What is the best anesthesia for a deep plane facelift?
⚠️ After your facelift: when to seek urgent care
Contact your surgeon immediately or go to an emergency room if you notice rapid swelling on one side of your face, difficulty breathing, sudden severe pain, or signs of infection such as fever, increasing redness, or discharge. These could signal a hematoma or other complication that needs prompt attention.
Short answer
The research shows that deep plane facelifts are most often performed under general anesthesia, though some modified versions can be done under local anesthesia with or without sedation. The choice depends on the complexity of the procedure, how long it takes, and the patient's own health and anxiety level.
What the research shows
Several studies on deep plane and related facelift techniques describe the anesthesia used. The double-sling composite facelift, a technique involving extensive deep-plane SMAS work, was performed under general anesthesia in all 72 patients studied [2]. Similarly, the temporal facelift series of 250 patients, which uses a deep-plane dissection in the midface, was also performed under general anesthesia [3].
On the other hand, one hybrid technique called the MADE (Minimal Access Deep Plane Extended) vertical facelift, which combines deep plane release with a shorter scar approach, was noted to be performable under local anesthesia, which was highlighted as an advantage for both patients and surgeons [1].
Importantly, a dedicated review of local anesthesia facelifts cautions that the short-scar anterior facelift is the most suitable procedure for local anesthesia due to its limited deep-plane dissection and shorter operating time. More extensive deep-plane work is harder to complete comfortably under local anesthesia alone [4].
What this means for you
In practice, a full traditional deep plane facelift is a longer and more involved surgery, and most surgeons perform it under general anesthesia for patient comfort and surgical precision. Hybrid or less extensive deep-plane techniques may sometimes be done with local anesthesia combined with oral or intravenous sedation, especially in carefully selected patients who have no history of anxiety and no problems tolerating dental procedures [4].
There is no single "best" answer for every patient. The right anesthesia depends on the specific technique your surgeon uses, the expected duration of the surgery, your medical history, and your own preferences and anxiety level [4].
What to ask your surgeon
Before your procedure, consider asking your surgeon these questions:
- Will this be a full deep plane facelift or a modified version? How long will it take?
- Do you typically perform this procedure under general anesthesia or local anesthesia with sedation?
- What monitoring will be in place if sedation is used?
- Will an anesthesiologist be present?
These questions will help you understand your options and feel confident going into surgery.
Caveats
All of the studies referenced here are cohort studies, meaning they describe what surgeons did in their own practice rather than directly comparing different anesthesia options head-to-head. No randomized controlled trial was found comparing general versus local anesthesia specifically for deep plane facelifts [1][2][3][4]. This means the evidence is based on expert practice patterns rather than formal experiments.