Local Injections for Upper Eyelid Surgery and Laser Under Eyes?

I was wondering, has anyone had upper eyelid surgery with local anesthetic injections? My doctor also recommends laser treatment for under lower eyelids to remove the crows feet and says it will make the skin tighter. I'm concerned about the laser treatment; what can I expect to feel after the local injections wear off? Thanks.

Doctor Answers 9


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This sounds reasonable, and usual for what you are intersted in.

I would recommend a topical anesthetic first such as Emla cream or some ohter so that the injections are not as ouchy. The injections themselves feel like a bee sting, but the numbing takes effect quickly.

After the numbing wears off, the lasered skin feels like a sun burn, and it will start to 'draw", or feel tiight as well. Mild narcotics or non-narcotics will help, as well as moisturizers like vasoline, or aquaphor ointment.

Hope this helps.


General anesthesia is preferred for blepharoplasty

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A blepharoplasty is best performed under general anesthesia, not local anesthetic. Fat pads underneath the eyelids that create the puffy look, do not numb up to the local anesthetic and is quite painful upon removal. It is best to have this done under a general anesthesia. Laser resurfacing for the eyelids will help to some degree with the lower lid wrinkles and crow’s-feet. However, it can leave the skin hypo-pigmented over the areas that were lasered. The transition zone between lasered to non-lasered skin can be noticeable. Laser surfacing is thermal injury to the skin that is quite painful. Expect stinging for the first few days and the area to remain pink for several months in the postoperative phase before full feeling takes effect.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 158 reviews

Upper eyelid sugery and laser for lower lids

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Yes, upper eyelids surgery can be done under local anesthesia, as well as laser to your lower eyelids. After the local wears off, you may have some discomort and burning sensations. So, make sure to request some pain killers for home use. Also, make sure you ice the lasered areas well afterward for several hours. Good luck!

Upper blepharoplasty with local is reasonable

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Upper lid cosmetic surgery could easily be done under local anaesthesia in the right patient! Lower lid surgery, laser or any other therapy requires a correct diagnosis of the underlying problem. Laser could tighten a mild skin laxity without any structural weakness or fat herniation. Do not expect laser to reverse muscle weakness, or other hardcore signs of peri-orbital aging. Best of luck!

Hisham Seify, MD, PhD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 19 reviews

Anesthesia for eyelid surgery

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What you've been told is very logical. Upper blepharoplasty can easily be done under local anesthesia. The injection of local anesthetic is slightly painful, but the discomfort disappears quickly. After surgery, pain is minimal and patients do well with oral pain medication.

Laser surgery for tightening of the lower eyelid works well. However certain lasers such as CO2 laser can lead to a relatively long period of redness. Ask your surgeon if he plans to use a fractionated laser. Fractionated lasers work by vaporizing microscopic islands of skin while leaving some intact skin behind. This leads to faster healing and less redness.

Maurice M. Khosh, MD
New York Facial Plastic Surgeon

Upper blepharoplasty and anesthesia

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I sometiems perform upper eyelid surgery under straight local. If I have to do work on the lower lids, I like to have the patient sedated especially for removal of fat or for a canthopexy.  Light laser peels can be done on the lower lids without sedation

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Why would anyone do upper eyelid surgery under general anesthesia?

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Dear Bangela

I often do eyelid surgery right in the office under local anesthesia. It can be done very comfortably this way exposing you to the absolute minimum of drugs. The key with upper eyelid surgery is that surgeons deprive themselves of critical information if they do eyelid surgery under general anesthesia. If one does cookie cutter eyelid surgery it could be argues that it does not so much matter. However, to have any degree of finesse with upper eyelid surgery, it is essential to be able to have the patient retain the ability to open and close the eyes during surgery. Therefore I insist that cosmetic eyelid surgery be performed either under straight local anesthesia or IV sedation where the patient is light enough to be able to follow commands.

The laser resurfacing can also be comfortably performed under this level of anesthesia.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Local Anestheisa for Upper Blepharoplasty is Common

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Most of the time if we are doing isolated upper lid blepharoplasties we do them under a local anesthetic. By using a solution of xylocaine containing sodium bicarbonate the stinging sensation from the injection is markedly reduced. The procedure takes less than 30 minutes and we often do a phenol chemical peel of the infraorbital area if indicated.

S. Randolph Waldman, MD
Lexington Facial Plastic Surgeon
4.6 out of 5 stars 19 reviews

Performing Blepharoplasty and Laser Under Local

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The local injections for the laser I would assume is going to be a local block. This means the nerve to the area is blocked so that the area is numb. This works well if it is a small area to be addressed. After the laser and when the block wears off you will feel like you have had a sun burn. Now this depends on the laser modality but in general that is what it is going to feel like.

Good luck.

Farbod Esmailian, MD
Orange County Plastic Surgeon
5.0 out of 5 stars 88 reviews

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.