Total IV Anesthesia (TIVA): The State-of-the-Art Choice for Facelift Surgery

Why Anesthesia Matters in Cosmetic Surgery

When patients think about surgery, one of the most common concerns is anesthesia. Will I feel pain? Will I wake up nauseous? Is it safe? At Gould Plastic Surgery, we use Total IV Anesthesia (TIVA)—also known as ORVA—because it offers the safest, smoothest, and most advanced anesthesia experience available today.

Unlike older techniques, TIVA uses carefully tailored intravenous medications to deliver a restful, comfortable, and controlled experience without the risks and side effects of traditional methods.

What Is Total IV Anesthesia?

TIVA is a form of anesthesia given entirely through an IV, without inhaled gases or tubes in the throat. Patients remain fully asleep and comfortable, yet the anesthesia is lighter and gentler on the body than conventional general anesthesia.

Benefits of TIVA for Facelift Surgery

Enhanced Safety – No need for breathing tubes or inhaled gases reduces risks to the airway and lungs.
Smoother Recovery – Patients typically wake up more quickly and feel more alert.
Minimal Nausea – We combine TIVA with Amend (aprepitant), a state-of-the-art anti-nausea medication, to dramatically reduce postoperative sickness.
Less Pain After Surgery – With advanced pain-control techniques like Jornavax and long-acting local anesthetics such as Exparel, most patients experience far less discomfort after surgery.
Reduced Grogginess – Compared to general anesthesia, patients feel more clear-headed and often need fewer pain medications in recovery.

Comparing Anesthesia Options

Feature	Conscious Sedation	General Anesthesia	Total IV Anesthesia (TIVA)
Awareness	Drowsy, may be aware of surroundings	Fully unconscious, often requires breathing tube	Fully asleep, no awareness
Airway	Breathing on your own	Breathing tube and inhaled gases	Breathing on your own
Recovery	Quick but sometimes incomplete	Longer recovery, grogginess	Smooth, fast, clear-headed
Side Effects	Higher risk of awareness or discomfort	Higher nausea, sore throat, grogginess	Minimal nausea, less discomfort
Safety	Safe for small procedures	Higher risks with longer cases	Safest balance for facelift and body surgery

Beyond Facelifts: Advanced Anesthesia Across Procedures

At Gould Plastic Surgery, we apply the same TIVA approach across many procedures:

Facelift & Neck Lift – Safe, comfortable, smooth recovery.
Body Procedures (tummy tuck, liposuction, mommy makeover) – Enhanced safety and pain control with Exparel and Jornavax.
Preservé™ Breast Augmentation – Our fascia-preserving, state-of-the-art technique pairs beautifully with TIVA for a gentler experience, faster recovery, and less pain.

Advanced Analgesia: Pain Control Without Heavy Narcotics

We combine TIVA with the latest pain-control strategies:

Amend (aprepitant) – Prevents nausea and vomiting.
Jornavax – Helps block pain pathways, reducing the need for opioids.
Exparel – A long-acting local anesthetic that keeps treated areas numb for days, not hours.

This multimodal approach means patients recover more comfortably, return to daily life faster, and rely less on narcotics.

Why Choose Gould Plastic Surgery?

As a board-certified plastic surgeon and academic leader, Dr. Gould prioritizes safety, comfort, and innovation. By pairing the most advanced surgical techniques with cutting-edge anesthesia and analgesia, we offer patients not just beautiful results—but also peace of mind every step of the way.

Ready to Learn More?

If you’re considering a facelift, body procedure, or our advanced Preservé™ breast augmentation, discover how TIVA can make your experience safer, smoother, and more comfortable.

TIVA FAQs

What makes TIVA different from general anesthesia?

TIVA is delivered entirely through an IV, without gases or breathing tubes. You stay fully asleep and comfortable but avoid many side effects of general anesthesia, like grogginess, nausea, or sore throat.

Will I be awake during facelift surgery with TIVA?

No. With TIVA, you’re completely asleep and unaware of the surgery, while still breathing on your own without a breathing tube.

Is TIVA safe for longer procedures?

Yes. TIVA is considered especially safe for longer cosmetic surgeries such as facelifts, tummy tucks, and mommy makeovers, thanks to its lighter impact on the body and smooth recovery profile.

How does recovery feel after TIVA?

Most patients wake up faster, clearer, and more comfortable compared to general anesthesia. With advanced medications that reduce pain and nausea, downtime is typically smoother and shorter.

Can TIVA be used for surgeries other than facelifts?

Absolutely. At Gould Plastic Surgery, we use TIVA for facelifts, body contouring, and Preservé™ breast augmentation. It provides comfort, safety, and easier recovery across multiple procedures.

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