Is It Uncomfortable to Have Upper Eyelid Surgery with Just Local Pain Medication?

I will be taking one hydrocodone/apap 7.5/500mg tablet and one diazepam 10 mg 1/2 hour prior to the surgery and given a local numbing injection. Do you know from your experience if this a comfortable option compared to general sedation? Plus have you performed this surgery without the protective eye lens cover?

Doctor Answers 27

Local anesthesia for blepharoplasty

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This really depends on the patient's tolerance, but an upper lid blepharoplasty can certainly be done under local anesthesia alone. I have done this on a number of occasions, as this is sometimes a safer approach for the patient. The majority of my patients choose to have some iv sedation for their upper lid blepharoplasty. Eye shields are not necessary in upper lid blepharoplasty, as long as the surgeon is careful.

Fort Lauderdale Facial Plastic Surgeon
5.0 out of 5 stars 85 reviews

Upper Eyelid Surgery with Local

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Upper Eyelid Surgery can easily be performed with local anesthesia.  We usually perform this procedure in our fully accredited office based surgical suites with oral sedation and local anesthesia.  We have never had a problem with this combination.  Performing the procedure in this fashion eliminates any of the potential side effects or risks of general anesthesia.

Jerome Potozkin, MD
Danville Dermatologic Surgeon
4.2 out of 5 stars 5 reviews

Upper blepharoplasty with local anesthesia

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Upper blepharoplasty may be performed with local anesthesia alone, sedation (oral or IV) with local anesthesia or with general anesthesia. All three are safe methods. Which of the three methods used is based on surgeon comfort and patient preference. I usually perform upper blepharoplasties under local anesthesia with some sedation. With a local anesthetic, the procedure is not painful, but the patient is aware of what is going on. Depending on how anxious the patient is, I offer them an oral medication to relax them during the procedure. With the regimen you described, you should be pretty comfortable for the duration of the procedure. Of course, a general anesthetic will be the most comfortable since you will be completely asleep but I really don’t think most people need a general anesthetic. Good luck!


Sarmela Sunder, MD
Los Angeles Facial Plastic Surgeon
5.0 out of 5 stars 21 reviews

Local is not as comfortable as general anesthesia for eyelid surgery

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 I have been a plastic and cosmetic surgeon for over 20 years and local anesthesia for upper eyelid surgery is doable but you will not be as comfortable as you would be with a geeral anesthetic.  You will feel the local infiltration, tissue as it is touched (not pain), hear the sounds of cutting, cautery as well as the general sounds of the OR and operating room staff.  If you are attempting to avoid the general anesthetic for some reason, the local can be done but it is no way as comfortable as being asleep under a general anesthetic.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 28 reviews

Upper eyelid surgery and anesthesia

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The type of anesthesia used is patient dependent. Most patients can tolerate upper blepharoplasty under local sedation with or without oral medications in an office setting. 

To be on the safe side, eye shields can be used for patients who are extremely nervous or highly sensitive to pain to prevent accidental damage to the eye.

Adam J. Cohen, MD
Glenview Oculoplastic Surgeon

Corneal shield for upper eyelid surgery

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I don't use corneal shields with eyelid surgery. I find them occasionally uncomfortable for the patient and generally unnecessary. They, too, can cause scratches or irritation during placement and removal. Although I typically perform blepharoplasty with patients asleep, local with some pre-op sedation is usually fine in the properly selected patient. Pain after blepharoplasty is similarly minimal. Most of my upper blepharoplasty patients will take Tylenol or nothing for pain control afterward.

Good luck with your surgery,

--David C. Pearson, M.D.

David C. Pearson, MD
Jacksonville Facial Plastic Surgeon

Upper Eyelid Surgery Performed With Local Anesthesia

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Upper eyelid surgery can be performed under local or general anesthesia. It really depends on the desire of the patient.  The combination you describe is tolerable for surgery. I do not use the eye lens cover, but some surgeons do.  Thank you, and I hope this helps answer your question.

Dr. Nassif

Paul S. Nassif, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 49 reviews

Anesthesia for lid surgery

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Lid surgery is often done under light sedation with oral or intravenous medications. Some patients also undergo surgery with just local lidocaine and do fine. It depends on how comfortable you feel- if you want intravenous sedation I'm sure your surgeon can accomadate you but it increases the cost. Most oculoplastics surgeons do this surgery with the patient slightly awake so that you can open your eyes during surgery which helps ensure symmetry.

Keshini Parbhu, MD
Orlando Oculoplastic Surgeon

Upper eyelid surgery with local anesthetic alone is well tolerated by most patients

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In my practice I screen prospective blepharoplasty patients based on whether they are comfortable receiving a local anesthetic injection (it is less painful than a dental injection, which most patients can relate to) and whether a procedure room setting is something they would rather not deal with. If the answer to either one is no, then intravenous sedation or general anesthetic are offered. 

Grigoriy Mashkevich, MD. New York Facial Plastic Surgeon.

Grigoriy Mashkevich, MD
Manhattan Facial Plastic Surgeon
4.7 out of 5 stars 10 reviews

Type of anesthesia and sedation for upper Blepharoplasty

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Upper eyelid lift is relatively quick and without significant disturbance of the deeper structures. It can be done with local anesthesia and no sedation all the way to general anesthesia. What you choose depends on your comfort level and ability to sit still for a while and tolerate minor sticks to get the area numb. I would not suggest this if you are also having something done to the brows or the lower lids. Although use of eye shields is safer, there really is very little risk with this particular surgery.

Robert T. Buchanan, MD
Highlands Plastic Surgeon

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.