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.