How Painful is Eyelid Surgery?

Blepharoplasty surgery can be performed under general anesthesia or local anesthesia with IV sedation. Both of these techniques provide safe anesthesia that's associated with minimal pain and discomfort.Although there's post-operative pain following any surgical procedure, the pain associated with blepharoplasty is generally not severe. This pain tends to resolve rapidly in 24 to 48 hours and is easily controlled with narcotic pain relievers. In fact, the vast majority of post-op blepharoplasty patients are more concerned about swelling and bruising than post-operative pain.For these reasons, the majority of patients easily tolerate this procedure. The procedure is associated with excellent clinical results and high levels of patient satisfaction.

Physical Discomfort During and After Eyelid Surgery

The pain experienced during  an eyelid surgery is usually tolerable and most frequently in my practice the procedure is done with oral sedation or IV sedation with local anesthesia. Although always an option we do not routinely use a general anesthetic. Postoperatively there is  Initial mild discomfort  controlled with oral medications. Swelling, discoloration, and some bruising are to be expected. It is not unusual to have some difficulty seeing during the first day or two after surgery because of the swelling and eye lubricants/ointment used during and after surgery.

 

Dear BHeZee
Eyelid surgery is so comfortable that many of my patients elect to have eyelid surgery in the office under local anesthesia. This is actually ideal because it is very important to have the ability to assess the effects of surgery intraoperatively with the patient sufficiently cooperative to open and close the eyes. When surgery is performed under deep iv sedation or general anesthesia this very important aspect of being able to monitor the effects of surgery intraoperatively goes out the window. Great eyelid surgery is all about finesse. Under general anesthesia this ability to monitor the effects of surgery dynamically is lost. I will not perform eyelid surgery under general anesthesia. These surgeries are surprisingly comfortable. It is not unusual for my patients not to require any narcotics post operatively.

The eyelid surgery itself is quite painful during the procedure, and therefore is done under a general anesthetic. The fat pads on the upper and lower lids have deep proprioceptive pain fibers that will not numb up to the lidocaine and should not be done under a local anesthesia. The recovery period for eyelids is not painful at all; most patients only take a very few pain pills in their entire postoperative period.

Of course this is somewhat related to what specifically is done. Some eyelid surgery on the lower lid requires lifting tissue off the bone or putting sutures from the lid tendon to the bone and this can be more painful. Usually, it is quite well tolerated and cold compresses on a frequent time schedule post-op can help mitigate discomfort tremendously. Skin removal only is nearly painless and pain medication requirements are very limited. Most patients do exceedingly well. In fact, symptoms of pain may be related to complications rather than the normal course of recovery.