The Safety and Complication Rate of Deep Plane Facelift Under Local Anesthesia.

BACKGROUND: The deep plane facelift is traditionally performed under general anesthesia or intravenous (IV) sedation. Because of demand increases among older patients and those with comorbidities, interest has grown in performing comprehensive facelift surgery under local anesthesia; however, safety data remain limited. OBJECTIVES: The objective of this study is to evaluate the complication rate associated with deep plane facelift surgery performed under local anesthesia and to compare these outcomes with established complication rates reported in the literature. METHODS: A retrospective review was conducted of 142 consecutive patients who underwent primary deep plane facelift and necklift under local anesthesia with oral sedation. All procedures were performed by a single surgeon in an office-based facility with a minimum follow-up of 90 days. Major and minor complications were recorded and compared with established complication rates for deep plane facelift reported in the literature using odds ratio analysis. RESULTS: The mean patient age was 63.5 years. There were no major hematomas, skin necrosis, or temporary or permanent facial nerve injuries. Minor complications included seroma (3.52%), minor hematoma (0.70%), and localized infection (1.40%), all resolving with conservative management. No patients required hospitalization or experienced thromboembolic events. Complication rates did not differ significantly from published data (P > .05). CONCLUSIONS: Deep plane facelift with necklift can be safely performed under local anesthesia with oral sedation, demonstrating complication rates in this cohort that are no higher than published benchmark rates for patients receiving general anesthesia or IV sedation. LEVEL OF EVIDENCE 4 THERAPEUTIC: For image description, please refer to the figure legend and surrounding text.