What Type of Anesthesia Does Dr. Hoenig Use For Eyelid Plastic Surgery?
Dr Hoenig performs eyelid surgery with local anesthesia with or without the addition of some relaxing and/or pain pills. Local anesthesia numbs a particular area of the body, and is overall safer than general or systemic anesthetics. While local anesthesia is very safe, there are risks of complications such as pain, bruising, hematoma (blood collecting under the skin), infection, allergic reaction, and nerve damage. If you are combining eyelid surgery with other procedures such as a brow lift or face lift, you will most likely use IV sedation or twilight anesthesia in addition to injections of local anesthesia.
Topical Local Anesthesia
When you come in for surgery, Dr Hoenig will apply numbing cream to the skin where the eyelid incisions will be placed and/or numbing drops in the eye if you will have incision on the inside of the eyelid. Using numbing cream or anesthetic eye drops, will make the subsequent injections of anesthesia more comfortable. The anesthetic eye drops do burn for about 5 seconds, but then your eyes will be numb. (you’ll still be able to see!) These types of topical anesthesia will numb the uppermost layers and a little bit below, but will not block pain in deeper structures, therefore injections of local anesthetic are still necessary for surgery. In addition to being useful for minor procedures, it is also helpful for people who are afraid of needles since topical anesthesia will reduce or eliminate the discomfort as the needle pierces the skin.
Cream anesthetics, such as the trade names EMLA, Betacaine, BLT, or LMX, combine local anesthetics into formulations that are able to penetrate the surface of the skin. Numbing cream must be applied directly to the surgical site anywhere from 30 to 90 minutes before the procedure.
Local Anesthesia Injections
Infiltration or injection into the surgical area with a needle is the most frequently used local anesthesia technique. Because direct injection can change the contour and appearance of the site, the Dr Hoenig may mark the area beforehand to identify certain landmarks. Lidocaine, lasting 30 to 60 minutes, is the most commonly injected medicine; however, for longer procedures, longer-lasting medicines such as Marcaine or Procaine can be added. Small doses of epinephrine (adrenaline) are often added to the local anesthetic solution to constrict the blood vessels and delay absorption of the medicine. This also benefits the patient by producing less bleeding, longer anesthesia, and the need for less medicine, however it can sometimes cause the heart to beat faster and stronger as it is absorbed into the bloodstream.
How much does anesthesia cost for eyelid surgery?
For eyelid surgery alone (without brow lift or other more extensive surgery), Dr Hoenig uses local anesthesia which is included in the cost of the operating room fees, therefore there is no additional charge for anesthesia unless you prefer heavier sedation (given through an IV like Propofol).
For heavier sedation, anesthesia fees are based on the amount of time that the anesthesiologist or nurse anesthetist is present. This time starts from when the patient is brought into the operating room, until he or she is taken to the recovery room. This time is usually about an hour longer than the actual time your surgeon will need to perform the operation. Typically, a greater amount is charged for the first hour of anesthesia (or portion thereof) to account for set up and preparation time, and then the fee is less for any subsequent hours.
After Anesthesia Guidelines
If you have had anesthesia combined any form of sedation (oral or intravenous), you will need someone responsible to drive you home after surgery.
Standard post anesthesia instructions for 24 hours after leaving the hospital or surgery center include:
- do not use alcohol
- do not drive a car or operate heavy machinery
- do not sign any legal documents
- do not make any important decisions
Dr Hoenig will also provide you with other specific post operative instructions and warning signs that you should refer to after surgery.