Can a facelift or mini lower facelift be done with local or twilight anesthetic?

It depends on how much work needs to be done.  We perform face lifts using both IV sedation and general anesthesia.

It can be done, but I don't recommend it. For my practice I do facelifts under general anesthesia as I want to keep the patient as comfortable as possible and not to be moving around during such delicate surgery. Good luck.

Hello and thank you for your question about facelift procedures and anesthesia. The answer is yes but it depends our your pain tolerance and how much work you are going to have done. If you are having a mini facelift and not that much work is needed, local anesthesia would be sufficient. However, if you are having a full facelift and require more substantial rejuvenation, you may consider general anesthesia for your comfort and safety and to allow your surgeon to perform all aspects of the procedure without unnecessary time pressure. Your board-certified facial plastic surgeon will recommend the type of anesthesia that best suits the specific procedure you will have.  If for some reason you cannot have general anesthesia, discuss this with your doctor before your surgery so he can propose alternatives for you. Good luck! 
- Jacqueline T. Cheng, MD

Thank you for your question. It is absolutely possible  to perform a comprehensive facelift under local anesthesia. In fact, it is preferable in many regards, and I perform 90% of my facelifts that way. There is clearly less bleeding during a local anesthetic facelift, as general anesthesia tends to make the blood vessels dilate. That means less bruising, swelling, and as a result, a quicker recovery. If you had told me ten years ago that I would be doing the vast majority of my facelifts this way, I would not have believed you. A few things happened to make this possible. I became much more efficient in my facelift technique. You obviously don't want a semi-awake patient to lie down on an operating table for hours and hours, so I had to become very adept at the procedure and not wonder what the next step was. Next, I had to make the infiltration of local anesthesia as painless as possible. After years of trial and error, I have a local anesthetic mixture that hardly stings at all when injected, yet lasts hours. The benefit of this that when we are done with the case, patients are awake, alert, and are not nauseated like they would be with general anesthesia.

Facelifts nowadays are done with only local anesthesia and some oral sedation.  Twilight refers to IV sedation which can be tricky since the procedure can last a few hours and having you sedated with no secure airway for hours is a bit tricky for the surgeon and anesthesiologist.  The other option is general anesthesia but most patients would like to avoid this option although in reality it is the safest.  

Thank you for your question.  I perform most of my facelifts under local anaesthetic, it can also be performed under twilight sedation or a general anaesthetic for patients who would prefer this.  The results will be the same, it will just be the anaesthetic which may change from patient to patient.  The results of a local anaesthetic facelift, give the same as a traditional facelift, therefore the longevity being approximately 5-10 years (depending on factors such as your skin quality and lifestyle).  The SMAS muscle is targeted to create this.  All The Best 

In my  practice the majority of the facial surgery in done under sedation and local anesthesia. In my personal view   allows me to control better the surgery, the patient is totally  in control  and the recovery after the surgery is much easier for the patients.  I had done this for over 30 years and the anesthesiologist and surgeon just need to understand the procedure and explain to the patients the process.

I almost always do my facelifts under general anesthesia. The level of comfort, the ability to control vitals such as blood pressure, and the modern anesthesia care that we enjoy make this the right choice for me. I am often fairly complete with my facelifts, including judicious use of fat to re-sculpt the face. Eyes and brows can sometimes be a part of facelifts. For all of this, I feel that it is safer and more expeditious if general is used. If a facelift is very minor, which is rare, then local with sedation can be used. Our group of board certified anesthesiologists that we use are extraordinary. 

Thank you for your question. The short answer is yes, it can be done. But just because it can be done does not mean that it should be done or is somehow better. In the majority of my patients, I perform facelift procedures using a general anesthetic. It is safe and more comfortable for the patient and allows me to achieve the surgical operation I have planned. The most important thing that you can do is make sure you are having your procedure performed by a plastic surgeon who is board certified by the American Board of Plastic Surgery and that operates in an accredited facility. Often several surgeons who try to sell procedures under local as "better" do so because they do not have privileges to operate in facilities where general anesthesia is used or where they do not want the facility to meet standards for general anesthesia. If your surgeon does not allow at least the option for a general anesthesia, in my opinion, you should go elsewhere.Hope this helps! 

Hello and thank you for your question.  The
best advice you can receive is from an in-person consultation.  I perform facelifts using either conscious sedation or general anesthesia. I always have a board-certified MD anesthesiologist there to administer anesthesia for the entire case.   This decision should
be based on a detailed discussion with equal input from both you
and your surgeon.   Make sure you specifically look
at before and after pictures of real patients who have had this surgery
performed by your surgeon and evaluate their results.   The most
important aspect is to find a surgeon you are comfortable with. I recommend
that you seek consultation with a qualified board-certified plastic surgeon who
can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D.  FACS
Harvard-trained plastic surgeon

A facelift can be done with either choice of anesthesia.  I usually perform my procedures under local anesthesia.