My doctor didn't wait 5-10 minutes for the local anesthesia (lidocaine) to fully numb my fat pad before performing excision. Due to my extremely painful procedure, I did my research and found that the doctor must wait 5-10 mins after injection before cutting. Instead, he cut right after he injected me with lidocaine. When I told him he should've waited for the anesthesia to work properly, he tells me he doesn't need to wait. That feeling pain in this procedure is expected? He knew it would hurt.
Answer: Patient comfort is an essential. It also does not sound like you had surgery in an accredited surgery center. While it is legal to perform surgery in an office procedure room that is not accredited, an accredited surgery center is needed to administer intravenous anesthesia or general anesthesia. It is possible to perform eyelid surgery under local anesthesia but it requires a very patient surgeon. The local anesthetic is effective almost immediately. We wait 15 minutes for hemostatic effect of the epinephrine in the local anesthetic. When you are uncomfortable with surgery, it is not because the anesthetic is not working, it is because the surgeon administering the local anesthetic, has not adequately anesthetized the tissue. Unfortunately, without the systemic anesthesia, issues like this are immediately unpleasant and are precisely the type of experience we are seeking to avoid with surgery. Surgery should not be a form of torture. Your surgeon is wrong here and unprofessional. The California Medical Board regulates the practice of physicians and surgeons in the state of California. They have a mechanism for consumers to report the unprofessional conduct of physicians. While a particular instance of this sort of thing is not likely to have much repercussions for this surgeon, when many reports are filed against a particular surgeon, it means something to the Medical Board. Speaking up may prevent another patient from suffering as you did.
Helpful 1 person found this helpful
Answer: Patient comfort is an essential. It also does not sound like you had surgery in an accredited surgery center. While it is legal to perform surgery in an office procedure room that is not accredited, an accredited surgery center is needed to administer intravenous anesthesia or general anesthesia. It is possible to perform eyelid surgery under local anesthesia but it requires a very patient surgeon. The local anesthetic is effective almost immediately. We wait 15 minutes for hemostatic effect of the epinephrine in the local anesthetic. When you are uncomfortable with surgery, it is not because the anesthetic is not working, it is because the surgeon administering the local anesthetic, has not adequately anesthetized the tissue. Unfortunately, without the systemic anesthesia, issues like this are immediately unpleasant and are precisely the type of experience we are seeking to avoid with surgery. Surgery should not be a form of torture. Your surgeon is wrong here and unprofessional. The California Medical Board regulates the practice of physicians and surgeons in the state of California. They have a mechanism for consumers to report the unprofessional conduct of physicians. While a particular instance of this sort of thing is not likely to have much repercussions for this surgeon, when many reports are filed against a particular surgeon, it means something to the Medical Board. Speaking up may prevent another patient from suffering as you did.
Helpful 1 person found this helpful
May 9, 2016
Answer: Effect of anesthetic The lidocaine works almost immediately. We only wait so that the epinephrine can have a chance to work and there is less bleeding. But cutting can actually be done right after injection. If you had pain then you just needed more lidocaine injected. Removing fat can be uncomfortable and often the fat pad needs extra local.
Helpful
May 9, 2016
Answer: Effect of anesthetic The lidocaine works almost immediately. We only wait so that the epinephrine can have a chance to work and there is less bleeding. But cutting can actually be done right after injection. If you had pain then you just needed more lidocaine injected. Removing fat can be uncomfortable and often the fat pad needs extra local.
Helpful
May 8, 2016
Answer: Need to wait for local to take effect? Thanks for your question. Lidocaine takes effect right away. The epinephrine used to diminish bleeding takes effect in a few minutes. It sounds like you needed more anesthetic. Hope this is helpful.
Helpful
May 8, 2016
Answer: Need to wait for local to take effect? Thanks for your question. Lidocaine takes effect right away. The epinephrine used to diminish bleeding takes effect in a few minutes. It sounds like you needed more anesthetic. Hope this is helpful.
Helpful
May 8, 2016
Answer: Local anesthetic is effective immediately You do not need to wait for a local anesthetic to take effect. Waiting increases the benefit of epinephrine but is not necessary. Blepharoplasty can be performed under local anesthesia with complete comfort. Fat resection does not hurt if it's adequately injected prior to resection and it's not a function of time.
Helpful
May 8, 2016
Answer: Local anesthetic is effective immediately You do not need to wait for a local anesthetic to take effect. Waiting increases the benefit of epinephrine but is not necessary. Blepharoplasty can be performed under local anesthesia with complete comfort. Fat resection does not hurt if it's adequately injected prior to resection and it's not a function of time.
Helpful
Answer: Pain during blepharoplasty Thank you for your question. I perform some upper eyelid surgery in the office under local anesthesia only in highly selected patients. There needs to be a skin excision only or removal of skin and a small amount of fat in a healthy patient without high blood pressure or other significant medical issues. All other cases are done at a Surgery Center or Hospital with sedation or general anesthesia.The local anesthetic injected before starting the procedure is allowed to work for 10-15 minutes primarily to allow the epinephrine to work to minimize bleeding. As has been written by other surgeons, the local anesthetic works very quickly as far as eliminating pain. After the skin (and possibly a small amount of muscle) is removed, additional local anesthetic is injected in the fat to numb that area where the original local anesthetic injection did not reach. That is often a sensitive area and additional anesthetic may be needed. The surgeon who wrote " Your surgeon is wrong here and unprofessional" and suggests you report him to the Medical Board is, in my opinion, wrong and unprofessional. There are many details about your surgery that we do not know.
Helpful
Answer: Pain during blepharoplasty Thank you for your question. I perform some upper eyelid surgery in the office under local anesthesia only in highly selected patients. There needs to be a skin excision only or removal of skin and a small amount of fat in a healthy patient without high blood pressure or other significant medical issues. All other cases are done at a Surgery Center or Hospital with sedation or general anesthesia.The local anesthetic injected before starting the procedure is allowed to work for 10-15 minutes primarily to allow the epinephrine to work to minimize bleeding. As has been written by other surgeons, the local anesthetic works very quickly as far as eliminating pain. After the skin (and possibly a small amount of muscle) is removed, additional local anesthetic is injected in the fat to numb that area where the original local anesthetic injection did not reach. That is often a sensitive area and additional anesthetic may be needed. The surgeon who wrote " Your surgeon is wrong here and unprofessional" and suggests you report him to the Medical Board is, in my opinion, wrong and unprofessional. There are many details about your surgery that we do not know.
Helpful
