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How Painful is the Local Anaesthetic Injections for Upper Eyelid Lid Lift when Combined with Twilight Anaesthetic. So Scared?

Doctor Answers (16)

Upper Blepharoplasty easily performed with twilight and local anesthesia

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Most of our upper blepharoplasties are performed with oral sedation (twilight anesthesia) and local anesthesia. Many do not remember the surgery at all. However, you have many choices of anesthesia. The most important of course is finding the most qualified surgeon.


Orange County Plastic Surgeon
5.0 out of 5 stars 45 reviews

Upper blepharoplasty anesthesia

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An upper blepharoplasty can be performed under a local anesthesia,  sedation, or general anesthesia. Our preference is to perform eyelid surgery under general anesthesia so that   patients do not feel any discomfort while they are asleep.   Some patient's don't tolerate sedation very well and become disoriented and have some recollection of the procedure. Local anesthesia is best used for  upper blepharoplasty when only a small amount of excess skin is removed. It is very important to have a board certified physician anesthesiologist present if sedation or general anesthesia is performed

William Portuese, MD
Seattle Facial Plastic Surgeon
5.0 out of 5 stars 56 reviews

Upper Eyelid Anesthetic Injection

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Hello Jozee.  Your concern is very understandable.  As always, it is important to discuss all concerns with your Surgeon prior to any procedure.  The local anesthesia is injected with a very small diameter needle.  Upper lid blepharoplasty may be performed (and is well-tolerated) under local anesthetic only, or with oral sedation (i.e. Valium).   IV sedation (i.e. "twilight anesthesia") is another option.  Patients do well with any of these three options, and I suspect you will do just fine.  Warm Regards, Andy Shah MD.

Anand G. Shah, MD
San Antonio Facial Plastic Surgeon

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How Painful is the Local Anaesthetic Injections for Upper Eyelid Lid Lift when Combined with Twilight Anesthetic. So Scared?

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       Upper eyelid surgery is not particularly painful with local anesthetic alone, and sedation will make this insignificant.  Find a plastic surgeon with ELITE credentials who performs hundreds of facial and eyelid surgeries each year.  Then look at the plastic surgeon's website before and after photo galleries to get a sense of who can deliver the results.  Kenneth Hughes, MD Los Angeles, CA

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 204 reviews

Upper Bleph with Local Anesthesia

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Thank you for the question.  It is normal to be anxious and you should address your fears with your anesthesiologist prior to surgery so that they can explain to you exactly how your pain will be controlled  while under twilight sedation.  It is quite common to perform upper blepharoplasty strictly under local anesthesia after giving just valium to patients, so you should be extremely comfortable during injections if you are having twilight sedation.

Mark Deutsch, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 11 reviews

Upper Eyelid Blepharoplasty Sedation

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With twilight sedation you should have no trouble with pain from the injection of local anesthetic.  I recommend sedation for almost all of my upper eyelid blepharoplasty patients for a more comfortable experience, particularly if they are nervous about surgery or pain. 

Geoffrey J. Gladstone, MD
Southfield Oculoplastic Surgeon
5.0 out of 5 stars 13 reviews

You will be very comfortable.

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You should be very comfortable with twilight anesthesia.  In fact, many patients choose to have upper eyelid surgery performed with only local anesthesia (with or without an oral medication such as Ativan).  Patients that have only local anesthesia will report that the initial injection stings, but this typically wears off in about 10-15 seconds.  It's not too different from getting an injection when you go to the dentist.  To further lessen any discomfort, I typically mix a buffer (sodium bicarbonate) into the local solution.  Sodium bicarbonate helps take some of the sting out of the medication.  All-in-all, most patients consider the injection a "non-event" afterwards.

Michael Ondik, MD
Philadelphia Facial Plastic Surgeon
5.0 out of 5 stars 5 reviews

Twighlight sleep and local anesthesia

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With intravenoius sedation ("twighlight sleep") and local anesthesia there should be no memory of any pain.

Sheldon S. Kabaker, MD
Oakland Facial Plastic Surgeon
5.0 out of 5 stars 8 reviews

Blepharoplasty and anesthesia

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If you are undergoing a blepharoplasty and have twilight anesthesia you should not have pain from the local injection.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 17 reviews

I operate on many, many upper eyelids in unsedated patients.

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The upper eyelid injections needed to perform surgery, can be provided with remarkable comfort.  Typically, I start with a topical anesthetic.  I use a pH adjusted local anesthetic and a special computer driving injecting systems that puts local anesthetic into the tissue much more slowly that it humanly possible.  Patients are actually shocked how comfortable the process is.  Many elect not be be sedated so they do not feel so drugged after surgery.  It is all technique.

Kenneth D. Steinsapir, MD
Los Angeles Oculoplastic Surgeon
5.0 out of 5 stars 16 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.