I want Eyelid Surgery, can it Be Done Without Anesthesia?

I want to get eyelid surgery but I have sleep apnea and am currently on pain medications. Can I still have the procedure without anesthesia? Some doctors have told me that anesthesia does not work well for people with those types of issues. It has been a problem for me my whole life. Any ideas?


F, 56, New Jersey

Tags:woman age 45-54 upper eyelids pain medication anesthesia

We receive many questions about facial plastic surgery and the types of anesthesia used or recommended. Certain types of eyelid rejuvenation can be done using local anesthesia only. More complex and deeper procedures involving fat or muscle work are performed with local and IV sedation, or general anesthesia. Local anesthesia is given with an injection; think of it as similar to what a dentist gives you to numb your face before they start working on your teeth.

Cosmetic eyelid surgery can be performed with straight local anesthesia. Bear in mind that there’s usually more work involved with lower eyelid surgery than surgery on the upper lid. You should discuss options with your plastic surgeon based on your medical conditions, but recognize that no surgical procedures on the body should be done without at least local anesthesia.

The quick answer is yes -- sort of. You'll need some form of anesthesia to mask the pain and get through any type of plastic surgery. There are three general types of anesthesia – local anesthesia, local with intravenous sedation, and general anesthesia. Local is similar to what you get when you're at the dentist's office. The plastic surgeon will inject a numbing medicine (usually lidocaine) at or near the area being treated. Some people prefer IV sedation (e.g. Valium) to relax them, along with local anesthesia for the procedure. Other patients want to be totally knocked out during cosmetic surgery, so they go with general anesthesia. Local and local with IV sedation usually don't require a breathing tube and are fairly easy to rebound from. General anesthesia requires a breathing tube and can take a couple of days to recover from. Some people also have a problem with nausea for a day or two.

Many upper and lower eyelid surgeries (upper blepharoplasty and lower blepharoplasty) are performed without general anesthesia. You may find that your best option is a local with IV sedation (if this agrees with your plastic surgeon's assessment). This way you will have the pain block from the local and be in a more relaxed state. This could come in handy to keep your blood pressure balanced once you see scalpels coming near your eyes.

After the surgery you'll have some bruising and swelling for a few days. Your plastic surgeon will provide you with a list of pre-procedure do's and don'ts along with a list of things you should and shouldn’t do after the procedure to speed the healing process along.

About half of the eyelid surgeries we do are done in the office without general anesthesia.  Give our office a call at 908-277-8750 and I'd be happy to see you for a consultation. You can also have an online consultation at no cost through our web site.


Yes!   It is very easy to have eyelid surgery without general anesthesia. We give numbing shots of local anesthesia instead.

You can most certainly have your lids done with just local anesthesia. With a surgeon who is expert at local anesthesia, there is minimal, if any pain with either the injections or the surgery. 

You can have the surgery done under local anesthesia -- but you will have to bear the temporary pain of the injections.

Elliot Jacobs, MD, FACS

New York City