesia during the entire surgery. Beforehand, the anesthesiologist and I - your board certified facial plastic surgeon - will have identified the right type of anesthesia for you, our patient, and will have described what the entire procedure entails so that you can feel comfortable in our expert hands.

As far as the 'turkey neck' and drooped muscles are concerned, a Laser-Assisted Weekend Necklift will produce the improved look that you desire. I created and refined this technique that employs laser technology to give patients a very attractive neckline in less time and with less recovery time.

Please see the link below to view pictures of my patients of the Laser-Assisted Weekend Necklift.  


Ross A. Clevens, MD, FACS

Ross A. Clevens, MD
Melbourne Facial Plastic Surgeon
4.7 out of 5 stars 117 reviews

Complete Neck lift under local anesthesia with oral sedation.

A complete neck lift with liposuction and platysma plasty can absolutely done under local anesthesia with oral sedation. I have done thousands of them with excellent results. If you have the turkey waddle as you suggest, the incision under the chin with correction of the platysma muscle will likely give you better results.

Oral vs IV Sedation is merely a matter of personal preference and costs. Both are safe and effective, but neither changes the results. The surgery can be preformed equally as well using either oral or IV sedation with local anesthesia. The surgeon is the key.
John Standefer MD

John A. Standefer Jr., MD, FACS
Dallas Facial Plastic Surgeon
4.6 out of 5 stars 60 reviews

Face and neck lift for loose turkey neck

When the incisions are placed in front and behind the ears to tighten up loose neck skin, this is a face/neck lift, not a neck lift alone. In our practice, we place patients under general anesthesia by a board-certified physician anesthesiologist for patient safety and comfort. The procedure lasts at least 3 hours in length and it's very difficult to sit still under oral sedation for that period of time. With oral sedation, will have complete conscious awareness with entire procedure.The primary goal for a lower face and neck lift is to get rid of the turkey waddle, tighten loose facial and neck muscles including the platysma plasty, tightened the jowls, removal of fatty deposits in the neck, and tightening loose facial and neck skin. The incision underneath the chin is required to perform a platysma plasty.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 143 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.