Upper Eyelid Surgery in Austin: Local Anesthesia Options including Ptosis Repair

The Eyes Say It All

Your eyes are often the first thing people notice — and one of the first areas to show signs of aging. Sagging skin, puffiness, or droopy eyelids can make you look tired even when you feel well-rested. Fortunately, upper eyelid surgery (blepharoplasty) and ptosis repair can restore a more alert, refreshed appearance — often performed comfortably under local anesthesia right here at Levesque Plastic Surgery in Austin .

What Is Upper Eyelid Surgery (Blepharoplasty)?

Upper eyelid surgery, or blepharoplasty, is a precision procedure that removes excess skin and fat from the upper eyelids. Over time, the delicate eyelid skin can stretch, creating hooding or folds that may weigh down the eyes.

Blepharoplasty can:  

• Eliminate heavy, drooping upper lids  
• Restore a smoother eyelid crease  
• Improve symmetry between eyes  
• Enhance the appearance of makeup application and make it easier to apply  
• Help patients look more rested and alert

In many cases, this procedure is performed purely for cosmetic rejuvenation. However, when excess skin begins to interfere with your visual field, it can also be considered a functional surgery.  This can sometimes be covered by insurance but different insurance companies have different requirements.  Most will require documentation of a significant decrease in your upper visual fields typically measured by optometrist or ophthalmologist with taping the eyelid and untaped tests.  Unfortunately at Levesque Plastic Surgery we are not accepting new patients for insurance.  Frankly we've been denied payment on procedures already performed one too many times.

What Is Ptosis and When Is It Repaired?

Ptosis refers to drooping of the upper eyelid margin itself — not just extra skin. This occurs when the levator muscle, which lifts the eyelid, becomes stretched or weakened. Ptosis can be present from birth (congenital ptosis) or develop gradually with age (acquired ptosis)

Common symptoms include: 

• One eyelid appearing lower than the other 
• Fatigue from constantly raising the brows to compensate 
• Partially obstructed vision 
• Asymmetry in photographs

When ptosis affects vision or causes strain, it can be corrected with ptosis repair, often performed at the same time as upper blepharoplasty. During ptosis repair, we tighten the levator muscle or its aponeurosis (tendon-like structure), restoring the eyelid’s natural height and contour.

While blepharoplasty focuses on removing skin and or fat, ptosis repair lifts the eyelid margin — and combining both can create the most balanced and natural result.

Upper Eyelid Surgery Under Local Anesthesia

Many patients are pleasantly surprised to learn that upper eyelid surgery and ptosis repair can be performed awake, using local anesthesia. There’s no need for general anesthesia in most cases, and patients remain completely comfortable throughout the procedure.  The majority of surgeons use intravenous sedation to perform these procedures but I have found that this is largely unnecessary with appropriate planning we can avoid intravenous sedation and safe on costs.

How It Works

A small amount of numbing medicine (similar to dental anesthesia) is injected into the eyelid area.

Optional mild oral sedation may be offered for additional comfort.

You’ll remain awake but relaxed — no pain, only a light sense of pressure or movement.

Surgery typically takes 45–90 minutes, depending on whether ptosis repair is included.

Benefits of Local Anesthesia 

• Lower risk compared to general anesthesia or intravenous sedation 
• Faster recovery and fewer side effects 
• Reduced cost (no operating room or anesthesiologist fees) 
• Convenient same-day procedure 
• Ability to go home shortly after surgery

The Day of Your Surgery

Here’s what to expect when you arrive for your upper eyelid surgery under local anesthesia: 

• Pre-procedure review and marking: I will carefully mark the eyelid creases and review your goals in the upright position before any injections to get an accurate surgical plan 
• Local anesthesia: The eyelids are gently numbed using tiny injections.
      
  • Surgical correction
            
    • For blepharoplasty, excess skin and small fat pads are precisely removed.   
  • For ptosis repair
            
    • The levator muscle is tightened to lift the eyelid and eyelid position compared and checked by having you open your eyes.  This is a important reason to perform the procedure under local anesthesia.   
  • Fine sutures: Tiny dissolvable and removable stitches are used to close the incision, hidden within the natural crease.   
• Immediate aftercare: You’ll rest with cool compresses, then head home the same day. 
• You can expect minimal discomfort, which is easily managed with over-the-counter pain relievers but prescription pain medications are always prescribed and available.

Recovery and Results

Most patients return to normal activities within 5–7 days. Bruising and swelling typically peak around day 2–3, then fade steadily.

Post-op guidelines:

• Keep the head elevated for 48 hours
• Apply cool compresses regularly for the first 2 days
• Avoid strenuous activity and bending over for one week
• Sutures are removed within 7 days typically

Results continue to refine for several weeks as swelling subsides. The incisions fade beautifully within the natural crease, becoming nearly invisible over time.

If a ptosis repair was performed, you’ll notice improved eyelid symmetry and a wider, brighter gaze immediately— often with better visual comfort as well.  The brow also typically relaxes as it is no longer needed to help lift the eyelid position resulting in less intense forehead wrinkles.

Complementary Treatments for Eye Rejuvenation

Upper eyelid surgery can be beautifully enhanced by addressing the surrounding areas: 

• Non-surgical skin rejuvenation: Treatments such as the CO2 Laser, VI Peels, or microneeedling help firm and hydrate delicate eyelid and facial skin. 
• Brow lift: A subtle brow elevation can further open the eyes. 
• Injectables: Neuromodulators (Botox®, Dysport®) can sm ooth crow’s feet and relax the brow for an overall refreshed look.

We will always create a personalized plan that fits your anatomy, lifestyle, and goals.

Why Choose Us?

I am a board-certified plastic surgeon in Austin, Texas, with advanced fellowship training in aesthetic surgery. I always approach facial surgery with a philosophy that less is often more — achieving results that look refreshed, not operated on.  We take a special interest in performing facial plastic surgery procedures under local anesthesia when the majority of surgeons electing to use intravenous or general anesthesia.  We are always welcome to discuss your goals and develop a personalized plan  to achieve your goals safely.  

Schedule Your Consultation 

Quick Facts

Procedure: Upper Blepharoplasty ± Ptosis Repair

Anesthesia: Local (awake, comfortable)

Duration: 45–90 minutes

Downtime:    5–7 days

Results:          Long-lasting, natural

Location: Austin, Texas

Price :             Menu of Prices 

FAQs about Upper Blepharoplasty and Ptosis Repair

Can upper eyelid surgery really be done while I’m awake?

Yes. Most patients are surprised at how comfortable and stress-free the procedure feels under local anesthesia.  Many of our patients ask for a little medications to calm their nerves.  We are happy to prescribe this to make the process even more comfortable.

How long does swelling last?

Initial swelling and bruising usually resolve within a week, and residual puffiness continues improving over several weeks.

Is ptosis repair the same as an eyelid lift?

Not exactly. Ptosis repair tightens the muscle that lifts the eyelid, while an eyelid lift (blepharoplasty) removes excess skin/muscle/and or fat. Many patients benefit from both together.