Eyelid surgery does not require anesthesia

Carole,

Eyelid surgery, both upper and lower lid does not require anesthesia. For many years now we have performed almost all facial cosmetic surgery under local medication with conscience sedation. The sedation need only be deep enough to place the numbing medication in the lid comfortably. The sedation is not needed to make the eyelid surgery a sucess, it is needed only to make the procedure a pleasant experience.

Regarding safety, sedation with local, and local alone compare very favorably. As you consider a surgeon also take time to review where your procedure will be performed. In the office setting it is important that the office facility be accredited by one of the major review organizations. That is your assurance that the facility is inspected regularly and has demonstrated a commitment to safe surgical practice standards.

Best of luck,

peterejohnsonmd

Depending on the extent of eyelid surgery and patient tolerance, there are many options available.

As mentioned by several of my colleagues, the options are (in order of increasing medication):

1. Straight local
2. Local with oral sedation
3. Local with IV sedation
4. General (LMA or Endotracheal)

A very minimal correction, particularly on the upper eyelid can easily be accomplished under local anesthesia, and is sometimes preferred in cases where patient participation in opening and closing the eyelid is useful to the final result.

In other instances where a more extensive procedure is performed necessitating treatment of the forehead and or cheeks, general anesthesia is a better choice.

Of course, patient tolerance is a critical factor and if someone is deathly afraid of needles, general anesthesia may be preferred to achieve an optimal result.

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There are three main forms of anesthesia:

1. local - just like at the dentist's office and you are completely aware and just numb at the surgical site 

2. eyelids - sedation or twilight, where you are groggy and may not remember anything, but you are awake; and lastly

3. general anesthesia - where you are asleep and will not be aware of anything.

Typically, eyelift surgeries can be done under local anaesthetic alone, but some patients may want to add sedation just to be more comfortable. This is especially if the surgery is going to be longer than one hour, which can be if you are doing both upper and lower eyelids or combining with another procedure.

If you are doing upper eyelids alone, local anaesthetic works really well and you will avoid the potential side effects of anesthesia such as nausea. Discuss your personal options with your board certified plastic surgeon.

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There are alot of good answers here already. At a minimum you would need local anesthesia which anesthetizes the area allowing for the surgeon to work with minimal discomfort and also decrease any bleeding from the effect of adrenaline. For added comfort, you may wish to have a small dose of an oral sedative. If you are particularly nervous, IV sedation, administered by an anesthesiologist, could be a best for you. Finally, general anesthesia is uncommonly used for isolated upper eyelid surgery.