FACIAL PLASTIC SUREGY ANASTHESIA
Meet the people who keep you safe while you sleep
When patients think about a facelift, they think about the surgeon and the result. Far fewer picture the person sitting beside them throughout – the consultant anaesthetist. It is this person whose entire job, for the whole operation, is your safety and comfort. Therefore, you should know exactly who that is before the day arrives
A small team, chosen on purpose
Most clinics draw their anaesthetists from a large, rotating pool, selecting whoever is available on the day. At Yapa Plastic Surgery we have made the deliberate choice to do the opposite.
We work with a small, hand-picked group of consultant anaesthetists that we know personally and trust completely. The same familiar faces, again and again, working alongside the same nursing team in the same theatre. That continuity is not a convenience; it is a safety feature. A team that operates together routinely communicates faster, anticipates more, and manages the rare unexpected moment more smoothly than one assembled from strangers.
Every one of these anaesthetists holds (or has held) a senior NHS consultant appointment, caring for patients through complex major surgery in some of the country’s leading hospitals. That depth of experience, brought to a planned, elective facial procedure in a healthy patient, is a substantial margin of safety.
You will meet your anaesthetist before your surgery, not for the first time on the operating table. Many patients say this single conversation is what finally settles their nerves.
Anaesthesia tailored to you, and to the operation
There is no single “best” anaesthetic for a facelift. The right choice depends on you, your health, your history, your previous experiences and your preferences, as well as on the operation itself.
This matters especially for deep plane surgery. Releasing and repositioning the deeper structures of the face takes time and demands a still, stable, controlled surgical field. Your anaesthetist plans your anaesthetic around exactly that – choosing the technique that holds those conditions steady throughout and gives you the smoothest possible recovery, rather than treating anaesthesia as an afterthought bolted on at the end.
At your consultation and pre-operative assessment, your anaesthetist will review your medical history, your medications, any past anaesthetic experiences and anything that worries you, and together you’ll agree a plan built around you.
Total Intravenous Anaesthesia (TIVA) — the standard choice for facial surgery
For most facial rejuvenation procedures, your anaesthetist will usually recommend TIVA, which delivers anaesthesia through carefully controlled intravenous medication rather than anaesthetic gases. You are fully asleep and aware of nothing, with your airway protected throughout. However, t the experience on waking is typically very different from older, gas-based techniques
TIVA is favoured for facial surgery because it can offer:
A smoother, clearer wake-up:
with markedly less of the nausea and grogginess many people associate with “going under”.
Precise, moment-to-moment control of anaesthetic depth:
and steadier control of your blood pressure during surgery, which can help limit bruising and swelling afterwards and support a quicker recovery.
No inhaled gases:
and a gentler overall experience that suits day-case facial work well.
Your anaesthetist will confirm whether TIVA is the right choice for you.
General Anaesthesia
Some procedures are best performed under conventional general anaesthesia. You are completely asleep and aware of nothing. Modern general anaesthesia, delivered by experienced consultants with advanced monitoring, has an excellent safety record for healthy patients undergoing planned surgery.
Twilight sedation
Sedation (usually called twilight) keeps you deeply relaxed and comfortable without a full general anaesthetic. It’s one of the questions I’m asked most, and for good reason: a general anaesthetic can feel daunting, and many people would far rather drift lightly through their surgery than be fully “under”.
For a carefully selected group of patients, Mr Yapa performs the deep plane facelift itself under twilight sedation making the procedures shorter. Whether twilight is right for you depends on your health, your anatomy and the extent of your surgery; your anaesthetist will talk you through it openly at your assessment and help you decide.
And if a full anaesthetic turns out to be the better route for you, there’s nothing to fear in it. The TIVA technique your anaesthetist most often uses is gentle and modern. You’re asleep and aware of nothing, your airway is protected throughout, and you wake calm and clear-headed with little of the nausea people dread. Most patients who arrive set on twilight feel completely at ease with TIVA once they understand what it actually involves.
Demystifying anaesthesia: the things patients actually worry about
Most anaesthetic anxiety isn’t about the medicine — it’s about the unknown. Here are honest answers to the questions patients ask me most, and rarely feel able to ask out loud:
“Will I feel anything, or be aware during the operation?”
No. Under general anaesthesia or TIVA you are fully unconscious and have no awareness, sensation or memory of the procedure. Your anaesthetist monitors the depth of your anaesthesia continuously and adjusts it throughout – it’s never left to chance.
“What if I don’t wake up?”
This is the fear almost everyone carries and almost nobody voices. For a healthy person having planned surgery, serious anaesthetic complications are very rare. Large UK studies put the risk of a serious problem from elective anaesthesia in the region of a few per million — lower than many everyday risks we don’t think twice about. My anaesthetist’s job, throughout, is simply to keep that margin as wide as possible.
“What does ‘twilight’ or ‘sedation’ actually mean?”
It’s a loosely used phrase that can mean very different depths of anaesthesia, which is part of why it causes confusion. Rather than a vague label, your anaesthetist will tell you precisely what you’ll experience and why it’s been chosen for you.
“Who looks after me while I’m asleep?”
One consultant anaesthetist, will be dedicated to you, for the entire operation. They will manage your breathing, circulation, comfort and depth of anaesthesia from the moment you drift off until you’re safely awake in recovery.
“What type of anaesthesia is used for a deep plane facelift?”
Deep plane facelift surgery can be performed using different anaesthetic techniques depending on your health, anatomy, the extent of surgery and your individual preferences. At Yapa Plastic Surgery, TIVA is often used because it allows the anaesthetist to maintain a carefully controlled level of anaesthesia throughout a longer facial procedure, while also supporting a smooth recovery.
In selected patients, deep plane facelift surgery may also be performed under twilight sedation. This is not suitable for everyone, and the choice is made after a detailed pre-operative assessment with your consultant anaesthetist.
Whichever technique is recommended, your anaesthetist remains dedicated to you throughout the procedure, continuously monitoring your breathing, circulation, comfort and depth of anaesthesia from the moment you go to sleep until you are safely awake in recovery.
Patient safety is at the core of our practice.
Before Surgery
You’ll have a thorough pre-operative assessment so that any medical condition is identified and optimised in good time. Where appropriate this may include blood tests, an ECG or a specialist medical review.
During Surgery
Your procedure takes place in a fully equipped, CQC-regulated theatre. You are continuously monitored on advanced equipment by your consultant anaesthetist, who remains dedicated solely to your care throughout – managing your comfort, breathing, circulation and recovery.
After Surgery
After surgery. The recovery nursing team and your anaesthetist continue to watch over you closely until you’re comfortable, stable and ready, ensuring a smooth and gentle recovery
A Team You Can Trust
At Yapa Plastic Surgery, we work with a carefully selected group of consultant anaesthetists who combine outstanding technical expertise with a calm, reassuring manner. Each is committed to providing highly individualised care and supporting you with confidence and compassion throughout your surgical journey.er and commitment to looking after each patient as an individual.
Talk to Mr Yapa
Every treatment starts with an honest, one-to-one conversation. Book a consultation with Mr Kshem Yapa to discuss your goals and whether surgery is right for you.
“I feel fantastic, look fantastic and natural. I can’t praise Mr Yapa enough. From the moment I met him I felt I am in good hands. I had many questions and he was always happy to provide answers and advice. He is very knowledgeable, professional and caring for his patients.”
Facelift patient
“Fantastic experience that I couldn’t fault what so ever! From the consultation to the operation to the anaesthetist and to the after-care has been nothing but exceptional, Dr Yapa an amazing Surgeon who achieves exactly what you ask for. I would have no hesitation what so ever recommending him to anyone.”
Browlift and upper blepharoplasty patient
“Mr Yapa understood what I wanted and went above and beyond to make it happen. During our consultation, I wanted a slight change in my nose, not to be a swoop just straight and he did just that. He understood what I wanted and just went above and beyond for it. This beyond what I expected. He is an amazing, empathetic surgeon.”
Rhinoplasty patient
“Mr Yapa completely changed my life – I can finally wear my hair up!
I would highly recommend considering this surgical procedure with Mr Yapa because my ears were completely different due to the shape of my ears and one stuck out more. I am unbelievably amazed by the outcome of the surgery and how my ears now look. “
Prominent Ear Correction patient
As seen on
Deep Plane Facelift Anaesthesia FAQs
For those undertaking a deep plane facelift, please don’t hesitate to get in touch if you have any questions regarding your anaesthesia. We will make sure you have the full scope of knowledge before you make a decision, which is key for peace of mind when approaching surgery. For the most commonly asked questions, please see the following:
When do I have to stop eating and drinking?
Your anaesthetist or the hospital pre-assessment team will give you exact timings for your operating list, and it is important to follow them precisely rather than rely on general advice you have read elsewhere. As a rule, patients are asked to stop food 6 hours before surgery, while clear fluids are usually permitted up to three hours before surgery. Modern practice tends to avoid the long, uncomfortable overnight fasts of the past. If you are unsure, or your surgery time changes, ring us rather than guess.
Should I keep taking my usual medications/ supplements and weight-loss drugs ?
Most regular medications are continued as normal, and stopping something unnecessarily can cause more difficulty than taking it. A few, particularly blood-thinning medication, some diabetes treatments and certain supplements, may need to be paused or adjusted before surgery. Bring a complete list of everything you take, including anything bought over the counter, to your pre-operative assessment, and your anaesthetist will tell you exactly what to do
with each one.
If you are taking any weight-loss / glp-1 medications please tell us. Medications in this group can slow the rate at which the stomach empties, which has implications for the safety of your anaesthetic
and for how long you are asked to fast. This is a well recognised consideration and easily managed, but only if we know about it in advance, so mention it at your first consultation even if you feel it is unrelated to your face.
Several common supplements can affect bleeding or interact with anaesthetic medication, so they are not automatically harmless simply because they are natural. You will usually be asked to stop most supplements for a period before surgery. List them at your assessment, including anything you take
only occasionally.
Do I need to stop smoking or vaping?
Stopping is one of the few things genuinely within your control that can improve both the safety of your anaesthetic and the quality of your healing, and the longer the period before surgery the better. Smoking affects the blood supply to the skin flaps raised during a facelift, so this matters to your result as well as to your anaesthetic. We will talk about this honestly at your consultation; there is no judgement in it.
Will I need tests beforehand?
Many healthy patients need very little. Depending on your age, your medical history and the extent of your surgery, your anaesthetist may request blood tests, an ECG or a review by a specialist physician. This is routine forward planning rather than a sign of concern, and it is arranged in good time so nothing is rushed near your date.
Deep Plane Neck Lift Consultation London
Book Your Appointment
Mr Yapa approaches every consultation with the time and honesty that this decision deserves. He will assess your concerns, walk you through the options available, and give you a clear, realistic picture of what deep plane neck lift surgery could achieve for you. If a different approach would serve you better, he will say so.
2026 consultation dates are now available to book online, costing £250 (redeemable against your surgery should you wish to go ahead). You can join our waiting list to be notified when new dates become available. For general enquiries or to learn more about our procedures and services, please use the form below to request a callback.
