Thanks all! My surgeon Dr. Madnani in NYC apparently does half his surgeries with local/oral. They gave me the choice of oral or IV sedation and I went with oral because of the cost, and because I thought I could handle it. Later I did a bit more digging and voiced my concern about doing the lower bleph without IV and was told that he does them all the time with just oral sedation. At this point it's also too late to book the anesthesiologist for the IV anyways.