Is lower blepharoplasty with fat repositioning ever done as an office procedure without IV sedation or General Anesthesia?

Question

I have had two consults and not sure why one would do with and the other without.

William Portuese, MD · Answer

A lower blepharoplasty procedure is performed  usually under deep IV sedation or general anesthesia. This is not performed in an office/ clinic setting, since this is real surgery and patients need to be monitored. In our practice, we perform fat removal, not repositioning  in the lower lids through trans conjunctival approach under a brief general anesthesia administered by a board-certified physician anesthesiologist for patient safety and comfort.  The fatty deposits in the lower lids have deep pain fibers and is very difficult to do this procedure without being placed completely asleep under anesthesia. Trying to perform the surgery  under local anesthesia patients will have conscious awareness of a very painful procedure

Afshin Farzadmehr, MD · Answer

I have been doing the lower lid surgery and other facial surgeries all without excwption with sedation only. There is no need whatsoever to have the risks of general anesthesia for these procedures at all.

Mehryar (Ray) Taban, MD, FACS · Answer

The type of anesthesia for lower blepharoplasty depends on the comfort of the patient and the comfort of the surgeon. Lower blepharoplasty can certainly be done under local anesthesia (see video below) if both the patient and surgeon are comfortable that way or it could be done under conscious sedation (IV sedation). However, general anesthesia is generally overkill and unnecessary.

Kenneth D. Steinsapir, MD · Answer

I would not recommend general anesthesia for this.  That means that you can not be asked to look up and down during surgery.  That bit of movement is very helpful to monitor the effect of surgery and assure that surgery is optimally performed.  That can be done under IV sedation.  Having this surgery under local anesthetic is stressful for both the surgeon and the patient.  Some surgeon to offer surgery this way.  Generally they are doing the procedure in an office procedure room that is not accredited.  The accreditation needed to offer intravenous sedation in most states means that the office has met a lot of standards that are designed to increase patient safety.

Michael A. Epstein, MD, FACS · Answer

Thank you for your question.Yes, with good local anesthesia, a lower lid blepharoplasty can be done.  However, proper patient selection is necessary for this (if you are more nervous about surgery, then it's best to have some sort of IV, or at least oral, anesthesia to relax you more so you aren't moving during this highly technical procedure).  I would choose the surgeon you feel is best for you, and not necessarily the method of anesthesia used.Best,Dr. Michael EpsteinMAE Plastic SurgeryNorthbrook, IL

Mariusz Sapijaszko, MD, FRCPC · Answer

Blepharoplasty can be performed either with or without the additional risks of general anesthesia. This depends on the experience of the doctor. It is important to ensure the comfort of the patient and that can be accomplished with some valium or similar medicine.As always, I recommend thorough assessment and consultation with experienced doctor prior to proceeding with any treatment.Best regards and I hope this helps, Dr. Sapijaszko.

James R. Gordon, MD, FACS, FAAO · Answer

Thank you for sharing your question. Blepharoplasty can be performed with or without anesthesia. Often Valium is sufficient to calm patients and local injection of anesthesia is sufficient for pain. It is more important to select an experienced surgeon to perform your operation. I hope this helps. Good luck,

Tracy E. McCall, MD · Answer

Some physicians will do this under local. I do it under general because that's how I'd want it if I were the patient, but I am often doing other things with the lower bleph as well. I would be more concerned with the technique differences.

Clyde Mathison, MD · Answer

The short answer is YES, a lower blepharoplasty with fat repositioning can be done under local anesthesia only. However, a lot of factors go into the decision. A patient's anxiety level is probably the most pertinent. If the patient is very nervous then some form of sedation (whether oral or IV) will be necessary to keep them from moving too much during the surgery. Surgeon preference is also part of the equation. I personally perform all of my lower blepharoplasties under either IV or general anesthesia (after discussing the pros and cons of each, I let the patient choose which one they want). Upper blepharoplasties can easily be performed under local anesthesia.

Good luck!

Good luck!

S. Randolph Waldman, MD · Answer

We always do our lower eyelid procedures under I V Sedation.  It is often too difficult to retract the eyelid and manipulate the fat when the patient is tense or uncomfortable.  Upper Eyelid surgery if done by itself can and often is done under a local anesthetic only ie without sedation.  A General Anesthetic is never a requirement however for either procedure.

Is lower blepharoplasty with fat repositioning ever done as an office procedure without IV sedation or General Anesthesia?

Answers (14)

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