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

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.

Thank you for your question.  Eyelid surgery is typically performed under local anaesthetic.  The patients being awake throughout the procedure, therefore not experiencing the health risks associated with general anaesthetic, also recovery time being significantly reduced.  There will be a slight sensation of pulling or touch during the procedure, having not experiencing pain (this can depends on the patient's tolerance).  

Please make sure you find a reputable and qualified plastic surgeon who can assess you properly to give you a realistic idea of what outcome you can achieve.


 All The Best

Most patients do just fine with this combination for upper eyelid surgery, Blepharoplasty.. We also use Ativan, an anti anxiety medicine and many of our patients snooze through the procedure and don't remember any of the details.

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!

Dr.Sunder

Hello,

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

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.

I read your concern. In my practice, the majority of patients with excessive upper eyelid skin require only skin and muscle removal. The only discomfort in upper blepharoplasty is when the medial fat-pad is removed. I have found that this is typically unnecessary, and if performed, may increase your risk of complications and lead to a hollow, "operated" result.

Upper blepharoplasty takes around an hour, and local anesthetic is offered and well tolerated by my patients. I do not give oral narcotics or anxiolytics preoperatively to any of my patients. If you're nervous, it may be safer for you to have a certified anesthesiologist administer IV sedation during your procedure.

I hope this is helpful for you.

Regards from NJ.

The level of sedation is often dealers preference.  Some surgeons are most comfortable with general anesthesia.  However, there is really no need for anesthesia this deep.  In addition, it is possible to have much more control over the surgery by having a patient who is able to follow commands.

If you are nervous, the oral anxiolytic and analgesic reduce your nervousness, and pain sensitivity which is very helpful.  A similar effect can be achieved with iv sedation which also has the advantage that the anesthesiologist can control the level of consciousness when needed.  The down side of iv sedation is that it needs to be performed in an accredited operating room.  Generally this type of setting adds to the expense of the surgery compared to having surgery in an office procedure room under straight local anesthesia.

Contact lens are not necessary for upper eyelid surgery unless a levator ptosis procedure is planned with the need for a suture to be place into the upper eyelid tarsus or if laser will be used during the surgery either as a cutting instrument or for skin resurfacing.

I often perform eyelid surgery under local anesthesia.  Patients are comfortable throughout the whole process.  It can a better, safer option for many patients.  The most important factor is your surgeon's comfort level.

Dr Taban

Hi Rebric.  Ultimately the decision is patient dependent; however what you are describing is not unreasonable for an upper lid blepharoplasty.  Also, shields may be withheld in upper lid blepharoplasty.Best wishes.