Effect of local anesthetic volume on early patient-reported outcomes after double-eyelid surgery: a pilot randomized clinical study

Background Double-eyelid surgery is among the most common aesthetic procedures in East Asia and is typically performed under local anesthesia. However, little is known about how anesthetic injection volume affects postoperative patient satisfaction. This study therefore examined whether local anesthetic volume affects early postoperative patient-reported outcomes after double-eyelid surgery.Methods This pilot randomized clinical study enrolled 25 patients who underwent double-eyelid surgery between May 2025 and March 2026. Patients received local anesthesia with lidocaine and were assigned to three groups according to the volume administered to each upper palpebral conjunctiva: 0.1 mL (low-volume), 0.25 mL (medium-volume), or 0.4 mL (high-volume). On postoperative days 0 and 7, a questionnaire assessed patient satisfaction with eyelid appearance and postoperative swelling, as well as the naturalness of the eyelid crease. The Wilcoxon signed-rank test was used for paired comparisons, and the Kruskal-Wallis test was used to compare changes among groups.Results The paired analysis included 17 patients who completed the questionnaires on both postoperative days 0 and 7. Median satisfaction scores for eyelid appearance, postoperative swelling, and crease naturalness tended to increase from day 0 to day 7. These increases, however, were not statistically significant. The magnitude of the changes also did not differ significantly among the anesthetic volume groups.Conclusions In this pilot randomized clinical study, early patient-reported outcomes did not differ significantly among the tested anesthetic volumes. Confirmation of these preliminary findings requires studies with larger cohorts, objective outcome assessments, and longer follow-up.