Doctor didn't wait 5-10 mins for lidocaine injection to work? Blepharoplasty?

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.

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.   

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.

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.

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.

There is not standard in terms of how long to wait; you may have experienced the pain because you either did not get enough of lidocaine or the area you experienced the pain was not injected.  In terms of waiting 5 min before cutting, I would say not everyone follows such a rule.  

and I assume that was his/hers.  Most surgeons who use epinephrine in their local, will wait at least 5 min but if it as not used or not needed, work may start immediately after the injection is administered.  So what your surgeon did isn't unheard of but most surgeons working around the eyes under local will be patient and your surgeon presumably was more accommodating when you complained of pains during the procedure.

 In our practice, we perform most  blepharoplasties are performed under general anesthesia for the very same reason that you have mentioned. There are deep proprioceptive nerve fibers it did not numb up to the lidocaine under local anesthesia. A blepharoplasty  is performed in our Surgery Center under general anesthesia administered by physician anesthesiologists for patient safety and comfort.

I'm not sure what the point of this question is or what you aim to accomplish. Did you have a good result? Your surgeon will determine how long he waits to make an incision after injecting the anesthetic as only your surgeon knows what he injected. additional anesthetic is injected into the fat pads once the lid skin is incised and fat pads exposed. That is the key injection for numbing he deeper proprioceptive nerves. Regardless, if you think something affected your result or your experience, you have that conversation with the surgeon YOU selected for your procedure.

While it requires several minutes for the effect of the adrenaline in the lidocaine to work, the anesthetic effects work withing a minute. But taking out fat pads under local anesthesia is something we don't do, it hurts.