Is Eyelid Surgery painful? Are patients usually put under general anesthesia or can they be awake?
Doctor Answers 11
Anesthesia and eyelid surgery
Pain During and After Eyelid Surgery
Eyelid Surgery Under Local
Local anaesthetic is strictly used for upper eyelid surgery, due to minimal pain. It can also be used for lower eyelid as well, however it will depend on patients pain threshold, to whether they opt for local or general anaesthetic for the lower eyelids. Lower Eyelid Surgery is more sensitive due to removal of excess skin and fat is removed or re-draped to improve the contour of the lower eyelid.
Surprising there is little after pain as well. The vast majority of patients need no more than paracetamol. Different people heal at different rates, but about 70% of the swelling and bruising is gone after one week. About 90% of the swelling and bruising is gone after two weeks. After two weeks, it is often difficult to tell that the patient has had eyelid surgery.
Best of Luck
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Eyelid Surgery Under Local
Answers will vary widely for these questions because much of it depends on the personal preference of the surgeon and also the desires of the patient. Bottom line is that there are lots of options.
In our practice, cases are typically done in the operating room under IV sedation (with local anesthetic as well) or in-office with local anesthetic only. With the anesthesia on board, patients are usually very comfortable during the surgery. Post-operatively, over the counter pain medication is typically adequate to manage pain. Narcotics are almost never necessary.
Eyelid surgery typically is not very painful compared to the many other surgeries plastic surgeons do.
It usually can be done awake or under general anesthesia.
To be sure, see two or more experienced, board-certified Plastic Surgeons, occuloplastic surgeons or facial ENT surgeons in your area for a complete evaluation to make sure you are a good candidate and that it is safe for you to have surgery.
I hope this helps.
Eyelid surgery performed under general anesthesia
Not all eyelid surgery is the same!
My personal preference is to do Upper eyelid surgery with numbing medication around the eyes (local anesthetic) and have the patient 100% awake (ie, no Valium, no Xanax). The patients that have their upper lids done that way are always the happiest! They do not feel any pain, they have minimal bruising, they don't get nauseous and we're able to have a very enjoyable conversation throughout the entire procedure. We listen to music and at the end of the case, you feel completely comfortable. Some patients are still nervous, so I have no problem prescribing an anxiety pill - but that is patient dependent.
For lower eyelid surgery - I always do that in an outpatient procedure setting, with minimal sedation (ie, twilight or IV sedation). Most patients describe this as an amazing nap. It is very comfortable and safer than general anesthesia. Also, depending on what medications you take and your medical conditions, if it is safer, than I will do an upper eyelid surgery in the procedure room as well. Safety always dictates the final decision.
Some of my good friends, who are general plastic surgeons or even other eyelid surgeons, will do eyelid surgery under general anesthesia. Personally, I think this is putting the patient under unnecessary risk. Eyelid surgery alone does not require general anesthesia, unless you are having another procedure done at the same time (ie, a facelift or nose job). If your surgeon is telling you that you need general anesthesia for an eyelid procedure, they might not be using the latest techniques.
As far as pain after surgery is considered. Everyone's perception of pain is different, so it is impossible to answer that directly. But to give you a framework, here are some key points. I never prescribe prescription pain medications or narcotics. I call all my patients the night of their surgery and remind them to take over-the-counter Tylenol for the first few days after surgery. Most of my patients say that they stopped using Tylenol after the 2nd or 3rd day. Again, in my humble opinion, if you have so much pain after eyelid surgery that you need narcotics, your surgeon hasn't done a thorough job coaching you through the post-operative process or something might be amiss.
Again, this is a great question. I hope it helps, but don't be too distraught by the multitude of answers. As long as your surgeon has a good reputation and is driven by safety, then I would follow their recommendation. Thanks!