Will I Jump with a Local Anthesthetic While Getting an Upper Eye Bleph?

I really want to get one one and my dr said he will do it just with local freezing, which is much safer than being put under and initally happy to hear that. My only hesitation is that I will blink or jump or twitch if I feel the cutting or pulling from the stitching and then poke my eye or cut him or me etc? Can anyone put my mind at ease here or am I correct in worrying? I am not even sure how long the surgery will last, will I get fidgety? Please any help would be appreciated! Thank you.

Doctor Answers 16

Local Anesthesia for Upper Eyelid Blepharoplasty

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First, it is important to dispel the myths;  anesthesia provided in an accredited facility isn't dangerous if you are a healthy person.  There is no statistical data anywhere to show that local anesthesia is actually safer in healthy patients.  This is an incorrect and frequently repeated assumption that makes no sense.  The majority of my patients do not want to be anxiously aware of a procedure, feel any pain, or have memories of the operating room atmosphere.  These are things that intravenous sedation prevents in a safe, effective fashion.  The simple answer is that some patients who have the right psychological profile prefer to have an upper eyelid blepharoplasty under local anesthesia; patients with a high degree of anxiety are not well suited for this experience.

Fort Myers Facial Plastic Surgeon
4.9 out of 5 stars 104 reviews

It will be a breeze

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Performing an upper bleph under local anesthetic is really the preferred approach in my opinion. As long as you have a ride, you can receive a small dose of an oral sedative. This will help calm you down. Using a soft approach, the numbing can be performed very easily and you will be comfortable. The procedure is fairly quick. As long as you've chosen a qualified plastic surgeon, you should be fine. 

Justin Yovino, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 103 reviews

Local anesthetic for eyelids

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We usually perform upper blepharoplasty under general anesthesia, which is very safe.  Under local anesthesia, patients will feel the injections which takes a few moments to get the eyelid numb.  If fat pads need to be removed , they can be quite painful momentarily wile they are trimmed.  Upper lids are less painful  than lower lids under local anesthesia

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 158 reviews

Local anesthesia for upper eyelid blepharoplasty

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Many patients are anxious when undergoing any surgical procedure.

This is a normal reaction. Upper eyelid blepharoplasty is commonly performed under local anesthesia without sedation. One will experience a few pinches and slight burning, but for most individuals this is easily tolerated.


Women who apply eyeliner and men and women who wear contact lenses are not frightened with a physician touching their eyelids and typically undergo upper eyelid blepharoplasty under straight local without any problem.


If you are an extremely anxious person, there is nothing wrong with having sedation.

Rand Rodgers, MD
New York Oculoplastic Surgeon

Every patient is different

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Twitching, jumping, and blinking is not an issue during the injection of blepharoplasty. Blepharoplasty, and many other types of surgery can be done safely under local anesthesia. However, some patients are more anxious than others and prefer not be fully awake during their procedures.

There is no right or wrong answer here; the cliche "different strokes for different folks" applies here. Local anesthesia for blepharoplasty may not be wrong....it just may not be the right option for you.

Oral sedation with valium is a wonderful option as well. If not, then move on to IV sedation. Some pratices, like ours, have anesthesia capability from straight local all the way to general anesthesia. But not all practices have that luxury.

The safety of blepharoplasty is not an issue with local or IV sedation [in a healthy patient]....its a matter of patient preference and physician capability.

Good luck.

A.J. Amadi, MD
Seattle Oculoplastic Surgeon
5.0 out of 5 stars 42 reviews

Upper blepharoplasty with local anesthesia

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It certainly is appropriate to have an upper blepharoplasty perfromed under local anesthesia.  You will feel the initial sting of the anesthesia injection and may feel some pulling during the procedure.  Sedation anesthesia is another option for patients uncomfortable with local anesthesia alone.

Arnold S. Breitbart, MD, FACS
Long Island Plastic Surgeon
4.8 out of 5 stars 160 reviews

Anesthesia for upper eyelid blepharoplasty

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Holding still and putting up with what is involved with an upper lid blepharoplasty is even easier than putting up with a dental procedure as the local anesthetic is quite easy to do and very effective in experienced hands. 

As a plastic surgeon who has done thousands of blepharoplasties, I have all options available to me and my patients -- general anesthesia, local anesthesia with IV sedation, and local anesthesia with oral sedation (no IV). I give the patient the choice but try to assess how comfortable they are with the idea of putting up with the procedure and being aware of it. About 90% will choose local anesthesia with oral sedation and about 10% will opt for local anesthesia with IV sedation (so they don't have to be aware of the procedure -- similar to IV sedation for a colonoscopy or wisdom tooth extraction). No one chooses general anesthesia when they look at the costs and possible side effects of general anesthesia. The risks of general anesthesia are indeed quite low but they are certainly greater than local anesthesia alone. 

I would add that I can do any facial procedure including a full facelift or rhinoplasty with local anesthesia and IV sedation in an accredited office facility but I don't give the patient the choice of local anesthesia with oral sedation for larger and more lengthy procedures.

Another example where local anesthesia only without IV sedation or general anesthesia is in eye surgery such as LASIK or a cataract lens replacement. Again the surgeon should be able to offer the different options after an assessment of the patient's concerns and preferences. 

Scott L. Replogle, MD
Boulder Plastic Surgeon

Upper Eyelid Lift Under Local Anesthesia

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Most people do very well under local anesthesia. However, people like you who are very apprehensive frequently need more, like conscious sedation or even general anesthesia. Both of these should be done in a fully certified facility in order to be as safe as possible. A surgeon who will only do the procedure under local anesthesia frequently does not have privileges in a certified procedure to do the procedure. Therefore, beware if your surgeon will consider only local anesthesia.

Robert T. Buchanan, MD
Highlands Plastic Surgeon

Blepharoplasty with local anesthesia

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It is very common to have an upper blepharoplasty with local anesthesia.  You can also talk to your doctor about taking a valium an hour before the procedure to help calm your nerves.  Alternatively, you can have your surgeon do twilight or IV sedation, which can help relax you, but not put you under full general anesthesia.


Good Luck.

Upper blepharoplasty

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An upper blepharoplasty can be performed just with local anesthetic.  If fat has to be removed it can be a bit uncomfortable without sensation.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 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.