Safety of anesthesia used for blepharoplasty on a 95 year old woman?

My 95 year old grandmother is scheduled to have blepharoplasty tomorrow. I'd like to hear different doctor's opinions/recommendations as far as anesthesia. She had hip surgery a little over a year ago and came out of the operation having had a mild stroke, and is still not able to speak as well as before the operation. I know she has had some leg swelling recently, so I'm worried about tomorrow. Please be honest, good or bad. How likely is local anesthesia to cause another stroke-like incident?

Doctor Answers 9

Going Under?

Thank you for your question! I would advise you to speak to your plastic surgeon about any concerns you may have.  Another alternative would be for her to have her procedure done under local anesthetic.  Best of luck!

Dr Dhaval Patel

Double Board Certified 

Plastic Surgeon


Hoffman Estates

Oak Brook

Hoffman Estates Plastic Surgeon
4.8 out of 5 stars 78 reviews

Local anesthesia in a 95 y/o

should be completely safe and I hope it went well for your grandmother.  Surgery is scary but when done under local, risks are minimized.

Curtis Wong, MD
Redding Plastic Surgeon
4.8 out of 5 stars 32 reviews

Safety of anesthesia used for blepharoplasty on a 95 year old woman?

These are great questions to pose to her primary care doctor and her anesthesiologist. Judging the risk of general anesthesia results in a risk range. Your grandmother would be considered fairly high risk given her age and prior history. Blepharoplasty is a much more straight forward and brief procedure so that might mitigate some of the risk. Local anesthesia in most cases is totally safe especially for a short procedure like blepharoplasty. This is an elective procedure so if you and your grandmother are unsure about the plan surgery can always be postponed or canceled. Your grandmother needs to be comfortable with the plan and potential risks. I hope this information is helpful for you.

Stephen Weber MD, FACS
Denver Facial Plastic Surgeon

Blepharoplasty under local anesthesia

In general, local anesthesia is extremely safe. You need to ask her internist or neurologist to get clearance.  Also have you ask yourself how necessary is the procedure for her.

Mehryar (Ray) Taban, MD, FACS
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 58 reviews

Blepharoplasty under local anesthesia

 First of all, its important to have medical clearance by your primary care physician before undergoing elective surgery. This involves a thorough history and physical examination with review of all medications. A skin only upper blepharoplasty can be  performed under local anesthesia without any sedation or general anesthesia.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.7 out of 5 stars 126 reviews

Nonagenerian for Blepharoplasty

I'm sure there must be a compelling reason to do an upper blepharoplasty on a 95 year old with significant health issues. Local anesthesia with anesthesic monitoring(MAC) and maybe some mild sedation should be the extent of anesthesia given. Fluctuating blood pressure, oxygen desaturation, the presence of anticoagulants which shouldn't be stopped due to the stroke history and the operative time are the enemies for this patient. A miniscule amount of epinephrine with the local shouldn't affect the blood pressure where a little high is better than a little low. The legs should be bent at the knees and graduated compression for the legs regardless of the length of surgery. I'm sure your plastic surgeon, the internal medicine team and the anesthesia team have all of this planned and more to prevent another stroke.

Paul S. Howard, MD, FACS
Hoover Plastic Surgeon
5.0 out of 5 stars 7 reviews

Anesthesia safety, local is best #localanesthesia

In our office, ALL procedures are performed under local anesthesia. Because of you grandmother's age, I would obtain medical clearance from her primary physician. 

The safest method for facial surgery is local anesthesia. She can have an oral sedative to relax, but the main anesthetic is the injected local. The likelihood of any adverse event is significantly reduced by going with local only. Of course, she will be monitored throughout the case, even her mental status, by following commands etc. I wish you the best!

Arnold Almonte, DO
Roseville Plastic Surgeon
4.8 out of 5 stars 28 reviews

Assuming her internist has cleared her for surgery, she should do fine.

Having said that, I personally believe that she is much better off having very light intravenous sedation administered by an anesthetist or anesthesiologist in a hospital out patient surgery setting.  These are generally part of the physical campus of the hospital or may actually be in the same building.  As an example I use the UCLA outpatient surgery center.  It has 15 operating rooms and while it is not physically part of the main hospital, there is a tremendous amount of resources immediately available should a medical issue arise.  Many surgeons also have an accredited operating room in their office.  I would not recommend surgery for a 95 year old be performed in an office accredited operating room simply because should a medical issue arise, there is very little help immediately available.  The risk of the procedure is really related to her overall health.  I think pain will be the most stressful aspect of surgery and local plus a small amount of intravenous sedation is a very helpful combination.  Often when just local anesthesia is performed, there is no anesthesia personal monitoring the patient during the procedure.  I think the extra personnel for her is helpful.

Kenneth D. Steinsapir, MD
Los Angeles Oculoplastic Surgeon
4.9 out of 5 stars 23 reviews

Bleph under local

If your grandmother is having her eyelid surgery under local anesthesia only, there is a very low risk for cerebrovascular complications. The shorter the procedure and the less local needed, the better. Be sure to discuss with the surgeon all possible risks and complications associated with the procedure. Good luck!

Mark Been, MD
Barrington Facial Plastic Surgeon
5.0 out of 5 stars 11 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.