Following surgery, cold compresses (ice packs) and a topical antibiotic ointment are applied for 3 to 4 days followed by warm compresses. Eye patches are not required. Discomfort is usually minimal and is typically handled by acetaminophen (Tylenol®). Aspirin containing compounds and non-steroidal anti-inflammatory products (Advil, Ibuprofen, etc.) should be avoided 2 weeks prior to surgery and up to 1 week following surgery. Most individuals will have swelling and some degree of bruising that will gradually improve over the first 1 to 3 weeks. Swelling make take weeks or months to completely resolve. Patient healing is variable with some individuals healing much quicker than others. Makeup can be applied to help hide residual bruising, usually starting two weeks after surgery.
For upper eyelid blepharoplasty, 5 to 7 days off work is average while up to 10 to 14 days may be best for those patients having both an upper and lower eyelid blepharoplasty. Patient's with occupations requiring minimal physical activity may return to work sooner. Patients may have diminished blinking and incomplete eyelid closure following eyelid surgery, particularly ptosis repair. Frequent ocular lubrication may be required for several weeks or months after eyelid surgery. Contact lens wear is typically avoided during the first 3 weeks after surgery or until adequate blinking and eyelid closure returns. After Surgery Instructions
What are some of the expectations of the healing process after eyelid surgery?
Smoking is an established risk factor for poor postop healing. Smoking cessation prior to surgery and during recovery will help diminish the risks of infection and other complications. Diabetic patients have similar increased risks associated with surgery.
BLURRED VISION: Your vision may be blurry after surgery and it may be a hard to read small print for at least 2-3 weeks after surgery. This is may be due to the lubricating ointment and drops in your eye(s), as well as secretions from your healing wounds and reduced blinking. Patients undergoing ptosis (droopy eyelid) surgery will experience more pronounced difficulties with blurred vision. You may need to avoid certain activities (work, computer, driving, athletic activities) until your vision improves. Always check your vision with your spectacles (distance or reading) and check each eye separately with the opposite eye completely covered. Patients with severe visual loss (ex/ unable to count fingers) or any vision concerns should always contact Dr. Klapper immediately at (317) 818-1000 or (877) 818-8101 [toll-free].
PAIN: There may be some minor or moderate discomfort following eyelid surgery. Most patients will only require Tylenol. Plain or Extra Strength Tylenol, one (1) or two (2) tablets every four (4) to six (6) hours is usually adequate to control postoperative pain. If a prescription or pain medicine has been given to you, use it as directed. Most of the general discomfort due to surgery resolves after 3-4 days. Some areas, particularly the outer corners of the eyes (following lower eyelid surgery) or the scalp (areas of implants in endoscopic forehead surgery) will remain tender for 2-3 months. If you have severe or excruciating pain, notify Dr. Klapper immediately at (317) 818-1000 or (877) 818-8101 [toll-free].
SWELLING: Swelling and bruising may occur around the eye and operated area. The swelling should be soft to the touch. If the swelling is tense or firm, please contact Dr. Klapper’s office. Gravity will cause swelling and bruising to occur in the lower eyelids, cheeks, and rarely into the neck and chest even in patients that only had eyelid or forehead procedures. Many patients will experience swelling on the surface of the eyeball that looks like “blisters” or “bubbles”. Swelling on the eyes improves with ocular lubrication (artificial tears, lubricating eye ointment). Swelling typically worsens during the first 48-72 hrs after surgery. It should begin to improve at around 5-7 days following surgery. While much of the swelling disappears during the first month, some swelling and redness can often still be detected for up to 3-4 months or more.
REDNESS/ITCHING: Moderate redness and itching in the operated area is common in the first few weeks following surgery. Some patients experience significant itching around the 4th or 5th postoperative day. If your itching is associated with significant redness and/or worsening of your swelling, you may be experiencing an allergic reaction to your topical antibiotic drop or ointment. If this occurs, discontinue your topical medications and contact our office immediately. A small number of patients experience worsening of their itching and swelling with prolonged use of ice packs. We may also recommend that you stop your ice packs. Benadryl or other over the counter anti-histamine medications are recommended for itching that is bothersome.
IF YOU DEVELOP A FEVER, SUDDEN INCREASE IN SWELLING, PAIN, EYE PROTRUSION, OR SEVERE VISION LOSS CONTACT Dr. Klapper IMMEDIATELY 317-818-1000.
“TIGHTNESS”: Following eyelid reconstruction, cheek reconstruction, or any facial procedure involving significant tissue tightening or mobilization, you may experience a sensation of “tightness”. Eyelid and facial tissues will begin to relax and “settle” starting around 3 weeks after surgery. This relaxation generally continues up to 6-12 months or more.
SUTURE REACTIONS: Some patients may react to deep absorbablestitches and form small, red, tender pustules 4-8 weeks after surgery. This is most common in the outer corners of the eyelids following lower eyelid tightening or eyelid reconstruction. These tender bumps may also occur in the stitch line of the upper eyelid or forehead. Hot compresses will usually help this problem that typically resolves over 2 weeks. Occasionally small incisions are made to relieve significant discomfort.
SCARS: All surgical incisions cause scars. Every attempt is made in elective surgery to minimize the appearance of scars. Incisions are generally made in the natural folds of the forehead and face whenever possible. Even so, many scars will remain visible. Scars are most prominent following surgery when they appear bright red. This rednesswill begin to fade around 3-4 months and by 6 months or so most of the redness will begone. The appearance of the scar will then slowly change and often improves for up to1-2 years following surgery. If a prominent scar requires revision this is not usually recommended until at least one year after surgery.