Anesthesia for the patient undergoing facial plastic surgery can be approached in a variety of ways. This article describes a technique with which the authors have had great success. The principles of patient safety and comfort are essential elements in providing anesthesia for a facial plastic surgical case. A well-performed anesthetic makes a smooth postoperative course more likely, but a poorly handled anesthetic can increase the likelihood of postoperative complications and can strain the relationship between surgeon and patient. There cannot be enough emphasis on making and keeping the patient happy. A happy patient will do better in the long run, will be more willing to undergo future procedures, and often provides the best form of advertisement: word of mouth.