The lower blepharoplasty

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Abstract
The day prior to the operation, or preferably on the morning of surgery, the patient is reexamined in the sitting position and, at that time, determinations are made regarding the placement of the incision and whether any fat should be removed.The author does the operation only under local anesthesia, and the patient is invariably admitted to the hospital, at least postoperatively. The patient is instructed to remove all make‐up the evening before and to wash her face with an antiseptic soap. A sedative, such as Nembutal, mg 100‐150, is always given to the patient one‐half hour before retiring, to permit a good night's sleep. A well‐rested patient has a higher pain threshold and tolerates the surgical procedure much better emotionally.On call to the operating room, the patient is premedicated with Demerol and Nembutal, mg 100 each, I.M., and an intravenous transfusion of 5 percent dextrose in water is commenced. Should it become necessary, a “piggyback” transfusion is added to the I.V. This consists of 250 cc of 5 percent dextrose in water to which are added 100 mg of Demerol. The Demerol solution may then be titrated during the operation, the rate usually ranging from four to 20 drops per minute.

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