Can a jowl and neck lift be done under local anesthesia?

Thank you for your question.

Considering a neck lift for skin laxity and correction of droopy jowls under local anaesthetic alone is an important decision. Based on your description of having heavy cheeks that contribute to droopy jowls, it’s important to understand the implications for your desired outcomes.

In general, when there is an association of heavy cheeks and jowl fullness, there is often excess volume in the neck as well. In this instance, the degree of correction achievable with local anaesthesia is more limited, and it is quite possible that you may not be satisfied with the outcome.

Local anaesthetic procedures are typically suitable when there is only skin laxity, both along the jowl line and under the chin. In these cases, lying down completely flat leads to a very good appearance of the neck. However, if the appearance of the neck still shows moderate fullness when lying down, it is likely that a local anaesthetic intervention would not yield very good results.

For more comprehensive correction, either sedation or general anaesthetic may be preferable. These approaches allow for a more thorough treatment of the underlying issues, including excess volume in the neck and heavy cheeks, resulting in a more satisfying outcome.

Another way to approach this decision would be to have a computer imaging and simulation of the desired changes, which would give you clearer identification of your preferred outcome and allow better clarity regarding the type of anaesthetic needed.

There are several different types of face and neck lifts. Mini lifts can be done under local anesthesia quite comfortably but don't deliver the same results as a more involved deep plane face and neck lift which is typically done under general or "twilight" anesthesia. Whether or not a mini or true deep plane facelift is best for you is up to your anatomy, goals and surgeons expertise. With that being said, in my experience, without a true deep plane release you will not be able to lift heavy cheeks. I would recommend consulting with a few different surgeons and reviewing their techniques and looking at their before and after pictures to help make this decision.