Lower Blepharoplasty while awake?

I think that upper lids can be done easily with local anesthesia.  For lowers we use IV sedation.  Even with the local anesthesia, patients are usually not comfortable with the manipulation of the fat.  Xanax or ativan pre-op can help, but still can be tough for some people.  When a patient is uncomfortable it makes it difficult to perform the surgery.  So much better for both the surgeon and the patient if some sedation is used.  I agree that 3K seems a bit steep for the OR fee.    

Debra,We perform many upper eyelid blephs in the office only using local anesthesia. However, lower eyelid blephs in our office are performed with IV sedation. It is much more comfortable for the patient and is a relatively short procedure. The $3000 increase in cost seems excessive.

Lower blepharoplasty can certainly be done under local anesthesia along with oral sedation (xanax or valium) as long as the surgeon and patient are comfortable with it. See video below for such example. See link below too.

Thank you for your question Debra.  Lower Blepharoplasty can be performed under local anaesthetic, I would stay 50% of my patients will opt for this when I advise.  Lower Blepharoplasty under local anaesthetic however can be sensitive if the fat pockets are particularly bad, therefore having to go deeper under local anaesthetic can be too uncomfortable for some patients.I always advise my patients, if the lower fat pockets are not very bad than local anaesthetic is a perfectly fine option, however due to some discomfort which may be cause, this could mean that instead of achieving a result with 100% removal of fat etc, only 70-80% could be achieved.  Patients will then have to weigh up the benefits of the results, discomfort and the finance cost (financial costing more under general anaesthetic and may be a health risk to some patients).  Debra, another option would be twilight sedation meaning you will be unaware of the procedure however again less health risks and costing less.Best Wishes with your procedure, I hope you get a great results!

At the end, anesthesia choice depends on doctor comfort and patient choice. It certainly is possible to perform a 4-lid blepharoplasty using local anesthesia only (and I have done so many times at patient's request). Personally, our routine for eyelid procedures is sedation performed in our accredited surgical center.We never use general anesthesia for blepharoplasty.

 In our practice, we perform all lower eyelid surgery under general anesthesia in an outpatient surgery Center  which is less expensive than hospital. We also use board certified physician anesthesiologists for patient safety and comfort. Performing  lower eyelid surgery under local anesthesia can be very painful and uncomfortable for the patient.

I prefer to do a lower lid blepharoplasty under sedation at least especially when I am removing fat pockets.  Best of luck.

While I do upper lids in the office with patients awake, I feel that the surgical time for both is too long to keep patients comfortable. This being said, many surgeons offer this to cut down the cost for the patient. It really depends on each patients comfort level. I do know the hospital/ anesthesia fee is lower in some facilities. I hope this helps and best of luck.

I agree with you. I would prefer to have anesthesia for this procedure and for the procedure to be performedin a medicare approved ambulatory surgical center or hospital.The total price for surgery may vary between ambulatory surgery centers and hospitals.An additional $3k sounds expensive.Best wishes!

Upper eye lids are commonly done with just local anesthesia in the office.  There is minimal discomfort with the   injection of local anesthesia; that is about all.  Lower eyelids, however, are safer with some anesthesia if the fat is being mored or cauterized.  Pulling on the fat can cause your heart to slow.  Better to do this in a safer environment