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Facial Expertise, Performed with Your Comfort in Mind

At Virginia Institute of Plastic Surgery, Drs. Burton and Reps Sundin bring an unmatched level of precision to facial surgery, and their awake facial procedures reflect that commitment. Dr. Reps Sundin completed his Aesthetic Surgery Fellowship at the renowned Manhattan Eye, Ear, and Throat/Lenox Hill, training alongside some of the world's most celebrated facial surgeons. Dr. Burton Sundin completed two advanced fellowship programs, including a cosmetic surgery fellowship at the University of Alabama, Birmingham, under Dr. Luis Vasconez. Together, they offer a range of facial procedures that can be performed awake, with the same level of artistry and attention to detail that their patients have come to expect. All awake procedures are also available under sedation or general anesthesia. Your anesthesia plan will be determined based on the procedure, your anatomy, and your personal preferences.

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Why Consider Awake Facial Surgery?

Awake facial procedures use local anesthesia and, in some cases, mild oral or IV sedation to numb the treatment area completely while you remain comfortable and conscious. This approach carries a number of meaningful advantages for the right patient, such as:

  • Eliminates general anesthesia risks, especially beneficial for patients with heart, lung, or metabolic conditions
  • Faster recovery with no anesthesia grogginess; most patients go home the same day feeling alert
  • Reduced downtime, as many patients return to normal activities sooner with less systemic sedation
  • Real-time feedback, allowing your surgeon to assess symmetry and natural expression in ways that are impossible under general anesthesia
  • Lower overall cost with no anesthesiologist or associated hospital fees
  • In-office convenience, as many procedures are performed at the Richmond facility rather than a hospital

Awake Facial Procedures at Virginia Institute of Plastic Surgery

Awake Eyelid Lift (Blepharoplasty)

Eyelid surgery is one of the most commonly performed awake facial procedures. Because the eyes are involved, performing this procedure awake allows the surgical team to assess natural eye position and symmetry in real time.

Awake Lip Lift

A lip lift shortens the distance between the base of the nose and the upper lip border, creating a more youthful, defined lip appearance without fillers. This relatively short procedure is well-suited to local anesthesia and can typically be completed in under an hour at the office.

Awake Facial Fat Grafting

Facial fat grafting harvests a small amount of fat from one part of the body and transfers it to the face to restore lost volume in the cheeks, under-eye area, temples, or around the mouth. When treatment areas are limited in scope, this procedure can be performed awake, avoiding general anesthesia entirely.

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Are You a Candidate for Awake Face Surgery in Richmond?

Awake facial procedures in Richmond may be a good fit if you:

  • Are in good overall health with no significant systemic conditions that require monitoring during surgery
  • Are considering a targeted facial procedure with a well-defined treatment area
  • Have concerns about general anesthesia or have had adverse reactions in the past
  • Want a faster recovery and prefer to remain alert post-procedure
  • Are comfortable being awake during surgery and have discussed this openly with your surgeon
  • Understand that more extensive procedures, such as a full facelift, typically require sedation or general anesthesia for optimal results and comfort

Candidates requiring extensive correction, multiple simultaneous procedures, or those who feel significant anxiety about being awake during surgery are generally better served by traditional anesthesia. Drs. Sundin will help you make the right choice during your consultation.

Why Choose Virginia Institute of Plastic Surgery for Awake Face Surgery?

Facial surgery performed awake demands a surgeon with extraordinary technical skill and a keen aesthetic eye. Drs. Burton and Reps Sundin have earned recognition from Castle Connolly, Modern Luxury DC, and Northern Virginia Magazine as top physicians precisely because of their meticulous attention to detail and commitment to natural-looking results. Dr. Burton Sundin's background in art history at Duke University informs a surgical aesthetic that goes beyond technique, producing results that are truly artful. With over 540 five-star patient reviews and a 4.7-star rating, their patients consistently describe feeling heard, cared for, and thrilled with their outcomes.

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What to Expect: Awake Face Surgery

Consultation and Cost

  • An in-person consultation with Drs. Sundin includes a thorough facial assessment, discussion of goals, and a review of both awake and traditional anesthesia options
  • Cost varies by procedure; awake procedures are typically more affordable due to reduced anesthesia and facility fees
  • Financing is available; virtual consultations are offered for traveling patients

Procedure Steps

  • Pre-operative photos are taken and treatment areas are carefully marked
  • Mild oral or IV sedation may be administered for relaxation
  • Local anesthetic is precisely injected to fully numb the treatment area
  • The procedure is performed with you comfortable, awake, and in communication with the surgical team
  • Real-time symmetry assessment is performed throughout
  • Incisions are closed; you walk out of the office the same day

Recovery and Results Timeline

  • Same day: Patients leave alert, without grogginess; mild swelling and sensitivity are normal
  • Days 1 to 5: Swelling peaks and begins to subside; most patients can rest comfortably at home
  • Days 5 to 10: Most patients feel comfortable resuming light activity and some return to work
  • 2 to 4 Weeks: Visible bruising and swelling resolve; early results are apparent
  • 3 to 6 Months: Final results are fully visible as residual swelling subsides and tissues settle
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Related Facial Procedures at Virginia Institute of Plastic Surgery

  • Facelift, full surgical facial rejuvenation typically performed under sedation
  • Neck Lift, which tightens loose skin and muscle bands in the neck and jawline
  • Rhinoplasty, which reshapes and refines the nose
  • Brow Lift, which elevates the brows and smooths forehead lines
  • Dermal Fillers, a non-surgical volume restoration option for patients who prefer no downtime
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Schedule Your Awake Facial Surgery Consultation in Richmond

Call (804) 390-5660 or request a consultation online today.

FAQs: Awake Face Surgery

Will my face look natural immediately after an awake facial procedure?

Can I wear makeup after awake facial surgery?

Are the results of an awake eyelid lift permanent?

Can awake facial surgery be combined with non-surgical treatments like BOTOX or fillers?

Is swelling worse after awake facial surgery compared to surgery under general anesthesia?

What should I sleep on or avoid after awake facial surgery?

Will awake facial procedures affect my ability to wear glasses or contacts?

How soon after a lip lift can I return to eating normally?

Will my face look natural immediately after an awake facial procedure?

Swelling and mild bruising in the days following surgery are normal and will temporarily affect how results appear. As these subside over the following weeks, your natural, refreshed appearance will become increasingly visible.

Can I wear makeup after awake facial surgery?

Most patients are advised to avoid applying makeup directly over incision sites until they are fully healed, typically for at least one to two weeks. Drs. Sundin's team will provide specific post-operative skincare guidance based on which procedure you had.

Are the results of an awake eyelid lift permanent?

Blepharoplasty produces long-lasting results, though the natural aging process will continue over time and some patients eventually seek a touch-up procedure years down the line. Maintaining a healthy lifestyle, protecting the skin from sun exposure, and following a good skincare routine can help extend your results.

Can awake facial surgery be combined with non-surgical treatments like BOTOX or fillers?

In many cases, injectable treatments can complement surgical results, though the timing of combining them requires careful planning. Drs. Sundin's team will advise on when it is appropriate to introduce or resume injectable treatments following your procedure.

Is swelling worse after awake facial surgery compared to surgery under general anesthesia?

Swelling is primarily determined by the extent of the procedure and individual patient factors rather than by the type of anesthesia used. Many patients find that awake facial procedures produce manageable swelling due to the reduced systemic impact of local versus general anesthesia.

What should I sleep on or avoid after awake facial surgery?

Sleeping with your head elevated for the first week helps minimize swelling and promotes more comfortable healing. Drs. Sundin's team will also advise you to avoid sleeping directly on the treated area until healing is sufficiently advanced.

Will awake facial procedures affect my ability to wear glasses or contacts?

Patients who have had eyelid surgery are typically advised to avoid contact lenses for a period following their procedure and may need to use glasses temporarily. Drs. Sundin will provide specific guidance based on your procedure and your prescription eyewear needs.

How soon after a lip lift can I return to eating normally?

Most patients can resume a soft diet shortly after the procedure and a normal diet once initial healing is underway and any soreness around the incision has subsided. Drs. Sundin will provide post-operative dietary guidance to ensure healing is not disrupted during the first week.

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Delivering premier plastic surgery and non-invasive procedures, our services extend to popular cosmetic procedures such as mommy makeover, facelift, and liposuction for clients in Richmond.

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