Do facelift or eye lift patients sedated only with oral medication and local anesthetic EVER feel pain during the surgery?

Are patients who are sedated As Described Above unable to feel any PAIN during the procedure and what if, after chosing this method of anesthesia, the patient is not tolerating either the procedure or the anesthesia well. Are they aware of the sounds and smells going on around them but have no memory of any of this?

Doctor Answers 13

Yes you feel pain.

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However, the discomfort is easily tolerated. The discomfort is on the order of being poke by your dentist for the injection of local anesthetic. I have had facelift patients whose surgery I performed under local with oral sedation actually sleep through the entire procedure. On the other hand, this type of anesthesia is not for everyone. Some people require more sedation and benefit from intravenous sedation. You can still be awake and cooperative which in my opinion is essential for eyelid surgery but the drugs make it impossible to be concerned about the awareness and in many cases, memories of the event do not form. Oral medication does not produce this depth of sedation.

Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Pain During Local Procedure.

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Most patients only experience pain during the injection of local anesthetic. Proecures under local are very common and safe. Best wishes.

Local anesthesia for facelifts

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this is an excellent way to perform these procedures and I have personally performed over 150 this year and have yet to have a complaint of pain or discomfort. Of course this type of anesthesia is very dependent on your doctor experience so be sure to go to someone with lots of experience and a great bedside manner

Jonathan Weiler, MD
Baton Rouge Plastic Surgeon
4.9 out of 5 stars 93 reviews

Facelift and eyelid surgery anesthesia

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For patient safety and comfort, we perform facelift and eyelid surgery under general anesthesia. Patients have no recollection of the injections or the surgery. Trying to perform these procedures under local anesthesia will be painful for the injection, and can be painful for the surgery as well, if the entire area is not anesthetized. In addition, patient's have conscious awareness of the sounds, smells and awareness of the situation while surgery is being performed

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 157 reviews

Properly done, facial rejuvenation under local is very comfortable

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I perform about 95% of my facelift and eyelid rejuvenation procedures under local anesthesia with some oral medications. I can only comment on the experience of my patients, of course. Each doctor may have a slightly different technique, medication combination, etc.

The only portion of the procedure which may be a little uncomfortable is the infusion of the local anesthetic mixture. We use a buffered solution, and inject using the smallest possible needles and/or cannulas which minimized discomfort. Properly done, few patients complain of "pain" during this portion of the procedure. You may have a mild stinging or burning sensation. After the anesthetic has been placed, there is no pain, although you can feel pressure and movement. If you do experience anything sharp or uncomfortable, you should let your surgeon know...a little more local anesthetic will prevent that from happening again. You may or may not remember portions of the procedure. This depends on your metabolism and what medicines are used.

Almost all patients are very satisfied with the experience of their procedure, and they like the fact they don't have to be put to sleep with a full anesthetic.

You should certainly discuss your concerns with your surgeon so you can understand what to expect from your procedure.

Michael Bowman, MD
Roanoke Facial Plastic Surgeon

Dr. Kimberly Henry

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Hello, thank you for your question! For the most comfort, especially for a facelift involving SMAS procedure and work on the neck, general anesthesia is required. There are multiple kinds of facelifts; however, most physicians prefer to do this procedure under general anesthesia because it requires precision for the best results, and the patient must be very still. Additional cost for general anethsesia is around $1,000, and personally, it is worth the price. The results are better. Procedures on the eyes are generally quick procedures, so local anesthetic is commonly used and effective, and you do not have to stay still for extended periods of time. Except for the "pinch" of the injection of the local anesthetic, there is minimal to no pain to the area, just a feeling of "pressure."

Kimberly A. Henry, MD
Greenbrae Plastic Surgeon

Oral sedation and local anesthesia

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I do all my surgery with oral sedation and local anesthesia. Specifically Valium and Ambien by mouth and Xylocaine by local injection. My patients are very comfortable. They do feel a small pinch with the injections and on occasion may ask for another Valium during the procedure. All this is a small price to pay for removing 95% of the risk which is in the anesthesia process. However you must use a confident surgeon with lots of experience who can get his procedures done in a few hours and not drag the process on. With my family there is no question that this is the process I would choose.

Oral Sedation and Local Anesthesia for Facial Rejuvenation Procedures

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With sedation techniques, many types of eyelid and facelift procedures can be comfortably done. But this is highly dependent on the surgeon and the anxiety level of the patient. I would be less sure about complete comfortability with just oral sedation alone, IV sedation would be better. When in doubt have a deep sedation or general anesthesia with an anesthesiologist where you will be the most assured to not feel or remember anything.

Cosmetic procedures with oral sedation and local anesthetics

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can be done and is usually well tolerated by most patients motivated to save by not going to the OR... but you will feel pains from the injections and at some points during the procedure where more local is injected as needed. So it really depends on you and what you are willing to put up with as you will remember what happens when only oral sedation is used.

Curtis Wong, MD
Redding Plastic Surgeon
4.8 out of 5 stars 33 reviews


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It is always possible to feel pain. Nobody can promise that you will never feel pain. I usually suggest IV sedation at the very least. If you are at all worried, then you should discuss this with your surgeon. You may be someone that should receive a GA if you're very anxious.


Asif Pirani, MD, FRCS(C)
Toronto Plastic Surgeon
5.0 out of 5 stars 35 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.