Type of anaesthesia? Local, general, local + twilight ?

Question

Hello, what type of anaesthesia is used for lower lid eye surgery (blepharoplasty) plus fat grafting which will then be transplanted into my under eyes in order to improve dark circles ?

David S. Felder, MD · Answer

We routinely perform this procedure with IV Sedation as it is much more comfortable for the patient.

Raymond E. Lee, MD · Answer

Thanks for sharing. I typically perform lower lid blepharoplasty and fat grafting under local anesthesia and oral valium. I do this in an accredited surgery center. In proper hands it is comfortable, safer, and the recovery easier.  It will also keep your costs lower without having an anesthesiologist. Procedures are straightforward and can be done in an easy amount of time where you would be comfortable. Speak with your surgeon regarding your anesthesia options.

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

Thank you for the question. Local anesthesia with oral sedation or IV sedation are both appropriate for lower blepharoplasty. The decision is often made by judging how the patient will be able to handle minor discomfort. I have found that oral sedation (Valium) with local infiltration of anesthesia is the best for most patients. There is less risk (over sedation), patients do not make random movements with local and they feel better immediately following surgery. I hope you find this helpful. Good luck,

Michelle R. Yagoda, MD · Answer

Dear Jeff,While upper lid blepharoplasty can be performed under local anesthesia quite comfortably; lower lid blepharoplasty is different.  In order to remove the fat in the lower lid, the surgeon must pull the fat forward -- and in the lower lid, this can be quite uncomfortable, giving the patient an intense pressure sensation behind the eye.  In my experience, local anesthesia PLUS IV sedation (aka 'twilight')  is the most comfortable way for most patients to undergo this procedure.  General anesthesia is not necessary unless the patient is extremely anxious.  However, if you want to save money, and you are not a very nervous person, you can have the lower lid blepharoplasty with lower lid fat transfer under local anesthesia with oral sedation.  But, know that you may experience some discomfort for a few short minutes during the procedure.  Hope this helps!Dr. Michelle Yagoda

Hector Milla, MD · Answer

Hi and thanks for your question. Actually any of these can be used it depends on how you want to feel during your procedure, do you want to feel needles, hear and see or your prefer to just wake up and have it finished?Best wishes.Dr Milla

William Portuese, MD · Answer

The lower eyelid fat pads have deep pain fibers that do not numb up well  with a local anesthetic, therefore we always recommend lower eyelid surgery be performed under a brief general anesthetic as an outpatient procedure. In our practice, we use board certified physician anesthesiologists  to place patients asleep under general anesthesia for patient safety and comfort.  Under twilight anesthesia or local anesthesia, patients will have conscious awareness of the procedure.

Ronald V. DeMars, MD (Retired) · Answer

It can be any of the types you mention, but because so many patients are a bit nervous about work around their eyes, we use a general anesthesia for that procedure.

Type of anaesthesia? Local, general, local + twilight ?

Answers (7)

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