​Is it normal to be on local Anesthesia on a Facelift? Are you totally wide awake?

Hi Kelloway,This is something which can be clarified pretty easily by contacting the Plastic Surgeon's office and find out if there was a misunderstanding.  All Facelift procedures use local anesthesia, even if you are going under general anesthesia.  We cannot make the skin incision without first injecting the skin with local anesthesia.  The local anesthesia completely numbs the skin and more importantly adrenaline is added to the local anesthesia to constrict the blood vessels for a more much less bleeding during the facelift surgery.Most "mini-facelifts" are around 1-2 hours only and can be performed "wide awake" without any sedation.  Some surgeons will at least add some Valium which is taken by mouth to make the patient "sleepy" so that they can at least sleep through a portion of the procedure.  Since the local anesthesia will make the skin completely numb, the patient will not feel any pain, but may feel some pushing and pulling as well as "hear" sounds of surgery, such as snipping of scissors, or beeping and buzzing from the electrocautery which helps to stop bleeding.I regularly perform a 3-3.5 hour lower face and necklift procedure which I call the Necklift plus.  To see what is possible with an awake facelift, please check out the Web reference link below.   I give the patient Valium and use local anesthesia injections.  This is more than just a mini-facelift which I consider a "shortcut" procedure and if the patient were under full IV sedation or general anesthesia, the same procedure I would perform.  The main complaint of the local anesthesia facelift with Valium is not from the facelift procedure, but instead from lower back pain or neck pain from laying still for so long.  In order to help relieve the back and neck pain, I will have a pillow place under their knees to reduce lower back discomfort, and as for the neck stiffness on the back of the neck, the patient's head is moved in three positions.  One is looking straight up towards the ceiling for about 30-45 minutes.  Then, head turned to the right for 45-60 minutes, and head turned to the left for 45-60 minutes.  When transitioning from the under chin/neck area, to the left cheek then to the right cheek, the patient gets some time to turn their neck from side to side to loosen up their neck.  Most surgeons do not offer a true lower face and necklift under local anesthesia with Valium, and will either offer a mini-facelift which is shorter, or simply use full IV sedation or General anesthesia for 3-4 hour facelift/necklift surgeries.  Ask your surgeon if an IV sedation similar to a colonoscopy will be used, but without using a breathing tube (general anesthesia.)  IV sedation has the same benefits of general anesthesia, which is amnesia of the entire procedure, but will a faster wake up, and often times less nausea during the recovery.Best,Dr. YangP.S. There is a new feature on Realself, which is the "Follow" button. It is similar to the "Like" button on Facebook. If you like my response or any of the doctor responses while you research on Realself, you should "Follow" them. You will get email updates, when the doctors you follow post any new answers to questions, post new photos, or have any new reviews.

Thank you for your question. I have performed many Facelift under local anaesthetic administered properly, patients are comfortable and have an easier recover.  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

If you are in good health then a facelift and necklift can be performed safely by either local anesthesia with oral sedation, intravenous sedation, or general anesthesia in my practice. The oral sedation with local anesthesia relaxes the patient and often they sleep during a good portion of the surgery and forget the details of it afterwards. The key is for you to feel most comfortable. Many patients select local anesthesia with sedation as they are afraid of General Anesthesia, whereas other patients are afraid of being aware or feeling the injections at the beginning of the procedure. General anesthesia is safer than many patients think, but if you are uncomfortable with the idea of being fully knocked out then your facelift can be performed with local anesthesia with IV sedation. Your doctor will check thoroughly to be certain that general anesthesia is safe for you. In any case, you are safest in the hands of a Board Certified Anesthesiologist. The most important decision you can make is deciding on the most qualified plastic surgeon (see link below) whose job it is to guide you on decisions such as the ones you are considering.#faceliftanesthesia#faceliftanesthesiachoices