Blepharoplasty, or eyelid surgery, whether upper blepharoplasty, lower blepharoplasty or upper with lower blepharoplasty, is done using local sedation only. If other surgery is performed at the same time, appropriate additional anesthesia will be administered upon completion of the eyelid surgery.
A neck lift or a cheek lift and other facial surgery may be done under intravenous sedation, sometimes called twilight sedation, or under general anesthesia.
An abdominoplasty, breast surgeries and most other surgeries are done under general anesthesia.
Liposuction may be either, depending on the extent of the liposuction.
Local anesthesia is administered specifically to block pain in a small area, and lasts for a very short time. Supervised recovery and after-effects are minimal.
Intravenous sedation, IV sedation, or "twilight" sedation, consists of a pain medication and a mild sedative and is used to relax you and make you sleep. The medications may also cause temporary forgetfulness. It is used in conjunction with local anesthesia.
General anesthesia is used when local or IV sedation is not appropriate. Temporary side effects from the medications are common and carefully managed in the hospital.
Some patients still worry about the safety of general anesthesia. In fact, general anesthesia is increasingly safe when done in a fully-equipped operating theatre by a board-certified anesthesiologist who has monitors to track your breathing, heart rate, circulation, blood pressure, temperature, and other body functions. In the past 10 years, deaths due to anesthesia have dropped 25-fold according to recent industry studies from one in 10,000 to one in 250,000.