Blepharoplasty of the eyelids under local anesthesia. Blepharo under local anesthesia. Methods of administering local anesthesia

To correct both the upper and lower eyelids, aesthetic surgery is performed - blepharoplasty. Drooping eyelids and bags under the eyes make the face appear older and tired, and can also contribute to poor vision. Aesthetic eyelid correction can eliminate these problems.

Circular blepharoplasty

Since blepharoplasty is a surgical procedure, it is performed under general anesthesia to ensure complete pain relief throughout the entire procedure. What type of anesthesia should be used during this operation: general or local? Will surgery hurt?

Local anesthesia

Most often, blepharoplasty is performed under local anesthesia in combination with sedation. This operation can be performed under general anesthesia if the patient is terrified of being conscious during any surgical procedure. Before using medicated sleep, you must undergo a thorough examination and obtain permission from your doctor.

The operation is simple and plastic surgeons perform it in about an hour. Since the surgical intervention is low-traumatic, it is better to choose local anesthesia. This anesthesia will reduce the risk of developing post-anesthesia complications and you will be able to go home the same day, a couple of hours after the procedure. It will hurt a little only in the place where the anesthetic injections are given, but this is tolerable, unlike the side effects after medicated sleep. Therefore, surgeons prefer to perform the operation under this method of anesthesia.

Transconjunctival blepharoplasty

Local anesthetics block nerve conduction, so there is a temporary loss of sensation in a limited area and the patient is not in pain during the operation. After a few hours after eyelid correction, the numbness will completely disappear. If the patient experiences pain after the procedure, the doctor will prescribe a pain reliever.

Sedative therapy is used before surgery, during correction in combination with local anesthetics and after it. It allows you to achieve complete calm and relaxation of the patient, and he will not worry that it will be painful when performing surgery under local anesthesia.

While under observation after performing blepharoplasty under local anesthesia, the patient must immediately contact medical staff if there are any negative sensations. For example, it is unbearably painful, a burning or itching sensation in the operated area, and so on. The supervising doctor will be able to provide first aid in a timely manner if complications develop.

Medication-induced sleep

Under general anesthesia, the patient is unconscious with a complete absence of pain throughout the body. To perform blepharoplasty, the patient is given such anesthesia if he is afraid that it will be painful under the local one or if transconjunctival aesthetic plastic surgery must be performed. In this operation, the surgeon makes an incision on the inside of the eyelids.

Only anesthesiologists perform anesthesia with complete loss of consciousness for patients undergoing surgery. Patients first undergo a full examination and undergo additional tests prescribed by the supervising physician. Anesthesiologists must conduct a preoperative consultation in order to identify the presence of allergic reactions to medications, previous serious illnesses, and so on.

Throughout the surgical procedure, the anesthesiologist monitors the condition of the patient being operated on. There is no pain for the person being operated on under general anesthesia when the surgeons perform all the necessary manipulations. After waking up completely, the patient does not remember the details of the operation due to complete loss of consciousness.

If it is possible to perform blepharoplasty under local anesthesia, it is better to refuse medicated sleep, because it will not hurt in any case. The rehabilitation period will pass much faster and without unnecessary post-anesthesia complications, and the patient will be able to return home earlier.

Preparation

Young woman having a consultation about blepharoplasty

Preparation for eyelid surgery depends on the type of anesthesia. Before using local anesthetics, preparation is minimal and does not require much effort. It is necessary to stop drinking alcohol 24 hours before the procedure, and you should also refrain from smoking. You should tell your surgeon if you are taking other medications, especially those that make your blood difficult to clot. If the operating doctor has prescribed you to take additional sedatives, you must follow the instructions.

General anesthesia requires more careful preparation. It is very important to quit smoking two months before the scheduled date of aesthetic surgery - blepharoplasty. Smoking greatly affects the lungs and after medicated sleep it can even provoke pneumonia. It is also not recommended to consume alcoholic beverages during the day before surgery, and then avoid it for the entire recovery period.

Pain and discomfort are constant companions of any surgical intervention, especially if it is performed in an area with very thin and delicate skin.

However, very often blepharoplasty under local anesthesia is even necessary, because in case of asymmetry of skin folds (and this happens very often), only by talking with the patient and controlling how the line of the future scar lies in the natural fold of the skin and what distance remains from the eyebrows, you can get a symmetrical result. Many women are interested in whether it is painful to have blepharoplasty under local anesthesia. This question can best be answered by patients who have already undergone surgery and all the difficulties of the rehabilitation period.

Eyelid lift POV

These are the impressions the plastic surgery left on the women who were operated on by the surgeon (names have been changed):

When the doctor said that she would do blepharoplasty under local anesthesia, whether it would hurt or not, I didn’t even think about it, to be honest. For the entire hour that the operation was going on, to my great surprise, I chatted with her, talked about my recent vacation, my family, and didn’t even notice how it all ended. (Irina, 36 years old).
The most unpleasant thing, in my opinion, is the “recovery” after general anesthesia, but there is little benefit from it for the body. Therefore, I immediately asked whether it was painful to do blepharoplasty under local anesthesia. She assured me that the most I would feel was an injection of anesthetic into my eyelid and the very fact that something was being done to my face. Indeed, I first felt pain only in the ward, when the anesthetic wore off. But this quickly passed after taking a painkiller. And so, everything is great, I recommend it to everyone! (Mila, 44 years old).
I underwent the operation quite easily and did not feel any particular pain or severe discomfort. All the difficulties began the next day, when I had already come to my senses a little. It was painful to open my eyes and even just blink, let alone read or watch TV. The huge bruises made me look like a panda. She was, of course, very upset, but she said that it should be so. On the second day, however, I felt much better. The discomfort finally went away along with the bruises in about a week. I am very pleased with the result. (Margarita, 30 years old).

What to expect after surgery?

It is not painful to do under local anesthesia. The doctor will administer the drug intravenously or give an injection directly into the eyelid. You will be fully conscious and able to talk to the surgeon.

As a rule, if the operation is performed correctly, patients do not experience unbearably severe pain in the postoperative period. Slight pain, swelling, and bruising are natural phenomena that are observed in all women. They usually go away on their own within 7-14 days and do not require special treatment. You can preliminary evaluate the result after 1 - 2 months.

Blepharoplasty is a plastic surgery that allows you to correct the shape of the eyes, remove drooping eyelids and bags under the eyes. Many women resort to such surgical intervention; the procedure is quite simple, easily tolerated, but requires effective pain relief.

Anesthesia for blepharoplasty can be general or local; what type of anesthesia will be used depends not only on the patient’s personal preferences, but also on the volume of the operation, associated disorders, tolerance of painkillers and a number of other conditions.

Types of anesthesia used for blepharoplasty

Blepharoplasty involves removing fat deposits and tightening muscles through incisions in the skin. Naturally, such manipulation is accompanied by severe pain, so it is impossible without high-quality pain relief.

Blepharoplasty can be performed under local or general anesthesia:

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Local anesthesia- local anesthesia of the skin and subcutaneous fat in the affected area. That is, the introduction of a local anesthetic temporarily disables pain receptors specifically in the eye area, and allows operations to be performed without general anesthesia;
General anesthesia. This term refers to the intravenous or inhalational administration of anesthetics, leading to inhibition of the central nervous system, as a result of which pain sensitivity disappears, muscles relax, reflex reactions are suppressed and consciousness is turned off. The use of modern drugs allows you to select a dose that has minimal negative effects on the body and its effect lasts exactly as long as necessary for the operation.

Local anesthesia is often combined with sedation - the administration of sedatives. Their use slows down the functioning of the central nervous system, but at the same time the person being operated on is conscious.

What to choose - general or local anesthesia

What anesthesia is required for blepharoplasty? It is better to choose the type of anesthesia together with your doctor. Most patients prefer local anesthesia, but you need to know that such anesthesia is only possible if the correction concerns only the lower or upper eyelid. With such an intervention, the volume of the operation is insignificant and not particularly complex in terms of technique, so local anesthesia will allow the plastic surgery to be carried out efficiently.

Most doctors even prefer to combine local anesthesia with sedation, since this puts the patient into a shallow sleep, therefore relaxes and does not interfere with the doctor’s eyelid surgery.

General anesthesia is definitely used if circular blepharoplasty is necessary - simultaneous correction of the lower and upper eyelids, changing the shape of the eyes. Such an intervention requires more time and full concentration of the surgeon, and the effect of local anesthesia to comply with these conditions is insufficient.

When choosing an anesthesia option for blepharoplasty, not only the type of correction is taken into account, but also a number of other conditions:

Patient's age;
Psycho-emotional status. For people with a high level of anxiety, neuroses, suspiciousness and doubts, general anesthesia is recommended, since with local anesthesia there is a high probability that they will constantly distract the surgeon, which will not have the best effect on the quality of blepharoplasty;
Tolerance of local anesthetics. A number of patients are allergic to drugs from this group, so they are indicated for general anesthesia;
Diagnostic data. Before blepharoplasty, an extensive examination is required; it is also necessary to identify indications and contraindications for anesthesia.

Any anesthesia requires preparation of the patient, so the type of anesthesia is selected in advance.

Preparatory stage

Preparing a patient for blepharoplasty involves conducting a number of examinations, these are:

Blood test, including blood clotting, sugar, infections;
Fluorography;
ECG - electrocardiogram of the heart.

Consultation with an ophthalmologist and anesthesiologist is required. If general anesthesia is necessary, permission from a physician or cardiologist will be required.

For the operation itself to be successful and for no negative consequences to arise, the following is required:

At least 3 weeks before surgery, stop smoking, drinking alcohol and using blood thinners;
Compliance with diet therapy on the eve of blepharoplasty. The day before surgery, preference should be given to easily digestible foods; in the morning before surgery, you should not eat or drink.

The patient should be warned in advance about the type of anesthesia chosen, the characteristics of its effect on the body and the condition after the operation.

Features of local anesthesia for blepharoplasty

Pain sensitivity during local anesthesia is turned off in two ways:

Application- apply cream or spray gel with anesthetics to the desired area of the body;
Injectable- the anesthetic is injected under the skin using a syringe with a needle.

Blepharoplasty under local anesthesia is performed after injection of drugs. The application method is not used for this type of plastic surgery, since external agents do not penetrate deeply and therefore do not affect the subcutaneous fat.

In most cases, injection anesthesia is performed with drugs containing ultracaine, lidocaine, and buvicaine.

Advantages and disadvantages

Blepharoplasty under local anesthesia is preferable to general anesthesia. The main advantages of such pain relief are:

Slight risk of developing systemic severe complications, possible due to the toxic effects of drugs used during general anesthesia;
Ability to follow physician orders. During the operation, the surgeon may ask the patient to periodically close and open his eyes, which has a positive effect on the results of the correction;
Short rehabilitation period after anesthesia. The patient can be under the supervision of clinic staff for only 2-3 hours, and then he is sent home.

Despite the obvious advantages of local anesthesia for blepharoplasty, this type of anesthesia is not always used. Its disadvantages are:

Possible increase in blood pressure. During plastic surgery on the eyes, most patients are nervous, which often leads to increased blood pressure. This condition does not threaten health, but increases the risk of bleeding, which complicates the surgeon’s work;
Risk of allergic reactions to the anesthetic used;
Inability to use local anesthesia for extensive surgery. Most often, local anesthesia is prescribed for upper eyelid blepharoplasty. When correcting a defect in the lower part, the incision is made from the inside and this is not always possible if the operated person is conscious.

Stages of surgery under local anesthesia

Blepharoplasty under local anesthesia is carried out in several stages:

The doctor uses a special marker in the area of intervention to mark areas that need correction;
The skin is treated with an antiseptic;
Local anesthesia is performed;
After turning off pain sensitivity, the surgeon proceeds directly to blepharoplasty.

The duration of the procedure is about 40 minutes, sometimes a little more or less. During this time, the anesthesia will remain in effect. But if pain occurs, you must immediately inform your doctor about it - additional administration of the medicine again blocks pain receptors.

Feelings during blepharoplasty under local anesthesia

There is no pain during eye and eyelid correction under local anesthesia. However, the person being operated on is conscious and may experience some discomfort:

When the injection is administered, quite severe pain is felt, but it lasts literally seconds and this time must be endured;
Pressure on eyelids from using instruments. At this time, complete calm is required from the patient, since both the quality of blepharoplasty and the absence of complications after the operation depend not least on this;
Stinging in the eyes from bright surgical lights. During upper eyelid surgery, the eyes are closed, but sometimes the surgeon may ask them to open, and temporary blindness may occur when looking at a bright light source located opposite;
Nervous tension, which can cause tachycardia, excessive sweating, weakness, and fainting. If the patient is predisposed to such mental changes, then it is better to use local anesthesia along with sedation.

There is no pain for about 1-2 hours after blepharoplasty, but then pain may appear. If their intensity is high, you can take a painkiller recommended by your doctor.

Possible complications of local anesthesia

The most dangerous thing that can happen with local anesthesia is an allergic reaction, which in severe cases can lead to anaphylaxis and angioedema. Fortunately, such complications occur extremely rarely.

The development of Quincke's edema and anaphylaxis requires immediate medical assistance. Therefore, blepharoplasty should be done only in those clinics whose offices have a first aid kit for emergency care, and in the institution itself there is an intensive care unit.

Other complications of local anesthesia include:

Impaired spontaneous breathing. This complication occurs in people with severe pathologies of the respiratory system, but usually any local anesthetics are contraindicated for them, so the diagnosis must be carefully carried out;
Hematoma formation due to puncture of the vessel at the time of injection. The complication is not dangerous, the bruising goes away within a few days;
Infection. The ingress of pathogenic microorganisms at the time of injection is possible if the rules of asepsis and antisepsis are not followed.

Blepharoplasty under local anesthesia does not lead to undesirable complications if all indications and contraindications are fully established before the procedure, and the surgeon strictly follows the technique of administering the injection and performing plastic surgery.

Blepharoplasty under general anesthesia

General anesthesia can be intravenous or inhalational. When performing blepharoplasty, preference is increasingly given to TIVA anesthesia - a modern method of turning off consciousness.

The abbreviation TIVA stands for total intravenous anesthesia, which uses only a mixture of drugs injected into a vein. Inhaled drugs to inhibit central nervous system are not used with this type of anesthesia.

The main advantages of TIVA anesthesia:

There is a slight likelihood of nausea and vomiting after anesthesia;
Hemodynamic stability of the patient;
Lowest risk of toxicity for the patient;
Reduced pressure inside blood vessels;
Fast recovery period after surgery.

TIVA anesthesia provides automatic administration of a pre-calculated dose of anesthetics and continuous monitoring of the patient's condition. Total intravenous anesthesia can also be used if the patient has a persistent form of arterial hypertension.

General anesthesia, unlike local anesthesia, ensures complete relaxation of the muscles and switches off the patient’s consciousness, which allows the doctor not to be distracted during blepharoplasty by factors unrelated to the course of the intervention.

After general anesthesia, the likelihood of systemic adverse reactions is high. But their development depends mainly on how correctly the dose of the drug is selected. When calculating it, the patient’s weight, age, and the presence of concomitant diseases are taken into account. Therefore, only a qualified anesthesiologist can give high-quality anesthesia.

Blepharoplasty is intended to correct the shape of the upper and lower eyelids. The operation is usually performed under local anesthesia or medicated sleep.

Doctors believe that anesthesia is preferable to blepharoplasty under general anesthesia. Especially if the operation is performed only on the upper or lower eyelid. Her the advantage is to minimize risks that may occur after drug-induced sleep. Plus, the person is given sedative therapy, as a result of which nervousness and anxiety are completely relieved.

Blepharoplasty can be performed under regional anesthesia. It eliminates sensation in the entire part of the body that is undergoing surgery.

This operation itself is not large-scale, lasting from half an hour to 40 minutes.

Tests before surgery:

general blood and urine analysis;
coagulogram;
HIV, hepatitis and syphilis;
analysis for allergic reactions to anesthesia;
fluorography.

The person must also undergo consultations with a therapist and an anesthesiologist.

Preparation for surgery:

you should not drink alcoholic beverages 24 hours before the intervention;
smoking is prohibited;
notify doctors about the medications you are taking. Among them may be those that reduce blood clotting. They must be excluded 3 days before surgery;

He uses a special marker to mark future cuts;
The skin is disinfected;
Next, they inject or apply an anesthetic;
Blepharoplasty is performed directly.

Rehabilitation after blepharoplasty under anesthesia is simple. But a complete absence of pain cannot be avoided. Recommendations for recovery:

do not strain your eyes;

What anesthesia is used to perform blepharoplasty?, depends on the client’s wishes and the doctor’s opinion after the test results. It is preferable to carry out under local anesthesia.

Pros and cons of anesthesia options:

- Under local. With it, the risk of complications is much lower: it does not affect the entire body, the sedative effect eliminates anxiety before and during surgery, there is no pain. After blepharoplasty under local anesthesia, the patient can leave the clinic within a few hours, if all indicators are normal. Rehabilitation takes much less time - up to 10 days. Afterwards, the patient almost completely returns to his normal life.

Minuses: you will have to endure the pain of the injection; a person can feel the touch of a scalpel, suturing. This type is suitable for those who are afraid of not waking up after general anesthesia, have contraindications, and can also switch their thoughts well and be distracted from everything that is happening.

- Under general. Direct indications for medicinal sleep include: transconjunctival aesthetic plastic surgery, when the incision is made from the inside of the eyelid; blepharoplasty of the upper and lower eyelids at once. Advantages of general anesthesia: the patient sleeps peacefully, the operation goes smoothly for the surgeon and staff. A person waking up after upper eyelid blepharoplasty under general anesthesia does not remember any parts of the operation.

Full recovery usually takes more than two weeks. And immediately after the intervention the patient will have to spend about a day in the hospital under the supervision of doctors. The pain after any type will be the same. Bruising and slight swelling may appear, which will go away on its own after a few days.

Read more in our article about blepharoplasty under anesthesia.

Read in this article

What anesthesia is used for eyelid blepharoplasty?

Blepharoplasty is intended to correct the shape of the upper and lower eyelids. With its help, you can make your look more open, remove bags under the eyes and change the shape of the incision. The operation is usually performed under local anesthesia or medicated sleep.

Doctors believe that anesthesia is preferable to blepharoplasty under anesthesia. Especially if the operation is performed only on the upper or lower eyelid. Its advantage is to minimize the risks that may arise after medicated sleep. Plus, the person is given sedative therapy, as a result of which nervousness and anxiety are completely relieved.

Expert opinion

Tatyana Somoilova

Cosmetology expert

It is also possible to perform blepharoplasty under regional anesthesia. It eliminates sensation in the entire part of the body that is undergoing surgery. This may be used for particularly sensitive patients.

This operation in itself is not large-scale. The removed tissue takes up only a few grams. It can last from half an hour to 40 minutes, depending on the complexity of the goal.

Preparatory stage

Before undergoing blepharoplasty, the patient will have to undergo a certain set of tests:

general blood and urine analysis;
coagulogram;
blood glucose level analysis;
HIV, hepatitis and syphilis;
analysis of allergic reactions to anesthesia;
fluorography.

The person must also undergo consultations with a therapist and an anesthesiologist, who will take a complete medical history of the client.

Preparing for surgery is nothing complicated. It is important to follow a number of simple recommendations:

you should not drink alcoholic beverages 24 hours before surgery;
smoking is prohibited;
the surgeon and anesthesiologist must be aware of all medications the patient is taking. Among them may be those that reduce blood clotting. They must be excluded 3 days before surgery;
A few days before blepharoplasty, take sedatives.

Right before the operation, the surgeon performs the following manipulations:

He uses a special marker to mark future cuts;
the skin is disinfected;
Then they inject or apply an anesthetic drug.

Recovery

Rehabilitation after blepharoplasty under anesthesia is simple. But a complete absence of pain cannot be avoided. Doctors can always prescribe additional medications.

To avoid complications, you need to follow the recommendations:

do not strain your eyes;
the first two days it is forbidden to bend over a lot and move sharply;
you need to protect your eyes from the sun, harsh and bright light, it is better to use dark glasses;
You can’t get the seams wet, that is, wash your face or put on makeup;
temporarily stop wearing contact lenses.

What anesthesia is better?

Under what anesthesia to perform blepharoplasty depends on the wishes of the client and the doctor’s opinion after the test results. Since the operation is not a complex intervention, it is preferable to perform it under local anesthesia. Each type has its own pros and cons.

Under local

The risk of complications is much lower. Local anesthesia does not affect the entire body as a whole. Accompanying sedatives completely eliminate the patient’s anxiety before and during surgery. The man is half asleep.

Blepharoplasty under local anesthesia is performed using two methods:

by injection;
applique.

In the first case, a special composition is applied to the skin, which blocks the nerve endings. The second involves injecting an anesthetic under the skin. They may also give you an injection of a sedative at the same time.

Performing blepharoplasty under local anesthesia is not painful, since tactile sensations are completely lost. There may be unpleasant moments during injection. The patient can feel the touch of a scalpel and sutures. After the operation is completed, an anesthetic injection is given.

After blepharoplasty under local anesthesia, the patient can leave the clinic within a few hours if all indicators are normal. In addition, the rehabilitation period is much shorter than with general treatment. It lasts up to 10 days. Afterwards, the patient almost completely returns to his normal life.

you will have to endure pain from an injection in such tender places as the upper and lower eyelids;
the client hears and sees everything that happens around;
local anesthesia resembles pain relief during dental treatment, that is, the person feels that something is being done to him.

This type is suitable for those who are afraid of not waking up after general anesthesia, have contraindications, and can also switch their thoughts well and be distracted from everything that is happening.

Watch this video about how blepharoplasty is performed using combined anesthesia:

Under general

These disadvantages may be unacceptable for the patient, so some choose medicated sleep. But there are also direct indications for performing blepharoplasty under general anesthesia. These include:

The advantage of general anesthesia is that the patient sleeps peacefully, the operation goes smoothly for the surgeon and staff. In addition, pain after any type of anesthesia will be the same. Bruising and slight swelling may also appear, which will go away on its own after a few days.

A person waking up after upper eyelid blepharoplasty under general anesthesia does not remember any parts of the operation.

Full recovery usually takes more than two weeks. Moreover, immediately after the intervention, the patient will have to spend about a day in the hospital under the supervision of doctors.

Blepharoplasty is not a complex operation, therefore, to reduce risks and facilitate the recovery period, it is performed under local anesthesia. But the final decision depends on the patient’s opinion and test results, the desired result. A painful recovery awaits in both cases.

Useful video

Watch this video about blepharoplasty under mini anesthesia:

Despite the fact that in recent years general anesthesia has become extremely safe and comfortable, patients are always happy to choose other, less profound options for pain relief.

Unlike most plastic surgeries, Blepharoplasty can be performed under local anesthesia, when the anesthetic effect affects only the area around the eyes, and the patient remains conscious. A full-fledged eyelid lift as an outpatient procedure certainly looks attractive - however, it has its own nuances and pitfalls that you should know about in advance.

So, does this method have objective advantages or disadvantages? In what cases is it indicated and in what cases is it not? What medications are used and how is the operation performed? The site goes into detail:

How do they do it?

It is not possible to do without general anesthesia during blepharoplasty in all cases. This is only possible if a technically simple small-scale operation is planned - for example, isolated correction of the upper eyelids - and the patient himself is mentally ready to endure it, being fully conscious. At the same time, local anesthesia has obvious advantages:

minimal likelihood of developing complications associated with the action of more “heavy” drugs for general anesthesia;
the ability to open and close the eyes on command, which greatly simplifies the operation for the surgeon and reduces the likelihood of under- and over-correction;
The hospital stay at the end of the intervention is limited to a few hours, after which you can immediately go home. All subsequent manipulations (observation, removal of sutures) are performed at an outpatient appointment.

So there are some disadvantages:

in the absence of general anesthesia, and also due to inevitable nervous tension, the patient’s blood pressure will be quite high - this does not threaten health, but may interfere with the surgeon (in addition, many doctors, in principle, prefer to work with “sleeping” patients);
there remains a small probability of allergic and other undesirable reactions to injected drugs.

There are two ways to turn off pain sensitivity without putting a person to sleep:

Application - an anesthetic cream or spray is applied to an area of skin, and after a few minutes it becomes “numb”. The main disadvantage of this option is that the effect practically does not affect the subcutaneous fat and muscles, so it is used only for minimally invasive procedures, such as or.
Injection - when the anesthetic is injected using a syringe with a thin needle. In this case, it will penetrate into much deeper layers of skin and tissue, and in addition, it will act much longer.

For eyelid surgery, only the second (injection) method is used. Specific drugs can be very different; they are selected by a surgeon or anesthesiologist “for the patient.” As a rule, these will be products based on lidocaine, ultracaine and bupivacaine. But novocaine, popular among cosmetologists, is not suitable due to its short duration of action.

Features of the operation under local anesthesia

Regardless of the type of anesthesia chosen, the preparatory stage will be approximately the same: the patient must undergo a standard set of tests, temporarily give up alcohol, smoking and a number of medications. In addition, his allergic and anesthesiological history is necessarily studied: whether operations were performed in the past, what kind of anesthesia was used and whether it led to any undesirable consequences, whether there is intolerance to certain drugs, etc. – this is necessary to exclude the possibility of anaphylactic shock and other serious complications.

Immediately before the operation begins, the areas where the lift will be done are marked on the skin of the eyelids with a special marker. Next, the entire face is treated with an antiseptic, injections are given to “turn off” sensitivity, and when they take effect, the surgeon begins work.

Many people are concerned about the question: will they feel pain during eyelid surgery if they choose local anesthesia?

During the injections themselves, you will have to be patient: they are extremely uncomfortable, since the anesthetic drug is injected quite deeply and at the same time into a very sensitive and delicate area near the eyes.
Further, during the operation, there will be no pain, but patients can feel the pressure of surgical instruments and the movement of threads during suturing - much the same as we feel the dentist’s manipulations inside our teeth and gums. In addition, you will have to look at the bright light of surgical lamps, and when using a laser scalpel, you will also have to smell the smell of burnt meat. For many, such sensations cause nervous tension and other unpleasant reactions, so local anesthesia is almost always supplemented with oral sedatives - they bring the person into a calmer, sleepy state.
For people with a very low pain threshold and/or increased anxiety, intravenous sedation, during which consciousness is completely switched off, may be indicated instead of oral sedation. Subjectively, this option is not much different from general anesthesia: the only difference is in the dosages of the drugs and the possibility of spontaneous breathing.
The intensity and duration of local anesthesia depends on the amount of the drug administered, its concentration, as well as the individual characteristics of the human body. It happens that right during the operation, the effect of the anesthetic weakens and sensitivity begins to return. This must be reported to the surgeon so that he can make an additional injection.

Upon completion of the plastic surgery, the patient is taken to the ward to monitor his condition for 2-3 hours. If no problems arise at this stage, painkillers are prescribed in the form of tablets or intramuscular injections (analgin, ketanov, paracetamol), after which you can go home.

Possible complications and side effects

The most formidable negative consequence of local anesthesia, which everyone has heard of at least once, is an allergic reaction leading to the development of Quincke's edema and anaphylactic shock, which directly threaten the patient's life. Fortunately, this happens extremely rarely - about 1 problem case per 15,000 successful operations (0.01%), which even according to the strict canons of aesthetic surgery is considered a relatively acceptable risk.

To completely eliminate the possibility of such negative reactions, the surgeon or anesthesiologist, firstly, carefully examines the health status and individual characteristics of the patient before the operation, and secondly, they can conduct additional tests for sensitivity to the drugs that are supposed to be used for pain relief. Even if it turns out that one or more of them actually cause an allergy, you can almost always find a safe replacement for them. Normally, such a test is carried out only if there are any reasonable concerns, but it is also possible simply at the request of the patient. Other undesirable consequences of local anesthesia include:

Possible problems with spontaneous breathing - they threaten only patients with serious pathologies of respiratory function; as a rule, local anesthetics are contraindicated for them in principle.
Puncture of a vessel: manifested by a burning sensation that occurs during an anesthetic injection, slight swelling and redness, and later a bruise may form in this place.
Other problems associated with injections as a method of delivering painkillers into the body: infection, hematomas, increased swelling. But in the vast majority of cases, these “side effects” do not pose a serious danger and do not require any special attention against the background of the main consequences of eyelid surgery.

What to remember

The choice between general and local anesthesia during blepharoplasty is made depending on the volume of the operation, which particular pair of eyelids - upper or lower - is being worked on, as well as the individual characteristics of the patient. Your wishes regarding anesthesia can be discussed during the consultation, but the final decision is made by the surgeon based on his professional knowledge. Wherein:

The final quality of the operation and its aesthetic effect do not depend in any way on which option is used.
Under local anesthesia, discomfort is partially preserved. In addition, looking at the surgeon’s work while conscious can be psychologically difficult, and it is impossible to visually isolate the surgical field (the eyelid area) from the patient. Therefore, in the vast majority of cases, additional sedatives are also used - orally or intravenously.
Even if you cannot do without general anesthesia, you should not panic again. Most of the information about its severity dates back to the end of the last century and is very outdated: modern drugs provide restful sleep, minimal risk of complications, as well as a cheerful, healthy state upon awakening - without nausea, dizziness and other unpleasant symptoms.

Experts' opinions:

I try not to do blepharoplasty under local anesthesia, only in rare cases when there is not a large volume of work - for example, if I need to remove part of the skin without delving into the deeper layers of tissue, a hernia.

Plastic surgeon, candidate of medical sciences

This type of anesthesia is used primarily if a small amount of surgical intervention is planned. At the same time, I always take into account the patient’s wishes, his emotional background and physiological reactions to stress. Naturally, a decision in favor of local anesthesia is also made in case of contraindications to general anesthesia. In general, the choice of pain relief method depends on a number of factors:

volume and duration of the proposed operation;
the patient’s physical condition and age;
psycho-emotional state;
presence of allergic reactions, etc.

Both options have their pros and cons. The most important thing is to take into account the characteristics of a particular patient.

Plastic surgeon, Doctor of Medical Sciences

Any blepharoplasty can be performed under local anesthesia. Its advantages are that the patient is always fully conscious and can go home immediately after the operation. Disadvantages: since all manipulations are carried out near the eyeball, for some it causes very unpleasant sensations. As a rule, men prefer general anesthesia, and women prefer local anesthesia.