How Painful is the Local Anaesthetic Injections for Upper Eyelid Lid Lift when Combined with Twilight Anaesthetic. So Scared?

Most of our upper blepharoplasties are performed with oral sedation (twilight anesthesia) and local anesthesia. Many do not remember the surgery at all. However, you have many choices of anesthesia. The most important of course is finding the most qualified surgeon.

       Upper eyelid surgery is not particularly painful with local anesthetic alone, and sedation will make this insignificant.  Find a plastic surgeon with ELITE credentials who performs hundreds of facial and eyelid surgeries each year.  Then look at the plastic surgeon's website before and after photo galleries to get a sense of who can deliver the results.  Kenneth Hughes, MD Los Angeles, CA

The upper eyelid injections needed to perform surgery, can be provided with remarkable comfort.  Typically, I start with a topical anesthetic.  I use a pH adjusted local anesthetic and a special computer driving injecting systems that puts local anesthetic into the tissue much more slowly that it humanly possible.  Patients are actually shocked how comfortable the process is.  Many elect not be be sedated so they do not feel so drugged after surgery.  It is all technique.

I perform most of my eyelid surgeries with IV sedation (aka twilight anesthesia).  A patient yesterday stated she did not even feel the numbing at all.

I don't give much to worry about. I do many upper eyelids with sedation and local or local only. The same cannot be said of lower lids why prefer to put patients to sleep.

Most eyelid surgeries can be performed under local anesthesia, more comfortably than going to a dentist !  If it is combined with IV sedation (twilight anesthesia), then it would be even more comfortable. 

An upper blepharoplasty can be performed under a local anesthesia,  sedation, or general anesthesia. Our preference is to perform eyelid surgery under general anesthesia so that   patients do not feel any discomfort while they are asleep.   Some patient's don't tolerate sedation very well and become disoriented and have some recollection of the procedure. Local anesthesia is best used for  upper blepharoplasty when only a small amount of excess skin is removed. It is very important to have a board certified physician anesthesiologist present if sedation or general anesthesia is performed

Hello Jozee.  Your concern is very understandable.  As always, it is important to discuss all concerns with your Surgeon prior to any procedure.  The local anesthesia is injected with a very small diameter needle.  Upper lid blepharoplasty may be performed (and is well-tolerated) under local anesthetic only, or with oral sedation (i.e. Valium).   IV sedation (i.e. "twilight anesthesia") is another option.  Patients do well with any of these three options, and I suspect you will do just fine.  Warm Regards, Andy Shah MD.

Thank you for the question.  It is normal to be anxious and you should address your fears with your anesthesiologist prior to surgery so that they can explain to you exactly how your pain will be controlled  while under twilight sedation.  It is quite common to perform upper blepharoplasty strictly under local anesthesia after giving just valium to patients, so you should be extremely comfortable during injections if you are having twilight sedation.

With twilight sedation you should have no trouble with pain from the injection of local anesthetic.  I recommend sedation for almost all of my upper eyelid blepharoplasty patients for a more comfortable experience, particularly if they are nervous about surgery or pain.