Awake face surgery
Awake Facelift in Ottawa
A facelift lifts and repositions the deeper tissues of the face and jawline and removes excess skin. Published series show that facelift can be performed with local anesthesia and light sedation, and for selected patients we offer an awake approach.
Facelift at a glance
| Typical operating time | About 3 to 5 hours |
|---|---|
| Awake suitability | Often suitable in selected patients |
| Typical return to desk work | Social downtime often about 2 to 3 weeks |
| Anesthesia | Local anesthesia with or without sedation. General anesthesia arranged if needed |
| Setting | Outpatient, with an anesthesiologist present throughout |
Times are typical ranges for planning, not promises. Your plan is individualized.
What is facelift?
Through incisions hidden around the ear and hairline, the deeper facial layer (SMAS) is tightened or repositioned and skin is redraped. Techniques include SMAS plication, high SMAS and deep plane, and are chosen based on your anatomy. It is often combined with a neck lift.
Who may be a good candidate
- Adults with jowls, lower-face laxity and loss of jawline definition
- Patients who want a natural, refreshed look
- Non-smokers in good general health
- People who would prefer to avoid a general anesthetic if suitable
Why awake facelift may work
Several published series report facelift performed safely under local anesthesia, including a 174-patient analysis using local anesthesia with oral sedation, a 117-patient series covering deep plane, high SMAS and coronal techniques, a deep plane series under local anesthesia, and a scoping review of the topic. Local anesthesia with tumescent technique also limits bleeding and provides numbness that continues into recovery. Staying awake can also mean less nausea and a quicker return to eating and walking for some patients.
When awake may not be the right choice
These are mostly observational series from experienced teams. Longer or combined facial operations, strong anxiety or certain health conditions can make general anesthesia or deeper sedation the better choice. We will advise honestly.
Your awake facelift journey
1. Before surgery (pre-op)
We examine facial structure, skin, hairline and neck, review photographs, and plan the technique and incisions. Smoking and certain supplements are stopped as advised.
- A consultation to review your goals, health history, medications and previous surgeries, and a physical examination
- An anesthesia assessment to decide whether an awake plan is appropriate and safe for you
- Photographs, with your consent, and a written plan, quote and consent form
- Medication guidance, including when to stop blood thinners, certain supplements, and smoking or vaping
- Fasting instructions from the anesthesia team. Follow them exactly
- A ride home and an adult to stay with you after surgery
2. Day of surgery (intra-op)
After facial nerve areas and the surgical field are numbed, sedation is added as needed. You may feel pressure or tugging but not sharp pain. Music is available, and the anesthesiologist adjusts comfort throughout.
- You arrive, change, and meet the surgeon and anesthesiologist, and your markings and plan are confirmed
- An IV and monitors are placed. The anesthesiologist stays with you from start to finish
- Local anesthetic is given. Expect brief stinging, then numbness, and light sedation if planned
- You can listen to music, talk with the team, and tell us at any time if you feel discomfort
- Afterward you rest in recovery, receive written instructions and go home with your driver
3. Recovery (post-op)
You are observed in recovery, given written instructions and pain-control guidance, and scheduled for follow-up. Call us or seek urgent care for fever, spreading redness, severe or worsening pain, heavy bleeding, chest pain, shortness of breath, or leg pain or swelling.
| When | What is typical |
|---|---|
| Days 1 to 3 | Swelling, tightness and bruising. Head elevated. A light dressing may be worn. |
| Days 4 to 7 | Swelling and bruising are most visible. Sutures may be removed. |
| Weeks 2 to 3 | Many feel comfortable socially. Residual swelling and tightness remain. |
| Months 1 to 3 | Swelling fades and results appear more natural. |
| Month 6 and beyond | Scars soften and the final result is judged. |
Timelines are general and vary. Your surgeon gives you instructions specific to you.
Anesthesia options
Anesthesia options range from local anesthesia, with or without sedation, to general anesthesia. An anesthesiologist is present throughout your procedure and recommends an approach after reviewing your health, the extent of surgery and your preferences. If an awake approach is not suitable, general anesthesia is arranged. Plans can change during surgery if comfort or safety requires it, including deepening sedation or converting to general anesthesia.
Learn more: anesthesia options, levels of anesthesia, fear of intubation, and pain perception and music.
Alternatives
Neck lift alone, non-surgical tightening, fillers, fat transfer, or no treatment.
Risks
Hematoma, infection, scarring, hair loss near the incisions, skin or wound-healing problems, nerve injury (facial motor or sensory), asymmetry, contour irregularity, unfavorable results needing revision, and anesthesia-related risks.
Anesthetic risks include reactions to medications, breathing or airway events, the need to deepen sedation or convert to general anesthesia, and, rarely, transfer for further care. All surgery carries risk, and results are not guaranteed.
Frequently asked questions about awake facelift
Can a facelift really be done awake?
Published series describe facelift under local anesthesia with light sedation. We confirm whether it suits you at a consultation.
Will I feel pain?
You are numbed and sedated as needed. Some pressure or tugging is expected.
How long do results last?
A facelift turns back the clock, but aging continues. Many patients enjoy results for years.
Is a facelift safer under local anesthesia?
It avoids a general anesthetic, but all surgery carries risks. We explain both options.
What is the difference between a facelift and a neck lift?
A facelift treats the cheeks and jawline, and a neck lift treats the area under the chin. They are often done together.
Related procedures
- Awake Neck Lift
- Awake Upper Eyelid Surgery (Blepharoplasty)
- Awake Facial Fat Transfer
- Awake J-Plasma Skin Tightening (Face and Neck)
Starting from $18,000 (CAD, before 13% HST), including surgeon, anesthesia and facility fees. Your written quote follows your consultation. See pricing and financing.
Explore your options at a consultation
References
- Frojo G, Dotson A, Christopher K, Kaswan S, Lund H. Facelift performed safely with local anesthesia and oral sedation: analysis of 174 patients. Aesthet Surg J. 2019;39(5):463-469. PMID 30107493
- DeJoseph LM, Pou JD. Local anesthetic facelift. Facial Plast Surg Clin North Am. 2020;28(3):409-418. PMID 32503722
- Beaufigeau M, et al. Facelift surgery under local anesthesia: a scoping review. Ann Chir Plast Esthet. 2026;71(4):358-366. PMID 42034464
- Novis S. The safety and complication rate of deep plane facelift under local anesthesia. Aesthet Surg J Open Forum. 2026;8:ojag156. PMID 42799456
- Lombardi M, Ponzo M, Santamaria E, et al. Facelift under local anesthesia: a retrospective single-center series of 117 patients undergoing deep plane, high SMAS, and coronal rhytidectomy. Aesthet Surg J Open Forum. 2026;8:ojag166. PMID 42819983