Pain During Cosmetic Eye Surgery Despite Sedation? Doctor Answers, Tips
Brow Lift: Q&A
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Pain During Cosmetic Eye Surgery Despite Sedation?

Is there a chance you feel pain with I.V. sedation in eye cosmetic surgery? I'm considering a Brow lift and lower Blepharoplasty, but I'm worried that I will feel some pain during the procedure.

13 Doctor Answers | Asked by Lana in NoCal in California
+2

Make sure your've got an Anesthesiologist

Sedation and local can be fine foreyelid surgery, but youhave to make sure it's being done right. You should have a board certified anestheioslogist doing the anesthesia. An operating rooom is preferable, but an office OR is OK if their is an anesthesiologist. Don't accept shortcuts or you'll be taking unnecessary risks.
+2

Intravenous sedation and pain

If the IV sedation is light, it is quite possible the patient will experience a small amount of pain during the surgery, usually during the injections of local anesthetic, and during manipulation of the fat in the upper eyelid. If the anesthetic is deeper, such as that performed by an anesthesiologist, the patient will be extremely unlikely to experience pain of any kind. Patients who are very concerned about pain or anxiety during their surgery should consider having sedation performed by... more
+2

Fat removal from the eyes can be painful

The eyelid surgery is generally well tolerated but some extra local anesthesia is usually needed if there is fat to remove.  The gentle pulling on the fat can irritate nerves deeper down than the original local covered.

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+1

General anesthesia is preferred

Cosmetic eyelid surgery is painful when the fat is removed from the eyelids. The lower lid happens to be more painful than the upper lid because of the more extensive fat removal. The patient’s safety and comfort is best when the patients are put to sleep briefly under general anesthetic to have this surgery performed. Patients will not remember and feel pain when the fat is removed. The fat does not respond to the local numbing medication.
+1

Well done anesthesia should leave you completely comfortable

Lana in NoCal: In my practice I have used a variety of methods for carefully selected patients, from local only (rare), to mild sedation plus local, to light general anesthesia. In my current situation we use general anesthesia for most patients (bear in mind that many patients are having combined procedures, such as facelift, etc.). It is certainly reasonable to expect to be completely comfortable with sedation and local anesthesia. Each surgeon and anesthesia provider (nurse anesthetist... more
+1

With good anesthesia, should not feel any pain

There are different options for anesthesia during cosmetic eyelid or brow surgery, but in general there is no reason to feel any pain. The procedures are usually done with either IV sedation or general anesthesia, and eyelid surgery can at times be done with the patient awake and with local anesthetic only. Speak with your surgeon about his plan, but there is little to no risk of pain during the procedure with proper IV sedation or a general anesthetic.
+1

Good anesthesia trumps pain in eyelid surgery

Under most circumstances a patient under IV sedation will not recollect any pain for eyelid surgery. That said, every person's threshold for good IV sedation differs and that is why a dedicated person administrating the sedation is best. The dept of sedation will determine the perception of pain one realizes. Good local anesthesia, especially when manipulating the medial fat pads will minimize the amount of IV sedation required. Overall, eyelid surgery is tolerated well even by the... more
+1

There is no reason to feel pain.

There are several ways of providing anesthesia for Browlift and Blepharoplasty. The one you mention works very well. Even then, there are options. Once the areas are anesthetized, you will feel only movement, pressure and wet/cold. You may feel the injection to the nerve under the eye and the several nerves just above rim of the orbital bone that establishes the anesthesia, however. If someone like an anesthesiologist is monitoring you, they can give you an IV medication that essentially... more
+1

General Anesthesia is your only guarantee for no pain

Although both procedures are generally well tolerated under local anesthesia with sedation, general anesthesia is the only way to guarantee no pain.  Surgeon preference generally dictates which type of anesthesia is used, but you should talk to your surgeon about your concerns.
+1

Shouldn't but...

With eye surgery it's easy enough to have the patient sleep while the lids are injected with local anesthetic. However, the brows require a much larger areas of coverage. With that said as long as your plastic surgeon blocks all of the appropriate nerves with a combination of short and long acting agents there shouldn't be a problem.
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