Facelift Under Local Anesthesia: Who Is a Candidate and What It Feels Like

9 hours ago

5 min read

Quick answer: A facelift under local anaesthesia is performed while you are awake or lightly sedated. The face and neck are numbed with a diluted anaesthetic solution, so you feel pressure and movement but not pain. It suits healthy patients who want to avoid general anaesthesia, older patients, and people having a neck lift, a lower face lift or eyelid surgery. Very long combined operations are usually better done under general anaesthesia.

Key takeaways

You stay awake or lightly sedated; the treated area is fully numb.
Recovery from the anaesthesia itself is faster, and most patients eat and walk the same day.
Neck lifts, lower face lifts and eyelid surgery are well suited to local anaesthesia.
Anxious patients and very long combined operations are better served by general anaesthesia.
The quality and longevity of the lift do not depend on the type of anaesthesia.

How does a local anaesthesia facelift work?

Before the operation, a diluted local anaesthetic is injected under the skin of the face and neck. This solution also contains a small amount of adrenaline, which reduces bleeding. After about 15 minutes, the area is numb. If you wish, a light sedative helps you feel relaxed or drowsy, while you continue to breathe on your own.

Prof. Dr. Suleyman Tas then performs the same lift he would perform under general anaesthesia: the deep layer of the face is repositioned, the neck is tightened and incisions are hidden around the ear and in the hairline.

Video: 80-year-old physician, scarless facelift under local anaesthesia. Watch on YouTube

What does it feel like?

Patients most often describe three sensations:

A short sting during the first injections, similar to a dental injection.
Pressure and pulling during the lift, without sharp pain.
Noise and movement around the head, which some people find easier with music or light sedation.

Many patients say afterwards that the operation was easier than they expected.

Who is a good candidate?

Patients who want to avoid general anaesthesia or have had a difficult experience with it before.
Older patients in good health, such as the 80-year-old physician in the video above.
People planning a neck lift, a lower face lift, a brow or temporal lift, or eyelid surgery.
Patients who are calm and comfortable with being awake.

A local anaesthesia facelift is usually not the right choice for people with strong anxiety, for very long combined operations (for example a facelift together with breast or body surgery), or when the anaesthesia team recommends otherwise for medical reasons.

Video: Neck lift and upper eyelid surgery under local anaesthesia, before and after. Watch on YouTube

Advantages and limits

Advantages

No breathing tube and no deep anaesthesia.
Less nausea and drowsiness after surgery.
Same-day walking and eating; often a shorter hospital stay.

Limits

The operation can feel long if you are anxious.
Very extensive combined surgery is more comfortable under general anaesthesia.
Local anaesthesia does not change the risks of the surgery itself, such as swelling or bruising.

Deep plane facelift before and after
Neck lift before and after
Neck lift before and after

"The anaesthesia is chosen for the patient, not for the surgeon. When a lift can be done comfortably with local anaesthesia, many patients appreciate walking out of the operating room on the same day." — Prof. Dr. Suleyman Tas

Recovery

Recovery from the lift is similar whichever anaesthesia is used: swelling and bruising peak in the first 2 to 3 days, stitches are checked around day 6 or 7, and most people return to social life after about 2 weeks. Read the day-by-day details in our facelift recovery timeline.

Is it safe?

Local anaesthesia is widely used in facial plastic surgery and has a long safety record. The total dose of anaesthetic is calculated according to your body weight, and your heart rate, blood pressure and oxygen level are monitored throughout the operation. If sedation is added, an anaesthetist or a trained team member supervises it. Patients with heart disease, high blood pressure or those taking blood thinners are assessed carefully before surgery, as they would be for general anaesthesia.

Preparing for the day of surgery

Follow the fasting instructions you are given, even if no sedation is planned, because sedation may be added on the day.
Wear a top that opens at the front so you do not pull clothes over your head afterwards.
Bring headphones if you would like to listen to music during the operation.
Arrange for someone to accompany you home or to your hotel.

Which procedures suit local anaesthesia?

Neck lift: tightens loose neck skin and bands; one of the most common local anaesthesia operations.
Lower face lift: lifts jowls and sharpens the jawline.
Temporal or brow lift: lifts the outer brow and is often used to create a fox eye effect.
Upper and lower eyelid surgery: removes excess skin and puffiness.
Full facelift: possible in selected, calm and healthy patients.

Frequently Asked Questions

Is a facelift under local anesthesia painful?

The injections sting for a short time. After the area is numb, patients feel pressure and pulling but not pain. Light sedation can be added for comfort.

Is the result as good as with general anesthesia?

Yes. The type of anaesthesia does not change the surgical technique, so the lift itself is the same.

Can a deep plane facelift be done under local anesthesia?

In selected patients, yes. The decision depends on the extent of the operation, your health and how comfortable you are with being awake.

How long does the operation take?

A neck lift or lower face lift usually takes 2 to 3 hours; a full facelift with neck lift can take longer.

Can I go home on the same day?

Many patients can, after a short observation period. Patients travelling from abroad usually spend the first night in the clinic or a nearby hotel and stay in Istanbul for about 7 to 10 days in total.

About the Author

This article was written and medically reviewed by Prof. Dr. Suleyman Tas, a plastic, reconstructive and aesthetic surgeon in Istanbul with over 20 years of experience. He is the author of Rhinoplasty in Practice (CRC Press, 2020), has more than 40 peer-reviewed scientific publications and five patents, and teaches facelift and rhinoplasty techniques to surgeons at international courses. Read more about Prof. Dr. Suleyman Tas.

Individual results vary. Before and after photos and videos are shared with patient consent. This article is for general information and does not replace a personal medical consultation.

See More Before and After Results

Would You Like a Similar Result?

You can send your photos for an online assessment or book an appointment at the Prof. Dr. Suleyman Tas Clinic, Terrace Fulya, Şişli, Istanbul. Book an online consultation.