Eyelid Surgery Q&A
75%
WORTH IT RATING
"Worth It Rating" shows the % of consumer reviewers that stated the procedure was "Worth It" or not. See more RealSelf Worth It Ratings or Add Your Review
477 Reviews
Eyelid Surgerybefore & after photos
View Before and Afters

Average Eyelid Surgery Cost: $3,875

Learn about Eyelid Surgery

2,260 people and 796 doctors are talking about Eyelid Surgery

Get Free Email Updates

Can Eyelid Surgery Be Done Without Anesthesia?

asked 3 years ago by Carole one in graham nc
Latest answer by Kris M. Reddy, MD, FACS
Question viewed 12,532 times
Tags: anesthesia

Can bleph eyelid surgery be done without anesthesia?  If so, how does it work?

50 answers to Can Eyelid Surgery Be Done Without Anesthesia?

+1

Eyelid surgery and anesthesia

Typically most eyelid surgery is performed under local anesthesia. This is the same type of anesthesia that your dentist uses. If a more complex procedure is being performed, we can use local anesthesia with IV sedation or general anesthesia.
Kami K. Parsa, MD

Los Angeles Oculoplastic Surgeon

www.oculoplastic.info

+1

Local vs sedation vs general

I'm assuming you are asking about which anesthetic options you have, not whether or not local anesthesia is needed. Almost all doctors in this country will use a local anesthetic while performing any blephaorplasty surgery, for the reasons listed in the posts below. Local anesthesia - Almost any surgery can be done under local anesthesia. Upper blepharoplasty alone, with or without remodeling of the fat, can be performed under local anesthesia. The patient is completely aware that... more
Brent Moelleken, MD

Beverly Hills Plastic Surgeon

www.drbrent.com

+5

Blepharoplasty should not be without anesthesis

Eyelid Surgery would need some form of anesthetic to ensure a comfortable state during surgery. While some surgeons may perform the surgery with local anesthetic, we recommend at least sedation.
Kris M. Reddy, MD, FACS

West Palm Beach Plastic Surgeon

www.drkrisreddy.com

+3

Don't pass on the local anesthesia!

Hi Carole, Upper and lower eyelid surgery is usually performed in my office under anesthesia. Local anesthesia with "adrenaline" is injected just under the skin about 5 to 10 minutes prior to the treatment. The only exception is if there is excessive fat pad protrusion in the lower lids, then I prefer having the patient under sedation anesthesia. Choose your surgeon carefully. Good luck. Dr. P
Michael A. Persky, MD

Los Angeles Facial Plastic Surgeon
+2

Eyelid surgery without anesthesia would be intolerably painful

Eyelid surgery or for that matter any surgery would be too painful to perform without any anesthesia. I suspect that you meant to ask whether eyelid surgery could be performed while you are completely awake under a local anesthetic alone. This would be comparable to having a cavity filled by your dentist with an injection of the local anesthetic in your gum. In the case of blephroplasty or eyelid surgery, local anesthetic alone would suffice but I wouldn't recommend it. Patients undergoing... more
David A. Ross, MD

Chicago Plastic Surgeon
+2

Local anesthesia is my routine for eyelid surgery

Local anesthesia is my general routine for blepharoplasty. The local anesthesia injections in the eyelids are not painless, but relatively low pain. Some patients desire a little oral or IV sedation which is always a possibility.
York Jay Yates, MD

Salt Lake City Plastic Surgeon
+2

Local anesthesia preferred for blepharoplasty

Upper eyelid blepharoplasty can be safely performed under local anesthesia in most patients. The preoperative workup of a patient for blepharoplasty is important in assessing the anesthetic and surgical risks of a patient. Your surgeon should be qualified in the surgical and perioperative managment of patients undergoing surgery. Upper eyelid blepharoplasty can be performed under general anesthesia and conscious sedation, however, local anesthesia with or without an anxiolytic is preferred. more
Raffy Karamanoukian, MD

Los Angeles Plastic Surgeon
+2

Eyelid surgery can be performed without general anesthesia.

Eyelid surgery can be performed without general anesthesia. It is reasonable to undergo upper eyelid blepharoplasty under straight local anesthesia. One can also perform some types of lower lid blepharoplasty procedures under local anesthesia as well. For some more aggressive procedures, patients will benefit from some sort of sedation or general anesthesia.
Sanjay Grover MD

Orange County Plastic Surgeon
+2

Blepharoplasty with valium and lidocaine

I have a plastic surgeon who does these in my office and uses 5 mg of valium and local anesthesia. His patients are very pleased and are driven home by a friend or spouse. I have watched him do this in many patients and I don't perceive them to have any discomfort whatsoever! Dr. Raffy Karamanoukian (disclosure - my brother) also does these in his offices. I think it is well tolerated. As a heart surgeon myself, I have done coronary bypass surgery on a dozen people who had eyelid surgery... more
Hratch Karamanoukian, MD

Buffalo General Surgeon
+2

It could - but you wouldn't want it

Some form of anesthesia is needed to do any kind of surgery. There are generally three levels of anesthesia - local, sedation, and general. Local is similar to what most dentists will administer. It involves injecting numbing medicine at the area to be operated on. Sedation involves some sort of medication which alters a person's state of consciousness. In general sedation will not require a breathing tube and is fairly easy to rebound from. General anesthesia is what is thought about for... more
D.J. Verret, MD

Dallas Facial Plastic Surgeon

innovationsfps.com

+2

Eyelid Surgery without General Anesthesia

Certain types of eyelid rejuvination can be done with only local anesthesia. More complex and deeper procedures involving fat or muscle work require sedation or general anesthesia. Local anesthesia is given with an injection (usually Lidocaine). No surgery on the body can be done without at least local anesthesia. Upper and lower eyelid blepharoplasty where only skin needs to be removed can be done under local. Look in the mirror and see if your upper eyelid skin appears to be excessive.... more
Richard W. Westreich, MD

Manhattan Facial Plastic Surgeon
+1

Eyelid Surgery without Anesthesia?

Thank you for your question. I do not think that any surgeon would perform this procedure with NO anesthesia. Some surgeons use General Anesthesia, some surgeons perform the blepharoplasty surgery under local anesthesia. Do your research and make sure that you are comfortable with your surgeons experience with this procedure. Ask to see before and after photos and even speak with other patients who have had this surgery performed. Best Wishes! more
Tom J. Pousti, MD

San Diego Plastic Surgeon
+1

Eyelid surgery without anesthesia

I assume that you are speaking about sedation and not anesthesia injected into the eyelids. My answer is, it depends. For a four lid blepharoplasty, you would be uncomfortable on the operating table for the duration of the procedure and I would not recommend it. An upper lid blepharoplasty is a short procedure and many patients can tolerate straight local. Your personality and tolerance are the critical factors. When I operate on my filler and Botox patients, I generally have a good... more
Robert L. Kraft, MD

New York Plastic Surgeon
+1

Eyelid sugery without anesthesia

I am assuming you mean having it down under straight local anesthesia, like the dentist, without sedation or without general anesthesia, being put entirely to sleep. The short answer is yes, in selected patients. If it is just a small amount of skin, it might be able to be performed in a patient that is quite tolerant of discomfort. But, you certainly do not want to move or squirm when the surgeon is performing the surgery and inadvertently cut something unintended. When the fat pockets are... more
Julio Garcia, MD

Las Vegas Plastic Surgeon

lvcosmeticsurgery.com

+1

Local anesthesia an option for blepharoplasty

Hello! Blepharoplasty, or eyelid surgery, is fairly easily done under local alone- a numbing injection is all that is needed, with or without valium or halcion before the procedure. If you are looking to not remember anything, consider sedation with IV medications to take away memory and pain. Regardless, the procedure is fairly quick, and the only pain that should be felt is the sting of the numbing injection. there is very little discomfort after surgery regardless of... more
Catherine Winslow, MD

Indianapolis Facial Plastic Surgeon

www.indyface.com

+1

Eyelid Surgery and Anesthesia

Eyelid surgery can be done quite easily with local anesthesia. One can do upper and lower eyelid surgery with IV sedation, however, where I am located in Dallas, TX most patients prefer general anesthesia. I prefer general anesthesia as well for my patients as I prefer speaking to my patients pre and post operatively, but not intra operatively. It also provides for optimal safety for the patient.
Rod J. Rohrich, MD

Dallas Plastic Surgeon
+1

General or local anesthetics can be used

Blepharoplasty can certainly be done under local anesthesia without the need for general sedation. For both lower and upper lids, local anesthetic can be injected moments before the procedure itself, to take away any potential discomfort. Under local you will feel pressure and movement but not pain. Any more potential pain can be addressed by using a little more injection of local anesthetic.
Yael Halaas, MD

Manhattan Facial Plastic Surgeon
+1

Local anesthesia usually adequate

Eyelid surgery, like any kind of surgery, usually requires some kind of anesthesia. I would not recommend surgery be done without anesthesia nowadays. Local anesthesia is relatively painless to administer, and within a few minutes the area will be numb for a couple of hours. Usually, eyelid surgery can be done quite adequately under just local anesthesia depending on the patient. Patients who are unusually sensitive may require additional anesthesia such as IV... more
James Tang, MD

Houston Plastic Surgeon
+1

Intravenous sedation (“twilight sleep”) combined with local anesthesia is best for eyelid surgery

I perform eyelid surgeries on the majority of my patients without using general anesthesia. Instead, I prefer to use intravenous sedation, otherwise known as “twilight sleep”, combined with local anesthesia. The “twilight sleep” relaxes you and eliminates any discomfort while the local anesthesia is being placed. The local anesthesia completely eliminates any pain sensation, while at the same time minimizing any bleeding during the surgery.
Michael R. Macdonald, MD

Bay Area Facial Plastic Surgeon

www.drmmacdonald.com

+1

Blepharoplasty and types of anesthesia

In my practice in Newport Beach, California I offer several options for anesthesia. These are usually discussed in the preoperative and consultative phase and depend on the extent of the surgery and if the blepharoplasty is being done as a single operation and not in conjunction with other procedures. Blepharoplasty is a term used for both upper and lower eyelid surgery. In respect to the upper eyelid area lidocaine or a local anesthesia may be used and usually accompanied with some IV... more
Michael Elam, MD

Orange County Facial Plastic Surgeon
+1

Can Eyelid Surgery Be Done Without Anesthesia?

I don’t know of many patients that can tolerate surgery without some kind of anesthetic, so I am assuming your concern is regarding the difference between general anesthesia and local (general anesthesia is when you are “put under”, versus lidocaine or some other local anesthetic that is simply injected into the surgery site to numb the “local area”). It is definitely possible to do a blepharoplasty with either local or general; it is really up to you to... more
Kenneth Bermudez, MD

San Francisco Plastic Surgeon
+1

Blepharoplasty is easily done without general anesthesia

I assume you mean general anesthesia.  Blepharoplasty in my hands is almost exclusively done under local anesthesia or local anesthesia with slight sedation.  Attached is a video showing the procedure. see video
Raghu Athre, MD

Houston Facial Plastic Surgeon

www.athresurgical.com

+1

Can Eyelid Surgery Be Done Without Anesthesia?

Eyelid surgery can and very often is done with only local anesthesia.  This means that the patient gets injections to the areas being operated on and is wide awake for the whole procedure.  This type of anesthesia is well tolerated by most people.  Some people prefer to be completely asleep and some prefer "twilight" anesthesia.
Sam Goldberger, MD

Beverly Hills Oculoplastic Surgeon

www.neweyelids.com

+1

Eyelid surgery can be safely performed under local anesthesia.

Eyelid surgery, or blepharoplasty, can safely be performed under local anesthesia.  In my experience, upper eyelids can easily be performed under straight local (numbing injections) or can be performed with local with some sedation.  Lower eyelid surgery is often more complex than upper eyelid surgery and most patients prefer to have general anesthesia (go completely to sleep) for this procedure.  Having local anesthesia instead of general anesthesia can also offer a... more
Gregory Pippin, MD

New Orleans Facial Plastic Surgeon

www.pippinmd.com

+1

Blepharoplasty without anesthesia

Eyelid surgery can be done locally which is essentially an injection of numbing medicine into the eyelid to numb the tissue. Most patients prefer the comfort of IV sedation or oral medication to relax them. It would be very painful to do the surgery without any numbing medicine at all. If you would like to avoid anesthetic costs (the anesthesiologist) I would recommend getting your surgeon to do the procedure with oral sedation and an injection of local.
Chris Thiagarajah, MD

Washington DC Oculoplastic Surgeon
+1

Eyelid surgery can be done without general anesthesia

Upper eyelid surgery can easily be done with only local anesthesia  or with  a small amount of sedation such as  Valium for those patients who are comfortable with the idea of being awake during their surgery.  Lower eyelid surgery can also be done under local anesthesia, especially if only the excess/loose skin is being tightened.  It can be slightly more difficult if the fat pads of the lower lid are being repositioned or removed as pulling on the fat pads can... more
Jeffrey M. Darrow, MD

Boston Plastic Surgeon
+1

Ideal choice of anesthesia for eyelid surgery

The short answer is, yes you can perform eyelid surgery under local anesthesia.  Nevertheless, in some cases where the procedure involves more advanced and elaborate techniques, especially in difficult revision cases, some type of sedation is needed. If the surgeon attempts to preform eyelid surgery strictly under local anesthesia in a more challenging cases, than the final result could be suboptimal as the surgeon will not be able to do what needs to be done.  Never... more
Boris M. Ackerman, MD

Newport Beach Plastic Surgeon

www.doctorackerman.com

+1

You can remain awake during eyelid surgery

A surgeon cannot perform surgery without some form of anesthesia.  The normal person could not tolerate the pain and sit still while the procedure is performed.  Anesthesia comes in many forms.   You can remain awake during surgery by your surgeon using local anesthesia such as Lidocaine.  By using this method, you may remain during the procedure and the surgeon can determine how much to remove from your lower eyelids.  Another method, but really the same, is to... more
Gary H. Manchester, MD

San Diego Plastic Surgeon

www.manchesterclinic.com

+1

Eyelid surgery with local anesthesia

Eyelid surgery can be certainly be performed using local anesthesia only. A lot of patients, however, are not interested in having their surgery in this manner since they will be able to see the instruments passing before their eyes which makes them nervous or "freaks" them out. I am always okay with using local for eyelid surgery if the patient is aware of what will be happening and is comfortable with it. You should talk to your surgeon about this and exactly how this... more
Deason Dunagan, MD

Huntsville Plastic Surgeon
+1

Anesthesia with eyelid surgery

Eyelid surgery can be done with just local anesthesia.  When just performing upper lid surgery just local anesthesia is sufficient.  Usually, when performing both upper and lower lid surgery local anesthesia with sedation is needed.  What this means is that one receives medicine through the IV for relaxation while local anesthesia is injected into the area.  General anesthesia is not usually needed.
David Freilich, MD

Englewood Oculoplastic Surgeon
+1

Eyelid surgery without anesthesia

Eyelid surgery can be easily done with local anesthesia, with or without sedation (twilight anesthesia).  The local anesthesia allows the area to be numb and also reducing bleeding/bruising.  If you choose to have the procedure done without sedation, you will feel some stinging during the injection and possibly when the fat is trimmed.
Randy J. Buckspan, MD

Austin Plastic Surgeon
+1

Choosing anesthesia for eyelid surgery

Eyelid surgery without any form of anesthesia would be cruel and unusual punishment. But I'm sure you are asking if eyelid surgery can be done without general anesthesia. And the answer is a definite yes. In fact, nearly everything that plastic surgeons do can be done without general anesthesia. Your choices for eyelid surgery are three: Local, Local with sedation, and general anesthesia. With local anesthesia you will feel the injections of the anesthetic and may have moments of pain during... more
Adam Rubinstein, MD

Miami Plastic Surgeon

dr-rubinstein.com

+1

Need sedation for best blepharoplasty results.

Hi. I don't believe in cutting corners.  To get the best possible result with a blepharoplasty, the patient needs to be quiet, relaxed, and comfortable.  That's why we insist on sedation along with local anesthesia.
George J. Beraka, MD

Manhattan Plastic Surgeon
+1

Blepharoplasty under local anesthesia

Blepharoplasty is commonly done safely and comfortably under local anesthesia. Other options include sedation or general anesthesia. Discuss all with your surgeon to see which is best for you. Good luck!  
Dean Fardo, MD

Atlanta Plastic Surgeon
+1

Eyelid surgery without anesthesia

Eyelid surgery without sedation or anesthesia is possible but depends on a few factors: Which eye lid is being treated. Generally, upper eyelid surgery can performed with local anesthesia i.e. numbing injections along with oral medication such as Valium to relax the patients. Lower eye lid surgery where fat is being removed requires some form of sedation anesthesia. Fat vs skin removal: Again, if only skin is being removed from the upper and lower eye lids, sedation anesthesia is not... more
Ran Y. Rubinstein, MD

Manhattan Facial Plastic Surgeon
+1

Eyelid surgery anesthesia

Upper Lid Lifts (Blepharoplasty) CAN be done under local anesthesia, local anesthesia supplemented by either anxiety calming pills OR anxiety calming intravenous medication and finally under general anesthesia. The mode of anesthesia depends on your wishes and what if any other procedures are done as well.
Peter A. Aldea, MD

Memphis Plastic Surgeon
+1

Blepharoplasty should get local anesthesia at minimum

Blepharoplasty is a procedure that can be easily be done under local anesthesia. While not necessary, we like to administer sedation in addition to help make the procedure more comfortable. This can range from simple oral sedation to IV sedation.  
Corey S. Maas, MD

San Francisco Facial Plastic Surgeon
+1

Blepharoplasty is a safe procedure to do without deep anesthesia.

To better answer your question, anesthesia is required for all surgical procedures including eyelid surgery. Typically, though eyelid surgery like many other surgeries can be done under local anesthesia without the requirements of general anesthesia or deep sedation that carry some other risks. To do it under local anesthesia, you need to have those areas anesthetized so that you will not have discomfort from the procedure itself. The upper eyelids are very easy and are normally done under... more
Scott Trimas, MD

Jacksonville Facial Plastic Surgeon
+1

It depends on what you call "anesthesia."

As you can see from all of the responses, most surgeons have recommended "local anesthesia," which is a form of anesthesia, simply not the type in which you go to sleep. I recommend local anesthesia, which requires placing anesthetic with a small needle in and around the area for surgery. Placing the anesthetic can be uncomfortable, but generally well tolerated. The advantage is that you can participate in opening and closing your eyelids. This can be a critical part of the... more
Charles K. Lee, MD

San Francisco Plastic Surgeon
+1

Anesthesia for Blepharoplasty

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): Straight local Local with oral sedation Local with IV sedation 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... more
Otto Joseph Placik, MD

Chicago Plastic Surgeon
+1

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... more
Peter E. Johnson, MD

Chicago Plastic Surgeon
+1

Blepharoplasty typically done under local anesthesia

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.... more
Bahram Ghaderi, MD

Chicago Plastic Surgeon
+1

Blepharoplasty under local anesthesia

I routinely perform upper eyelid surgery under local anesthesia. These patients usually just have excess upper eyelid skin and are capable of lying still for 30 minutes. Oral sedation can be added for patients that are anxious or fidgety.
Daniel Reichner, MD

Newport Beach Plastic Surgeon
+1

Anesthesia and Blepharoplasty

Eyelid surgery can be done without general anesthesia or sedation. However, you must have some local anesthesia to be injected to one make the procedure painless and two limit the bleeding during the procedure.
Steven Wallach, MD

Manhattan Plastic Surgeon
+1

Need Some Form of Anesthesia

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. more
Anil R. Shah, MD

Chicago Facial Plastic Surgeon
+1

Anesthesia means without pain.

All surgeries can be done without anesthesia, but there will be considerable pain. I think what you may really be asking is do I have to go to sleep to have a blepharoplasty? The answer is no. Local anesthesia by way of needle injections can make the pain nerve fibers not respond to the surgery. Thereby causing no pain and then you would have your eyelids done. You may also have oral medications to further relax you prior to the needles. So it really depends on you and your doctors... more
Michael J. Brown, MD

Leesburg Plastic Surgeon
+1

Anesthesia is necessary for Eyelid Surgery

Some type of anesthesia is necessary for eyleid surgery. Most cosmetic surgeons place local anesthesia (freezing) to the eyelid tissues prior to the surgery. This helps with two parts of the surgery: It helps for the patient's comfort It decreases bleeding since most use a drug called epinephrine in the local anesthetic The majority of physicians also give some type of relaxing medication at the same time. This may be given in pill form or utlizing the services of an anesthesiologist or... more
Mark Berkowitz, MD

Sterling Heights Oculoplastic Surgeon
+1

Eyelid surgery typically cannot be done without anesthesia

Eyelid tissues are very vascular and they bleed easily. Local anesthetic, at the minimum, must be used to decrease pain and bruising. Occasionally, a little oral sedation might be helpful. You do not need to go to sleep to have eyelid surgery. However, you are the best judge of your pain tolerances. You may not want to know what is going on and might do best with IV sedation or general anesthesia. Good luck. Dr. Shah
Manish H. Shah, MD

Denver Plastic Surgeon
+1

You always need some kind of anesthetic!

Upper lids can be done with local anesthesia to numb the tissues. If you are very calm, that might be all you need. If you are slightly anxious, some sedation either oral or IV can help. If you are very anxious you might be best with a brief general anesthetic. Lower lids are more complex and usually require some sedation or general anesthesia in combination with the local anesthetic. Once you have selected the best doctor for your care, ask them how they would recommend you do this. You... more
Richard P. Rand, MD, FACS

Seattle Plastic Surgeon
+1

Blepharoplasty under local anesthetic

I do virtually all of my upper lid blephs in the office under local anesthetic, and I do most of my lower lids, through the inside of the lower eyelid, under local anesthetic. I give all patients a pill to help keep them relaxed. However, different doctors have other philosophies, so they are not wrong if they do not feel comfortable doing it this way. Sincerely, David Berman, MD
David E. Berman, MD

Sterling Plastic Surgeon

Ask a question