Twilight Sedation Anaesthesia in London
A Patented, Safer Alternative to General Anaesthetic by Dr Julian De Silva
What is Twilight Sedation?
Twilight sedation—also called conscious sedation or twilight anaesthesia — is a breakthrough, gentler alternative to general anaesthetic for facial cosmetic surgery.
At The Centre, 23 Harley Street, Dr Julian De Silva has developed a patented sedation formulation, refined over more than a decade and thousands of facial surgeries, offering unmatched safety, comfort, and recovery outcomes.
This exclusive technique is one of the reasons patients travel from across the UK, Europe, the US, and the Middle East to undergo facial surgery with Dr De Silva.
Why Twilight Sedation Is Transforming Facial Cosmetic Surgery
Traditional general anaesthetic forces the body into deep unconsciousness, requires a breathing tube, and often leads to nausea, grogginess and prolonged downtime.
Twilight sedation changes this entirely.
Under Dr De Silva’s patented method, patients:
- Breathe naturally throughout surgery
- Experience a sleep-like state with no awareness
- Avoid intubation, gas anaesthetic, and deep physiological stress
- Recover faster and feel clearer sooner
This approach is particularly beneficial for precision facial procedures, where stability, minimal swelling, and controlled healing are essential
How Dr De Silva’s Patented Sedation Technique Works
(Backed by UK Patent GB2602123)
Having pioneered sedation in UK facial cosmetic surgery, Dr De Silva created a proprietary system consisting of:
A carefully balanced combination of four to five ultra-low-dose medications that work together to create a smooth, sleep-like state — not the blunt force of general anaesthesia.
The surgical area is gently numbed to eliminate pain while maintaining the body's natural physiology.
Each patient receives a tailored plan based on:
- Age
- Physiology
- Medical history
- Metabolic rate
- Anxiety level
- Expected surgical duration
All sedation specialists at the clinic:
- Work exclusively with sedation anaesthesia
- Have thousands of cases of experience
- Are hand-selected by Dr De Silva
- Are the same doctors trusted for his family and friends
Patients awaken naturally — clear-headed, comfortable, with minimal side effects — often surprised by how easy the experience feels.
Twilight Sedation vs General Anaesthetic
A Clear Difference in Safety, Comfort & Recovery
| Aspect | Twilight Sedation (Our Patented Formulation) | General Anaesthetic |
| Breathing | Natural, self-regulated | Requires breathing tube |
| Awareness | Sleep-like, no memory | Full unconsciousness |
| Risks | Very low Sleeping under Anaesthetic (Natural reflexes function normally) | Deep Vein Thrombosis Serious reaction to inhaled Anaesthetic Malignant Hyperthermia Higher cardiovascular & respiratory risks |
| Side Effects | 0.7% nausea, 4% headache/shivering Short recovery, home same day | 30–40% nausea, high grogginess Possibility of longer recovery, overnight stay |
| Recovery Time | 30–60 minutes | Several hours |
| Hospital Admission | Not required | Sometimes required |
| Ideal For Facial Surgery? | Yes — supports precision and healing | Not optimised for facial procedures |
This is why Dr De Silva performs 100% of surgeries under twilight sedation.
Video Testimonials — Real Patient Experiences
Patients share what twilight sedation felt like, how quickly they recovered, and why they would choose it again.
Benefits of Dr De Silva’s Twilight Sedation Technique
1. Safer Than General Anaesthetic
- No intubation
- Natural breathing maintained
- Protective reflexes remain intact
- Gentle on the cardiovascular system
- Avoid serious risks of general anaesthesia including deep vein thrombosis, malignant hyperthermia
2. Faster, Easier Recovery
Most patients walk out within 30minutes, without grogginess or nausea.
3. Dramatically Fewer Side Effects
- 4% shivering
- 4% headache
- 0.7% nausea/vomiting Compared with 30–40% under general anaesthetic.
4. Precision for Facial Surgery
Twilight sedation supports:
- Stable blood pressure
- Less bleeding
- Increased surgical accuracy
- Better early healing
5. Minimal Need for Pain Medication
Over half of patients use no painkillers at all after surgery.
Read Our Surgery Reviews
What a Patient Actually Experiences
*Real Patient Story
A patient who previously had rhinoplasty under general anaesthetic chose twilight sedation for her revision surgery with Dr De Silva. Here is her experience:
“I was extremely nervous, but the anaesthetist explained everything step-by-step and stayed with me the entire time. I drifted off and woke up about two hours later — no pain, just a heaviness on my nose. I went home the same day and even slept well that night. My recovery was straightforward, and I didn’t need pain medication. I would choose sedation every time.”
She chose Dr De Silva because of:
- His advanced understanding of facial symmetry
- His artistic approach to natural results
- The team’s compassion and communication
- Confidence in his vast experience
What Procedures Can Be Performed Under Twilight Sedation?
- Deep Plane Facelift
- Neck Lift & Deep Neck Lift
- Upper & Lower Blepharoplasty
- Rhinoplasty (selected cases)
- Fat Transfer
- Mini Facelift
- Revision Facial Surgery
- Chin Implant / Jawline Surgery
Every procedure Dr De Silva performs is carried out under twilight sedation for maximum safety and comfort.
Why Choose Dr Julian De Silva for Twilight Sedation?
Patented Sedation Technique (UK Patent GB2602123)
Exclusive formulation and methodology available only at 23 Harley Street.
Over 20 Years Specialist Experience
Dedicated entirely to facial cosmetic surgery.
Internationally Recognised Surgeon
Patients travel from more than 40 countries.
Over 1,000 Five-Star Reviews
Across TrustPilot, Google, and RealSelf.
State-of-the-Art Facial Surgery Centre
Custom-built for sedation-based surgical care.
Enhanced Recovery Program
Hyperbaric oxygen therapy, regenerative medicine, MLD, and personalised aftercare.
Frequently Asked Questions About Twilight Sedation
Yes. It avoids intubation, maintains natural breathing, and has a significantly lower risk profile.
No. Patients sleep naturally and have no awareness of the procedure.
Most patients go home within 30–60 minutes and feel normal by the afternoon or next day.
Absolutely — it is gentler than general anaesthetic and suitable for patients in their 50s–80s.
Yes. His proprietary sedation formulation is legally patented in the UK and exclusive to his clinic.
Book a Consultation With Dr De Silva
Experience the safest and most advanced anaesthetic technique available in facial cosmetic surgery.
Dr. Julian De Silva is a renowned facial cosmetic surgeon at Harley Street, London, specializing in facelift, blepharoplasty, and rhinoplasty. Known for natural-looking results, he has treated top celebrities and uses advanced technology for fast recovery. Dr. De Silva is also a recognized author and educator in aesthetic surgery.