In our practice, we place patients to sleep under a brief general anesthetic for patient safety and comfort. The surgery is performed in a licensed and certified outpatient surgery center , and the anesthesia is administered by a board-certified physician anesthesiologist. The fatty deposits around the eyes in both the upper and lower lids, have deep proprioceptive pain fibers that don't numb up well to local anesthetic. The fat pads when removed, can be quite painful during the surgery. After the surgery, there is usually very little pain associated with either upper or lower eye lid surgery. In our practice most patients take only a few pain pills for the first day or 2 after the procedure.