Hello @Jo needham 66, thank you for your question. In my opinion the best way to perform upper and lower eyelid surgery is under general anesthesia. That say, If you begin to feel anxious or panicked during the procedure, it is crucial to communicate your concerns to your surgeon or their medical team. They can offer you additional support and guidance to help you feel more comfortable and alleviate any fears you may have. Best wishes! Alan Gonzalez MD, FACS. American Society of Plastic Surgery Member (ASPS),International Federation for Adipose Therapeutics and Science” Member (IFATS), American Society of Plastic Surgery Member (ASPS), Colombian Society of Plastic Surgery member (SCCP)