Blepharoplasty - How Painful is Eyelid Surgery Using Local Anesthesia?

Written by Frank P. Fechner, MD

We feel that blepharoplasty is well suited to be performed under local anesthesia with pre-operative relaxing medications. Although everybody is very protective of one’s eyes, our patients are usually surprised how relatively easy the procedure is for them. The sedatives are administered by mouth and take usually about 30 minutes to be effective. Once the patient finds themselves in a relaxed state, markings are performed for accurate planning of the procedure. Next, using a tiny needle, local anesthetic solution is deposited underneath the lid skin. After the first injection, additional “pokes” are performed through the already numb skin. Therefore, the patient feels only a slight stinging as the solution ”freezes” the lids. Once complete, the blepharoplasty procedure itself can be performed without discomfort. The lids will stay anesthetized for approximately 1 hour.

We conducted a study evaluating the discomfort associated with local anesthesia injection in 56 patients. When using a scale from 1 to 10 (1 representing no pain; 10 excruciating pain), the average discomfort level was 4 (mild to moderate pain).