A well-equipped office operating room should work as well as (and in some cases, better than) a general hospital surgery suite primarily equipped to perform operations like gallbladder surgery and total hip replacements. Blood pressure and pulse can be monitored throughout a blepharoplasty whether in an office setting or at a hospital. Besides, if you are afflicted by major medical problems that mandate more comprehensive monitoring and preclude accepting any added risk, you might want to think twice before undergoing cosmetic eyelid surgery at any facility.
If your doctor maintains an office operating room equipped to perform blepharoplasty, this may be your best bet. Why? Because not only will the doctor feel more comfortable working on his or her own home turf, but, assuming he or she is conscientious and does a reasonable volume of cosmetic eyelid surgery, your surgeon will know that the facility is equipped with exactly the right instruments and supplies and that he or she will be assisted in surgery by someone with special training and experience in eyelid surgery rather than whichever scrub technician or nurse (or student nurse!) happens to be assigned to the hospital operating room that day.
From a patient's point of view, it's hard for most hospitals to compete with the comfort and level of personal attention doled out in most office operating rooms. Office operating rooms are staffed by people you may have already met during your consultation. They know who you are, and they treat you as if you were their sole object of attention (because, in fact, at that moment you are). Having already visited your doctor's office, you can more readily imagine yourself as a patient undergoing your procedure. By decreasing the anxiety of the unknown, the overall experience is generally made more positive.
In our experience, blepharoplasty can be performed quite successfully under local anesthesia with moderate oral sedation and analgesia. Some doctors, however, prefer general inhalation anesthesia or deep intravenous twilight sleep (see the next chapter); in such cases where the risk of drug side-effects is higher and the recovery from anesthesia will take longer, you may wish to give consideration to the added security of a large hospital or out-patient surgicenter.
