Sometimes the perception of plastic surgery is that all operations involve a full general anaesthetic, a hospital stay and a lengthy recovery with bandages and support garments. However, this isn’t always the case, there are a number of procedures which can be undertaken more simply in the consulting rooms under local anaesthetic. At Rodin clinic we have a fully equipped procedure room, with on-site sterilisation, enabling us to perform these procedures safely.
The most common procedure done under local anaesthetic is upper lid blepharoplasty. Like any cosmetic procedure, a consultation process and body dysmorphia screening is required, however if the patient is suitable this can be arranged more flexibly than a procedure requiring admission to hospital.
The process from walking in, to walking out of the clinic takes approximately 90 minutes. Once the consent has been gained and pre-operative photos taken, the surgeons draws on the patient’s eyelids planning the amount of excess skin or fat to be removed. A small amount of local anaesthetic is then injected, taking approximately 20 seconds on each eyelid. The skin is then cleaned with antiseptic and sterile drapes are placed around the patient’s face. A bright light shines on the face, which takes a little while to get used to. All the patient needs to do is lie still and keep their eyes closed. We often have music playing and talk with the patient during the procedure, which is a good distraction.
During the operation a cautery device is used to stop minor bleeding – this creates some smoke and heat. A combination of internal dissolvable stitches and a single removable stitch is used to close the incision; small skin-coloured tapes are the only dressing required. Aftercare advice is provided, this involves measures to reduce swelling like cold compress eye masks and simple pain relief.
It is generally a very well tolerated recovery, patients can be out and about with sunglasses on from day 1. We prescribe some eye ointment to lubricate the eyes in the first few days. After one week the patient returns and has their single stitch removed on each eyelid, by which point the majority of the swelling and bruising has settled, so makeup can be applied from one week onwards. Complete scar maturation can take up to 18 months but normally fades more quickly.
Other treatments that can be undertaken safely under local anaesthetic with a similar process to eyelids include removal of skin lesions, small skin grafts and local flaps, brow lifts, ear surgery and hand surgery like trigger finger or carpal tunnel release.
All of our specialist plastic surgeons carry out these smaller procedures. In many cases, having a cosmetic procedure under local anaesthetic can be more cost effective to patients, which in turn makes the treatment more accessible. If you have questions whether a procedure is feasible under local anaesthetic please get in touch.