Local anesthesia for upper eyelid surgery is a good option for patients who consider themselves “stoic” and have a relatively high pain threshold. In this technique, only numbing medications are used to provide comfort and so they are awake during the entire procedure.
Without general anesthesia that puts patients to a state similar to sleep, they avoid its common side effects such as nausea and lethargy, which in turn promote quicker recovery.
Leading Los Angeles plastic surgeon Dr. Tarick Smiley has recently demonstrated a surgery via Snapchat performed completely under local anesthesia. The patient requested for this procedure so she could drive herself home after surgery.
The patient was awake during the entire surgery, which involved removing some loose skin (and muscle) to eliminate the upper lid hooding that was aging her eyes and interfering with her vision.
A local anesthesia-alone surgery also precludes the need for fasting; this is not the case with general anesthesia in which the patients are required to avoid foods and drinks for 8-12 hours prior to the operation.
While local anesthesia for upper eyelid surgery is a reasonably safe option—some doctors would even compare this to a dentist visit involving cavity fillers treatments—Dr. Smiley says that not everyone is a good candidate for this approach, particularly those requiring other concurrent procedures like facelift, fat transfer, and brow lift.
Also, patients who are anxious are poor candidates for “pure” local anesthesia as they might experience increase in blood pressure, which can result in more bleeding and thus the surgery becomes more difficult. For these individuals, the use of local anesthesia with sedation or general anesthesia remains the most ideal approach.
For patients who want to avoid general anesthesia but may be too nervous to be awake during surgery, a good alternative is to combine local anesthesia with sedation, which means that they will have no memory of the surgical experience.
Furthermore, sedation does not involve placing a tube in the throat, which the general anesthesia entails.