Why is the Recovery After a Head/neck Procedure (E.g. Neck Lift) Supposedly Faster when Performed Under Local Anesthetic?

I have been told that recovery following a procedure (neck lift for instance) done under local anesthetic or light sedation is faster than one done under general? If that is the case, why do many doctors still only perform surgery under general? What is the pro/con to local vs general? Thanks.

Doctor Answers 22

Recovery After a Facelift or Neck Lift Under Local Anesthesia vs General Ansethesia

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Great question.  Over that last few years, a lot of evidence has come out to suggest that there is less swelling and bruising if a local anesthesia technique for a neck lift or a facelift.  After doing these procedures for 20 years under general anesthesia, I have switched to doing them under local or twilight anesthesia because of this.  With either anesthetic choice, the local anesthesia that is used is "tumescent" anesthesia which means that a lot of saline or salt water is mixed with the local anesthetic agent, lidocaine.  This is really the "secret sauce" that helps with bruising and swelling. 

There are a couple of other compelling reasons that I made this switch.  First, with the local anesthesia, you have little or no pain for the first few hours after surgery and thus do not need any narcotics which can slow recovery for several reasons.  Second, under local or twilight anesthesia, the risk of developing a blood clot, which can be lethal, is all but eliminated.  And finally, patients are familiar with twilight anesthesia and feel more comfortable with it.  Patients today, do not want to go under anesthesia and for facelift lifts and neck lifts there is no need. 

I hope that helps and if it does please give it and up vote at the top right at the "report' button.  Thanks.

Best regards.

Kirkland Plastic Surgeon
4.9 out of 5 stars 64 reviews

Local or sedation anesthesia will often result in faster recovery.

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Many board certified plastic surgeons are only trained to perform procedures under general anesthesia as it is often more comfortable for them to perform the procedure. I prefer conscious sedation for most of my facial procedures, although I offer general anesthesia as well. While it takes extra effort from my part to keep the patient comfortable throughout the procedure, their recovery after surgery is drastically better with less nausea, vomiting, and headache. Bruising and swelling is very similar between both modalities.


{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

In my experience, doctors who make claims about the advantages of local anesthesia do not have the capability, expertise or certification to perform general anesthesia in their offices.  When your only tool is a hammer, the whole world looks like a nail.  It is fair to say that one 'prefers' to do surgery under local anesthesia, but not that it is far safer, quicker recovery or routinely better results.   

David Marcus, MD
Santa Rosa Plastic Surgeon
4.9 out of 5 stars 34 reviews

Face lift under local anesthesia

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

I have not seen any difference in recovery post face lift,neck lift wiyh general or local anesthesia. I have seen more patient discomfort during surgery in patients with local anesthesia.Many times the complaint has nothing to do with the surgery,my back hurts,my I.V. burns,etc.I think patients in the U.S. are not as stoic as in other countries and generally dont want to be involved with the surgery.

Terry A. Cromwell, MD (retired)
Lafayette Plastic Surgeon

Recovery depends on what is done NOT the anesthesia

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Recovery depends on what is done NOT the anesthesia.  In fact procedures done under local anesthesia alone can often have MORE bruising than procedures done with IV sedation or general anesthesia since the patient's blood pressure is higher when awake and there is more bleeding.

Sam Naficy, MD, FACS
Seattle Facial Plastic Surgeon
4.7 out of 5 stars 231 reviews

Recovery time is not dependent on the type of anesthesia

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Some patients will experience less nausea and vomiting using light sedation with local anesthetic over doing full general anesthetic but that is not always the case. A good anesthesiologist working with a good surgeon that uses generous amounts of local anesthetic can achieve comparable recovery times. The recovery from the actual surgery (swelling and bruising) will be the same 10 days to 2 weeks.

I hope this helps.

Ivan Wayne, MD
Oklahoma City Facial Plastic Surgeon
5.0 out of 5 stars 65 reviews

Facial Procedures Done Under Local Do Not Have A Faster Surgical Recovery

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

There is no difference in the surgical recovery whether a facial procedure is done under local vs a general anesthetic. Presuming that the facial operations done are the same, the amount of tissue trauma is identical. Therefore, the amount of swelling, bruising and the duration of heailng will be the same. The only time a facial procedure done under local has a faster surgical recovery is when the extent of the procedure is less. (which is often the case) The only difference in recovery between local and general is in the anesthetic recovery as one is completely awake during the procedure, thus there is little anesthetic recovery.

General vs Local Anesthesia for Cosmetic Procedures

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}


When done properly by a trained anesthesiologist who understands cosmetic procedures there is no difference in the recovery. In fact, when a procedure is done under local anesthesia with enough sedation to make it where you can tolerate it well, the recovery is frequently longer than with a light general anesthesia. Many physicians who cannot get privileges in a certified operative facility are loudly touting the benefits of local anesthesia because that is all they can do. Without a certified facility (which you need for safety) they cannot get an anesthesiologist to give general anesthesia. Most of these claims are made to get you to forego other safety concerns and allow them to do the procedure. I personally stopped doing almost all major cosmetic procedures under local anesthesia over 17 years ago. I did so because I became convinced that monitored general anesthesia was the best for the patient, the safest method and had the fastest recovery. Since then, the safety and rapidity of recovery have only improved. Beware of the surgeon who does not offer you the option of general anesthesia.


Robert T. Buchanan, MD
Highlands Plastic Surgeon

Facelift or neck lift local-general?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Excellent question. It is not true that you heal faster with either. I have done facelifts for 35 years and have had patients working on their computer 2 hours after a full facelift under general anesthesia and back in public 2 days later IF they do not have much bruising. 

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 38 reviews

Why is the Recovery After a Head/neck Procedure (E.g. Neck Lift) Supposedly Faster when Performed Under Local Anesthetic?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
   The recovery after both types of anesthesia should be similar, but the patient is more comfortable with something other than local alone. 

Kenneth Hughes, MD
Los Angeles, CA

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.