Anesthesia during eyelid surgery

by | Aug 7, 2019

Let’s talk about anesthesia and eyelid surgery. Different surgeons will have different preferences, but here are my thoughts.⠀

Upper blepharoplasty is very comfortable to perform in the office under local anesthesia. If patients are really nervous, a Xanax or Valium can be given ahead of time to help reduce anxiety. In my private practice, I also have Pro-Nox (inhaled nitrous oxide aka laughing gas) to help patients relax during the procedure.⠀

If patients want to be more sedated, the surgery can definitely be done in the operating room, but the vast majority of patients find office surgery very comfortable for this procedure. The surgery itself takes less than 30 minutes once we get started.⠀

In contrast, lower blepharoplasty can be much more uncomfortable and I like to perform this surgery in the operating room under general anesthesia or at least intravenous sedation.⠀

Lower blepharoplasty surgery involves removal of excess eyelid fat. I like to do this procedure in a way that minimizes complications of excess bleeding. During the procedure, I dissect pockets of excess fat from the lower eyelids and then clamp the tissue before cutting it to minimize bleeding.⠀

Performing the surgery this way causes less bleeding, which reduces complications and get patients back to work more quickly. Less bleeding during the surgery often means less bruising later. Manipulating and clamping fat can be really uncomfortable. When patients are in pain, their blood pressure goes up and there is more bleeding. When patients are asleep (and can’t feel anything), their blood pressure stays low and there is much less bleeding. I can concentrate on surgery instead of worrying about patient comfort. This makes the whole experience better for both the surgeon and the patient.⠀

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