Awake Facelifts: What You Need to Know

Written by Cameron Erickson, MD, Board Certified Plastic Surgeon on May 18, 2022 No Comments

facelift woman

An awake facelift refers not to the type of facelift, but to the type of anesthesia that’s used. As the name suggests, an awake facelift is not performed under general anesthesia used in traditional plastic surgery procedures. Instead, awake facelifts utilize on a combination of local and twilight anesthesia that keep patients in an awake (but pain free) state throughout the procedure.

What Is an Awake Facelift?

Facelift is a surgical cosmetic procedure that corrects loose or sagging skin as well as wrinkles and fine lines. It results in tighter, smoother skin and an overall younger appearance. Some facelift techniques are quite invasive and must be performed under general anesthesia. Others are less invasive and can be performed with a combination of local and twilight anesthesia. This is referred to as an awake facelift.

What Type of Anesthesia Is Used?

IV sedation, conscious sedation or twilight anesthesia are all names for the type of anesthesia used in an awake facelift. During this type of sedation, the patient is technically awake, but remains in a sleepy, relaxed state. Unlike general anesthesia, ventilators are not needed to help with breathing when a patient is under twilight anesthesia.

In addition, awake facelifts make use of local anesthesia, which numbs the area to be treated without any effect on the patient’s consciousness. Tumescent fluid, a combination of epinephrine, lidocaine, and saline is often used.

Awake anesthesia reduces cost considerably, and allows patients to recover more quickly in the hours immediately following their surgery.

Awake Facelift Results

Like other facelift techniques, awake facelifts can correct lines, winkles, and sagging skin in the lower face; leaving the patient looking significantly younger. The exact results of an awake facelift will depend on the technique and type of surgery used.

As with any type of facelift, awake facelift results can last for upwards of 10-15 years, but are not considered permanent as they are subject to the continued process of aging.

Who Is An Ideal Candidate?

The best candidates for an awake facelift are younger patients looking for a subtle change, or older patients seeking to refresh the results of a previous facelift.  You might also consider the nature of the anesthesia used and the procedure itself. An awake facelift is not suitable for you if the sounds, smells, or sights of facelift surgery may cause you anxiety or severe discomfort.

What Is Recovery Like?

Recovery time after an awake facelift differs from a traditional facelift only in the first few hours after surgery. Patients awake sooner and will feel more comfortable standing and walking out of the surgical center the same day.

Long term recovery is based not on anesthesia, but on the depth and breadth of the surgery and the specific facelift technique used.

Are Awake Facelifts Risky?

Anesthesia is never risk-free, whether it’s general anesthesia or twilight sedation. Common side effects of IV sedation include the following:

  • Sleepiness and sluggishness
  • Drop in blood pressure
  • Drop in heart rate
  • Headache
  • Nausea

Conscious sedation may cause loss of memory during or before the procedure, although most patients appreciate this known side effect.

The risk of the facelift procedure itself depends on the technique used, but may include unexpected swelling, bruising or bleeding, long term tightness or numbness, nerve damage, facial asymmetry or infection.

Awake vs Traditional Facelifts

An awake facelift differs from a traditional facelift in the type of anesthesia used. Because of this, awake facelifts are also limited to less invasive facelift procedures.

Awake Facelift Pros:

  • Less costly than a traditional facelift
  • Less invasive than a traditional facelift (may speed recovery time)

Awake Facelift Cons:

  • May not be suitable for patients with high anxiety about being awake.</li
  • May not be suitable for patients who require dramatic surgical intervention (i.e. a higher invasive technique)

Ultimately, whether or not an awake facelift is for you depends on the cosmetic issues you’d like to address. If a facelift is under consideration, you might talk to your plastic surgeon about the possibility of foregoing general anesthesia.

Cameron Erickson, MD

Dr. Cameron Erickson is a native Texan and board certified plastic surgeon practicing in the Southwest Parkway and Dripping Springs locations. Dr. Erickson specializes in aesthetic procedures including rhinoplasty, brow lifts, eyelid surgery, lip lifts, facelifts, breast augmentation and lifts, breast reduction, body contouring and liposuction, abdominoplasty (Tummy Tuck), brachioplasty (Arm Lift), 360° liposuction with fat transfer to the buttocks, vaginal rejuvenation, and hormone replacement therapy. In addition, he has had additional training in non-surgical treatments including injectables (Botox/fillers), lasers, and skin resurfacing treatments.

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