Upper Lid Blepharoplasty: Is Local Anesthesia with Oral Sedation Effective for a Positive Outcome, Safety and Comfort?

I will be only using the money insurance will give me for the upper eyelid surgery mainly involving skin removal. I prefer to keep the fat and muscle in tact. The surgeons I have seen believe that I am suited for mainly the skin removal. I am pretty nervous about the IV and local anesthesia and want to know if I would be compromising anything (positive outcome, safety, comfort) with NOT having IV sedation and doing this with BOTH oral medication and local anesthesia (numbing) only? Thank you!

Doctor Answers 18

Upper Blepharoplasty Under Local Anesthesia

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Upper blepharoplasties are the one eyelid procedure that can be done under local anesthesia and is very well tolerated. The upper eyelid is easy to get numb and the surgery is done outside of your field of vision which makes it less stressful. Add in some oral sedation and you will be very comfortable. This is a very safe procedure and is the preferred approach for many patients if only their upper eyelids are being done.

Comfort with Oral Sedation for Upper Bleph

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

I often perform upper eyelid blepharoplasty in my office using local anesthesia with a simple pre-op oral tranquilizer or pain pill as pre-medication.  Patients routinely feel comfortable and tolerate the surgery very well.  There is no compromise on the quality of surgical result with an oral pre-op medication and local anesthesia.  However, if an individual is extremely anxious, it may be more appropriate to consider IV sedation.

Richard G. Schwartz, MD
West Palm Beach Plastic Surgeon
5.0 out of 5 stars 32 reviews

Upper blepharoplasty under local...?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

An Upper blepharoplasty can be easily done using a local injection, resulting in little or no pain and discomfort.  For patient comfort and reduction in anxiety level, a sedative may be prescribed to take orally before the surgery.  The procedure does not take a lot of time and is quite tolerable being awake.  If you decide to take the oral sedative, someone will have to drive you home after the surgery.  The bottom line is that local anesthesia will not compromise the procedure.  It is important, however to choose a well experienced facial plastic or plastic surgeon to perform the procedure.

Andrew Miller, MD
Edison Facial Plastic Surgeon
4.8 out of 5 stars 222 reviews

Upper Lid Blepharoplasty-Anesthesia Options

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Upper lid blepharoplasty can be a very well tolerated procedure depending on the patient. The area is easily numbed with local anesthesia so the main deterrent would be someone with a strong adversity to needles. An oral medication may adequately relieve this anxiety but if not sedation anesthesia may be preferred. In cases where only skin is removed, a patient should not feel any discomfort once the injections are completed. Even if some fat removal is done, most patients will describe only a sense of pressure rather than pain. The procedure is not very long so if a patient is able to lie still for about an hour or less, local anesthesia is certainly a viable option which should not have an Impact on the outcome.

Pamela Henderson, MD
Phoenix Facial Plastic Surgeon
4.8 out of 5 stars 20 reviews


{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Hello.  Upper lid blepharoplasty may be performed in an office setting, or in a more formal surgery center, per patient preference. It may be performed with local anesthetic only, or with light sedation.

Anand G. Shah, MD
San Antonio Facial Plastic Surgeon

The goals of anesthesia...General, IV Sedation and Oral Sedation

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

There are 3 main things an anesthetic of any type needs to accomplish:

  1. The patient should not feel pain
  2. The patient should remain still enough to allow the surgeon to perform the procedure...it's much harder to hit a moving target ;)
  3. The patient should be mentally relaxed during the procedure (depending on the depth of anesthesia, the patient may or may not have some memory of the procedure)

I perform the vast majority of facelift, eyelid rejuvenation and other procedures in the office with oral sedation and local anesthesia. The remainder are usually done with IV sedation. Provided your surgeon is comfortable with the techniques required for oral sedation with local anesthesia, most facial rejuvenation procedures can be done safely with excellent results. There are reasonable arguments to be made in favor IV (twilight) anesthesia as well as oral sedation. In reality, I think the two most important factors are the surgeon and the patient.

Although I perform over 95% of my procedures with oral medicines and local anesthesia, some patients are not good candidates. These are usually patients who are very nervous, anxious, and/or want to make sure they remember nothing about the operation.

Even if you are a great candidate for oral sedation and local anesthesia, your surgeon may not be well versed in dealing with patients under lighter sedation. In this scenario, you might actually get a better result under IV sedation. Properly done, IV sedation is very safe and reliable. Ask your surgeon about the qualifications of the facility where you will receive IV sedation. IV sedation should only be performed in a certified facility.

Yours in good health, MKB

Michael Bowman, MD
Roanoke Facial Plastic Surgeon

Local Anesthesia with oral sedation for Upper Eyelid, Blepharoplasty Procedures is a great choice in the right person

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Local Anesthesia with oral sedation for Upper Eyelid, Blepharoplasty Procedures is a great choice in the right person. If you are overly anxious about the procedure than perhaps more sedation will make you more comfortable.
Both Upper and Lower eyelid procedures can be done safely under local anesthesia with oral sedation, IV sedation or general anesthesia.  I use all these approaches safely and determination which method of anesthesia is best  is determined at the time of the initial consultation.

Upper bllepoh local

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
This can be done in the office just under styaright local maybe with a little po valium or in the surgery center with IV sedation.Both are safe and effective.

Robert Brueck, MD
Fort Myers Plastic Surgeon
4.9 out of 5 stars 70 reviews

Local Anesthesia with Oral Sedation is safe for Blepharoplasty

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Upper eylid blepharoplasty can be a very well tolerated procedure.  It really depends on the patient and how nervous you are for surgery if you want oral or IV sedation.  You can be more sedated or sleepy with IV sedation  and if you are nervous this is a good option.  In patients that are comfortable with the procedure oral sedation and local is a great option.  You should not feel anything during the procedure except for a small initial sting as the numbing agent is injected.  Be sure to tell your doctor all medications you are taking as occasionally these can interact with the sedation medications and require a stronger dose for full effect. 



Jill Hessler, MD
Palo Alto Facial Plastic Surgeon
4.9 out of 5 stars 32 reviews

Upper Eyelid Surgery and Sedation

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Upper eyelid surgery can be performed by a competent Surgeon without compromise via oral or IV sedation.  Many patients prefer IV sedation so that they will have no awareness of the procedure.  However, if you choose local anesthesia with oral sedation, a well qualified Surgeon will be able to perform the procedure effectively.

Stephen Prendiville, MD
Fort Myers Facial Plastic Surgeon
4.9 out of 5 stars 104 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.