Upper Blepharoplasty: Local Anesthesia or Sedation?

Young asian woman on OR table about to be placed under general anesthesia.

Droopy eyelids don’t just make you look tired, they can also affect your vision. This sagging can be caused by a loss of skin elasticity or conditions affecting eye nerves or muscles such as a stroke, brain tumor, or cancer. If your sagging eyelids have altered your appearance or sight, you may want to consider blepharoplasty at our Nashville practice.

The procedure removes excess skin on the eyelid, giving the eyes a  more alert, youthful appearance. Blepharoplasty can be performed on the upper or lower eyelid or both. We’ll focus on the upper blepharoplasty procedure in this blog post, explaining what happens during the procedure and what type of anesthesia is preferred.

What is upper blepharoplasty?

As people age, they may start to notice a heavy feeling in their eyelids due to:

  • The descent of the eyebrow
  • Extra skin around the upper eyelid area

An upper blepharoplasty, also known as an eyelid lift, alleviates that heavy eyelid feeling. However, this procedure is not the same as a brow lift, although we may perform these two procedures together. 

Upper blepharoplasty can provide benefits for both cosmetic and functional purposes:

  • Reduce signs of aging
  • Diminish vision obstruction caused by excess or overhanging skin
  • Remove puffiness of the upper lids

You can learn more about why people are choosing eyelid surgery in a related blog post.

How do I know if I am a candidate for blepharoplasty?

The first step is to meet with a skilled facial plastic surgeon such as Dr. Boggess in Nashville. The initial meeting will serve as a consultation to determine whether you are a candidate for the surgery. This consultation helps Dr. Boggess and his team understand your issues, goals, and medical history.

Are you awake during upper eyelid surgery?

Dr. Boggess has been successfully performing eyelid lifts for more than 19 years. One of the most common questions our facial plastic surgery experts are asked is whether the patient will be sedated throughout the surgery. An eyelid lift can safely be performed with local anesthesia, conscious sedation, or general anesthesia.

Local Anesthesia

Local anesthesia is accomplished by injecting local anesthetic medication into the specific part of the body where the surgery is to be performed, causing temporary loss of sensitivity. In the case of blepharoplasty, after the local anesthetic injections, the upper eyelid becomes completely insensitive, or numb, throughout the whole procedure.

Conscious Sedation

Conscious sedation involves using sedative medications that may be administered orally or through an IV to relax the patient during the procedure.  Oral sedation is a light level of sedation in which the patient is relaxed but still likely awake and aware during the procedure. An IV sedation is a deeper level of sedation, where the patient will likely be dozing in and out of sleep during the procedure but remains arousable to vocal stimuli.  Local anesthesia is used in combination with these conscious sedation techniques to locally anesthetize the surgical site so that the patient does not feel discomfort from the procedure.

Youthful Reflections prefers local anesthesia with or without conscious sedation for blepharoplasty procedures because it is a safer and more cost-effective alternative to general anesthesia.

General Anesthesia

In other practices, blepharoplasty is often performed under general anesthesia. With general anesthesia, the patient will be completely asleep and unaware of the surroundings and will not respond to any stimuli. Dr. Boggess believes that general anesthesia unnecessarily increases the risk and cost of the procedure and prolongs recovery. At Youthful Reflections, we have a perfect safety record performing blepharoplasty without the need for general anesthesia.

Dr. Boggess and his team will talk to you about your previous experiences with anesthesia, your preferences, and the risks and benefits of anesthesia alternatives to make certain the most appropriate anesthesia plan is determined for your procedure.  You will not need to stay overnight at a hospital because eyelid surgery can be done safely in an outpatient setting.

How is eyelid surgery performed? 

During an eyelid lift, your doctor will create a very small incision that hides in the natural eyelid crease. They will then remove the excess skin. In some cases, when a tiny part of the muscle responsible for closing the eyelids, known as orbicularis oculi, will be removed.

If protruding fat in the upper eyelids is creating fullness, your doctor may remove it to contour the eyelids. The incisions are then closed with tiny sutures hidden in the natural crease of your eyes so any scars are not noticeable.

The procedure typically only takes 30 minutes, and you can even go home right after.

You will likely experience some bruising and swelling afterward, but these side effects typically resolve in 10 to 14 days. Most people can return to normal activities within 1 week. 

You can see some of our blepharoplasty patients’ before and after pictures to get an idea of the type of results that are possible with the procedure.

If you’re interested in upper blepharoplasty and want to know if you’re a suitable candidate for eyelid surgery, contact our Nashville facial plastic surgery practice online or call today to schedule your consultation!

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