ArticleAesthetic surgery journal. Open forum2026
Facelift Under Local Anesthesia: A Retrospective Single-Center Series of 117 Patients Undergoing Deep Plane, High SMAS, and Coronal Rhytidectomy.
Article in Aesthetic surgery journal. Open forum, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Authors and funding
14 authors.
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Abstract
Background: Facelift surgery is increasingly performed in an outpatient setting, and local anesthesia with minimal sedation may reduce the anesthesiologic burden while preserving patient cooperation. However, the safety of local-anesthesia pathways for procedures of varying extent, including deep plane rhytidectomy, high SMAS facelift, and coronal rhytidectomy, remains incompletely characterized. Objectives: To evaluate the feasibility and early safety of a standardized local-anesthesia pathway in a single-center retrospective series of primary aesthetic cervicofacial lifting procedures and to contextualize the findings within the existing literature on awake facial rejuvenation. Methods: A retrospective analysis was conducted of consecutive primary aesthetic facelifts performed under local anesthesia between March 6, 2024, and January 14, 2026. Results: Overall, 117 procedures were included: 90 deep plane facelifts, 6 high superficial musculoaponeurotic system (SMAS) facelifts, and 21 coronal rhytidectomies. The cohort included 110 women (94.0%) and 7 men (6.0%), with a mean age of 56.53 ± 7.92 years and a mean BMI of 24.6 ± 3.1 kg/m Conclusions: In selected patients, primary facelift surgery under local anesthesia appears feasible across a broad spectrum of cervicofacial lifting techniques when performed within a structured pathway including preoperative screening, standardized infiltration, maintenance of verbal responsiveness, and careful hemodynamic monitoring. Patient selection, procedural predictability, and proactive control of anxiety, pain, blood pressure, and nausea/vomiting are likely more important than any single anesthetic formula. Level of Evidence 4 Therapeutic:
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