Is it possible to have eyelid retraction surgery or canthoplasty under local anesthesia?

It is possible but best to have consultation to determine exactly what is your expected goal of surgery and understand the details involves.

Eyelid retraction repair and canthoplasty/canthopexy (which are different procedures), can and often are done under local anesthesia, most commonly with oral or IV sedation. I have done them all three ways depending on the person and their individual needs. Make sure you see a surgeon that has extensive experience with eyelid surgery. Usually an oculoplastic surgeon has the most experience in this type of subtle surgery that potentially can have unintended, unnatural results. Good luck. 

The procedure you describe, a lateral canthopexy or canthoplasty, most commonly is done with the patient mildly sedated so that he/she can cooperate during surgery while the surgeon attempts to place the outer corners into an ideal position. Although the procedure can be done under general, it is less precise and is done this way only if the patient is unable to tolerate being awake or as part of a larger combined procedure requiring general anesthesia. 

However, before you sign yourself up for surgery, you better be pretty darn sure that surgery for your issue will actually help you. There are individuals with inferior scleral show who do benefit from lateral canthal surgery and there are many who don't. You need a surgeon for this with true expertise. If you are seeing surgeons who are proposing to do this work under general anesthesia, they are unlikely to be experts in the procedure. That is because the bulk of this work must be performed with the patient cooperative. That allows the surgeon to sit you up during surgery, have you open and close the eyes and assess the effect of surgery. It is very common to reset the supporting suture more than once to get the ideal position. That simply cannot be done under general anesthesia. On the other hand, I seldom do this under straight local. It is very helpful to have light intravenous sedation with local to make the procedure as comfortable as possible. There is no substitute for an actual personal consultation to determine if you are even an appropriate candidate for this procedure.

A canthoplasty or lid-tigthening procedure can be done under local anesthesia only however I do recommend at least having some sedation so that you are comfortable and less prone to moving during the procedure. Sedation does not mean you go fully to sleep or stop breathing as in general anesthesia. It simply makes you unaware of what is happening so that you are more comfortable. Hope this helps!Johnson C. Lee, MD
Board Certified Plastic Surgeon