Hallo, welcome to our frequently asked questions.
Today I’m answering a commonly asked question
about blepharoplasty.
Do I need to have general anesthetic
in order to have lower blepharoplasty?
And my approach to answering this question will be
to talk to you about one of the different types
of anesthetic that are available.
What are the potential advantages and disadvantages
of the different type of anesthetic?
And then finally, what is going to be
the most suitable type of anesthetic for you?
My name is Dr. Julian De Silva
and I’m a London based Facial Cosmetic and Plastic Surgeon.
And blepharoplasty is one of the commonest procedures
that I complete for patients every day.
And I have used all the different types of anesthetic
that I’m talking to you today about.
And these are common discussions
that I have with my patients on a regular basis.
So, the first thing,
what are the different types of anesthetic?
Well, broadly speaking
there are 3 different types of anesthetic.
There are local anesthetic and what local anesthetic means
is using a numbing agent, a numbing local anesthetic
into the localized area of the lower eyelid
in order to numb the lower eyelid.
And this means that you’re fully conscious
or fully awake during the surgery,
and there is just numbing agent that is in that local area.
And equivalent you can say dentistry would be
having local anesthetic such around the tooth
that you’re having a procedure to.
The second form of anesthetic is general anesthetic,
and general anesthetic means you’re fully unconscious
or fully asleep during the surgery.
And this means that there’re more complex machines
that are looking after your breathing.
And there is anesthetist who’s supervising
both the machines and your care.
And this does mean that there is a tube down your throat
and air way in order to protect the air way.
And we will talk about some of their advantages
and disadvantages of general anesthetic in a moment.
Thirdly there is a newer form of anesthetic
called sedation anesthesia,
and sometimes it’s called twilight anesthesia.
And this type of anesthetic
means literally you’re sleeping during the surgery.
You’re still breathing yourself
and all your natural protective reflexes are working normally.
But you’re literally sleeping during the surgery
which does mean that you’re recovery tends to be faster.
So, what are the different advantages and disadvantages
of these types of anesthetic?
So, local anesthetic as we talked about
means there is a numbing agent just in that localized area
in which you’re having the lower eyelid surgery.
Now, the lower eyelid tends
to be quite a delicate area of the face.
And the lower eyelid although
it does numb with local anesthetic
tends to be more delicate.
And generally speaking having lower blepharoplasty
and the local anesthetic can be a little challenging
for patients because of the sensitivity of the lower eyelid.
And often as part of lower blepharoplasty
it’s necessarily to reshape or remove,
or reposition some of the lower eyelid fat
also called orbital fat.
And this tends to be very sensitive even when
it is now with local anesthetic.
So, moving on to general anesthetic,
well, by definition general anesthetic means
you’re fully asleep, you’re fully unconscious
during the surgery.
So, there is a tube that is down on your throat,
down your air way that protects your air way.
And there are more sophisticated machines
that look after your breathing during the general anesthetic.
Now, general anesthetic generally has a recovery
of 4 to 6 hours before you can go home.
And so, one the drawbacks of this anesthetic is that it does,
sometimes I mean you have to stay overnight in hospital
because if you have 4 to 6 hours to recover,
it may mean that that is necessary.
In addition because of the side effects
of general anesthetic often, you can feel slightly tired
or washed out after general anesthetic.
And approximately a third of patients will have some nausea
or feelings of sickness after the general anesthetic
because it’s the side effect of the medicine.
Having said that, general anesthetic is very safe,
it’s been used for many years.
And although it does tend to have a, a longer recover
and have some side effects such as feeling nausea or sickness,
it’s a very safe form of anesthetic.
The third type of anesthetic,
well, this is a type of anesthetic called
sedation or twilight anesthesia.
And it literally means you are sleeping during your surgery.
And the benefits of sedation anesthesia are that,
because you’re asleep, you’re still breathing yourself
just like you would, when you sleep at night.
All your natural protective reflexes, all the way,
all the forms that regulate your body are working naturally.
So, it tends to be a very safe form of anesthetic
and it tends to have a very fast recovery.
And although not so commonly used in UK, worldwide sedation
is very commonly used for lower blepharoplasty.
What it does mean is that
you’re recovery tends to be about 30 minutes
and for most patients that can be less.
And it does mean that you will definitely go home
on the day of the surgery.
Things like nausea or feeling sick
are relatively very uncommon with sedation anesthesia
and generally happen less than one percent of the time.
So, in summary, well, we’ve talked about the different types
of anesthetic and what their potential advantages
and disadvantages are.
What is the ideal form of anesthetic
for you to have lower blepharoplasty?
Well, there’re a few other considerations
because ultimately the type of anesthetic
needs to be tailored towards you the individual.
And so, depending on,
if you feel particularly anxious about surgery.
Whether you’ve had any previous surgery
that might result in scarring
in which case the anesthetic
may be a little bit less effective in the lower eyelid.
Well, these are considerations
that are very specific to each patient.
Generally speaking, my preference for saying the sedation,
by preference for lower blepharoplasty
is to give patients sedation anesthesia.
This is having used all 3 different types of anesthetic.
From my experience patients have
the most comfortable experience,
they’re the most relaxed during surgery
and they have the fastest recovery.
Plus they’re ensured
that they will go home on the day of the surgery.
In terms of sedation anesthesia,
well, you generally have half an hour
in terms of recovery before you can go home.
Generally the side effects are relatively rare,
such as nausea or sickness.
And so, has many of the advantages of a relaxing experience,
but a fast recovery.
In summary, we’ve talked about
the different types of anesthetic.
We’ve talked about the different advantages and disadvantages
of those different types of anesthetic.
And we’ve also talked about
what maybe the best form of anesthetic for you
to have lower blepharoplasty.
I hope this information has been useful for you,
thank you for watching.
If you would like further information
about having blepharoplasty or eyelid surgery,
please have a look at Dr. De Silva’s book.
This is a comprehensive patient guide with over 250 pages
including color illustrations and photographs,
including all commonly asked questions
and fears that patients have.
This is available through either
Dr. Julian De Silva’s website or by searching on Amazon.