Is it protocol for a Macs lift and lower bleph to not use twilight sedation?

Good evening. In short- every doctor's practice is different. Although some surgeons prefer putting patients fully asleep under general anesthesia for this procedure, some perform it under IV sedation ("twilight sedation") with local anesthesia, or just under straight local sedation, as you are describing here. It ultimately comes down to surgeon and patient preference, so always have the conversation with your surgeon so you both know exactly what to expect, and so you both feel comfortable with how the procedure will be performed prior to proceeding. Hope this helps! Best, Dr. Donald Groves Plastic Surgeon