Can a deep plane face lift (SMAS) be performed using only oral (valium or equivalent) meds and local injections?

Question

Can the composite/deep plane lift (technique of working beneath the SMAS layer and moving skin and SMAS as single unit) be done using only an orally administered sedative and local injections of lidocaine or similar numbing agent? Among practitioners of the deep plane is this typical?

Miguel Delgado, MD · Answer

I only perform a facelift under general anesthesia, it is far too delicate of a surgery to take a chance that the patient will be uncomfortable and move around. Be sure to see a Board Certified Plastic Surgeon. good luck!

Mansher Singh, MD, FACS · Answer

Yes - it can absolutely be performed. However, you need to ask your plastic surgeon few questions. 1) you should ask them how many awake facelift do they. 2) how any deep facelift do they do? 3) how many awake deep plane facelift do they perform every month?

John Michael Thomassen, MD · Answer

Yes, this surgery can be performed with local anesthesia alone.  It is becoming more commonplace as patients are looking for alternatives to anesthesia.

Michael Orseck, MD · Answer

a deep plane facelift should not be done under local and oral sedationFace lifts that are not as complex certainly can

William Portuese, MD · Answer

The short answer is yes it can be done, however the patients will probably be rather uncomfortable since the entire face and neck will need to undergo local anesthetic injections and the procedure takes approximately three hours which is very difficult to sit still for that long of time. In our practice, we perform a high-SMAS lower face and neck lift under general anesthesia by a board-certified physician anesthesiologist for patient safety and comfort. For many examples and more information, please see the video and link below

Steven Wallach, MD · Answer

Yes, some surgeons will perform facelifts under local with some sedation by taking some medications by mouth.

Francis R. Palmer, III, MD (retired) · Answer

Hi, I have performed facelifts for over 30 years and have performed many minimally, invasive SMAS facelifts.  This version of a SMAS facelifts uses smaller incisions, less tissue dissection and for that reason can be completed using local infiltration in 90 minutes or less.  If you're considering a "deep plane", mid face or a traditional SMAS facelift with a neck lift this can take 5 to 6 hours to complete which would take much longer than the 2 hour period within which local infiltration can be used.  After that time the epinephrine (that constricts the blood vessels within the tissues) will wear off making the tissues prone to significant bleeding.  For extended facelift and neck lifts, general anesthesia is recommended.
 Following my beauty principles, women look the most feminine, youthful and attractive with heart shaped faces.  Heart shaped faces have cheeks that are full and round in the front.  Cheek augmentation with a dermal filler or using cheek implants for a permanent enhancement will create full, round cheeks that will feminize the entire face.
 A weak chin creates an imbalance making the nose appear larger, the mid face top heavy and the lower face look short that de-emphasizes the lips and allows early formation of a double chin.  Chin augmentation using a chin implant will add projection to the chin creating harmony and balance to the lower face.   I have found that placement of a silastic chin implant, through a small curved incision under the chin (also allows excess skin removal) to be very safe, quick and highly effective.
 If you have "jowls” these are sagging facial tissues and an indication for some form of a SMAS facelift.  The underlying SMAS layer, of the face, must be dissected, lifted, trimmed and re-sutured (not merely folded or suspended with threads or sutures that will not last).  The excess skin is then removed and the facelift incisions closed.
My most popular facelift is the minimally invasive, short incision facelift that has all the benefits of more invasive facelifts (traditional, mid-face, deep plane, cheek lift and subperiosteal facelifts) but with these added benefits:
very small incisions and no incisions extend or are placed within the hair.
minimal tissue dissection = less bruising and swelling = rapid recovery ( several days instead of weeks or months with the more invasive type facelifts mentioned)
can be performed in 90 minutes or less, with or without general anesthesia
no incisions within the hair = no hair loss
excess fat can be removed
excess skin removed
cheeks, chin and jaw line can be augmented with dermal fillers (I prefer Restylane Lyft) or facial implants
most patients fly back home to parts all over the world in as little as 3 days post-op
I combine facial shaping with every facelift procedure.  When jowls are present, these should be done in concert and not alone or separately in order to create a naturally, more attractive face.
Hope this helps

Can a deep plane face lift (SMAS) be performed using only oral (valium or equivalent) meds and local injections?

Answers (7)

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