When considering a facelift, one of the most common concerns among patients is anesthesia. Specifically, many ask: Can a SMAS facelift be done under local anesthesia? The short answer is yes—in select cases, a SMAS (Superficial Musculoaponeurotic System) facelift can be performed under local anesthesia, also referred to as an awake facelift. However, the suitability depends on several factors, including the extent of the procedure, patient comfort, and the surgeon’s expertise.
Facelift Anesthesia Options
There are typically three anesthesia approaches for facelift procedures:
- Local Anesthesia with Sedation (Awake Facelift)
This involves numbing the surgical area while keeping the patient awake but relaxed with mild sedatives. The patient is conscious but doesn’t feel pain. - IV Sedation (Twilight Anesthesia)
Deeper than local anesthesia alone, IV sedation keeps patients drowsy and often unaware of the procedure, though not fully unconscious. - General Anesthesia
The patient is completely unconscious and intubated, and the procedure is managed by an anesthesiologist.
Pros and Cons of Local vs General Anesthesia for SMAS Facelift
Local Anesthesia (Awake Facelift)
Pros:
- Lower risk of anesthesia-related complications.
- Faster recovery and less post-op grogginess.
- Often performed in-office, reducing facility fees.
- Ideal for less invasive or shorter procedures.
Cons:
- Not ideal for more extensive SMAS work or combined procedures.
- May cause anxiety in patients uncomfortable being awake during surgery.
- Limited surgical time compared to general anesthesia.
General Anesthesia
Pros:
- Complete comfort with no awareness of the procedure.
- Allows for longer and more complex surgeries, including full SMAS lifting and repositioning.
- Better for patients with low tolerance for discomfort or anxiety.
Cons:
- Higher risk profile, especially for older patients or those with medical conditions.
- Longer recovery time and potential for side effects like nausea.
- Requires a hospital or accredited surgical facility.
Is Local Anesthesia Right for Your SMAS Facelift?
If you’re considering a SMAS facelift under local anesthesia, it’s important to consult with a board-certified facial plastic surgeon. Some patients are excellent candidates for an awake facelift, particularly if they require only moderate lifting and prefer to avoid the risks of general anesthesia. Others may benefit more from the comprehensive access and comfort general anesthesia provides.
Final Thoughts
Understanding your facelift anesthesia options is a key part of the decision-making process. While a SMAS facelift under local anesthesia is possible, it’s not right for everyone. An experienced surgeon will assess your goals, medical history, and comfort level to recommend the safest and most effective approach.
