What kind of anesthesia is used for upper and lower eyelid blepharoplasty?

We are the only practice in San Diego that performs blepharoplasty everyday.  Upper eyelid blepharoplasty involves the removal of skin from the upper eyelid.  Dr. Iyengar is one of the most experienced surgeons in Southern California with this procedure and has performed this procedure on thousands of patients including those in the public eye.

First and foremost in our practice is patient safety.  During an evaluation for blepharoplasty in our Encinitas or La Jolla office, Dr. Iyengar will be able to first confirm that is the right procedure for you and that it is safe to have this done.  We regularly see patients who have had plastic surgery around the eyes by surgeons who are not eyelid specialists.  Two of the most common conditions missed by surgeons who are not eye plastic surgeons are dry eyes and ptosis.  Many of these plastic surgeons do not even realize these complications until they are recognized by other doctors after the surgery.   We sincerely believe there is value in seeing some who operates on a part of the body everyday and that there is no substitute for the highest level of training in an area.  Dr. Iyengar is a board-certified, fellowship-trained, oculoplastic surgeon that operates on eyelids everyday.

San Diego physicians who have trusted Dr. Iyengar with their own eyelids.

After Dr. Iyengar has throughly evaluated your eyelid and determined that you are a candidate for upper or lower eyelid blepharoplasty, the next steps involve deciding where would be the most comfortable location for each patient. Dr. Iyengar performs upper eyelid blepharoplasty for cosmetic reasons in our customized surgical suite under local anesthesia.  As you do your research, you will see the number of physicians that have chosen Dr. Iyengar for their own cosmetic eyelid surgery.  We are especially proud of the facial plastic surgeons, oral/maxillofacial surgeons, dermatologists, emergency physicians, pathologists, anesthesiologists, gastroenterologists, internists, general surgeons, ophthalmologists, otolaryngologists, cardiologists and psychiatrists that have chosen to have their own eyelid surgery at our San Diego practice. Each of these physicians had their cosmetic upper eyelid surgery performed in the office under local anesthesia and found minimal discomfort during the procedure.  It is critical for a cosmetic practice like ours to have patient comfort to be optimized.  Dr. Iyengar uses a special local anesthetic formula that requires only 2-3 injections around the eyelids using a needle that is smaller than a Botox needle.  The upper eyelid bleparoplasty procedure in our practice only takes about 15-20 minutes, as we do this everyday, but we spend the time to make sure you are comfortable and relaxed in the pre- and post-procedure setting.  Patients enjoy their selection of music during the procedure and walk in and walk out without an IVs or the like.

Lower eyelid blepharoplasty involves addressing the bags underneath the eyelid.  Most candidates for lower eyelid blepharoplasty are aware that the lower eyelid has three pockets of fat that come forward with time.  Often these fat pads can clearly be demonstrated and identified on photographs.  Dr. Iyengar will often demarcate these fat pads in the eyelid evaluation process.  In the past, many older surgeons and plastic surgeons who are not eyelid specialists  would make an incision in the lower eyelid to access these fat pockets.  This incision would be carried through the entire eyelid and severe the muscle responsible for eyelid closure.  This same muscle, the orbicularis oculi, is also the same muscle that helps drain the lymphatics around the eyelid and helps reduce postoperative swelling.  Dr. Iyengar is one of the most experienced surgeons in the San Diego area with transconjunctival lower eyelid blepharoplasty.  This is an approach that involves a hidden incision, inside the eyelid, and no resultant scar that is visible.  Additionally, it preserved the muscle around the eye, resulting a quicker recovery and no damage to surrounding tissue.  Once these fat pockets in the eyelid are accessed through this approach, they can either be removed or repositioned.  Depending on the patient, Dr. Iyengar will determine which is the best approach for each individual patient and eyelid.    Lower eyelid blepharoplasty is performed in the operating room under IV sedation or light general anesthetic at a San Diego outpatient surgery center and anesthesia is provided by board-certified anesthesiologists.

Post-operative recovery from each of these procedures takes about 1-2 weeks.  Sutures for upper eyelid blepharoplasty are removed at one week.  There are no sutures (or scars) from our approach to lower eyelid blepharoplasty.  We generally see patients who have had eyelid surgery at one week and one month following surgery but are welcome to return to see Dr. Iyengar at any time following their procedure.  Patients often as about scar creams for their eyelid surgery.  In our experience, incisions from cosmetic upper eyelid surgery heal extremely well with Dr. Iyengar’s meticulous closure. We do offer a scar cream that is safe around the eyes and is about $40.  Patients undergoing eyelid surgery also often ask about Arnica. We generally leave it up to the patient’s discretion as to whether they choose to use this product.  In our experience, patients who are generally healthy and not on any blood thinners have minimal bruising from their eyelid surgery with or without the use of these medications.