How long does it take to heal after surgery?
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
How long will I be bruised and swollen following my surgery?
The amount of swelling and bruising varies from patient to patient and even from the left and right sides in the same patient. Mild bruising may resolve in 2-4 days, whereas more significant bruising may last 10-14 days. Patients may wish to hold blood thinner medications (such as aspirin, ibuprofen, some arthritis medications, Plavix, Coumadin, etc.) prior to surgery in order to minimize the risk of severe bleeding and bruising. Patients should only modify their medication regimen with the advice of their primary care physician, cardiologist, or other prescribing physician.
Eyelid and facial swelling tends to worsen the first few days following surgery. Ice packs, head elevation, and rest may help minimize swelling. Swelling (edema) will often improve considerably over the first 2-3 weeks after surgery but may take several weeks and even months to completely resolve. Go to Postoperative Care to learn more.
What type of anesthesia is used during surgery?
Office procedures are performed with local anesthesia which may include eye drops and small injections under the skin in the area requiring surgery.
Surgeries performed in an ambulatory care center or hospital are usually performed with intravenous sedation administered by an anesthesiologist. Some surgeries, such as orbital procedures, are performed under general anesthesia.
Dr. Klapper will be able to discuss anesthesia options once a surgical plan has been developed.
What are the risks of eyelid surgery?
The expectations and risks associated with eyelid surgery may depend on the type of eyelid procedure(s) and may also vary from patient to patient. Patiet compliance with postoperative instructions is critical to achieve the most optimal surgical result. Even in the best of surgical hands, unexpected results may occur.
Excessive pain, bleeding, and infection are very uncommon. Severe loss of vision following eyelid surgery has been reported but fortunately is extremely rare (approximately 1 in 2,000 cases). It may occur if deep orbital hemorrhage (bleeding) occurs postoperatively. This typically would occur within the first 24 hours following surgery, so it important for patients to have a responsible adult with them the afternoon, evening, and day following eyelid surgery. Incomplete eyelid closure and inadequate lubrication of the eyes following surgery (ex/ upper eyelid ptosis repair) may also result in corneal scarring or infection causing vision loss. it is critical for patients to understand the signficant risks associated with eyelid surgery and recognize the role the patient will have in their recovery and follow-up. Communication with Dr. Klapper and his staff regarding any concerns, particularly relating to vision or pain, is essential to potentially reduced the consequences of unexpected events following eyelid and other oculoplastic surgical procedures.
Reconstruction - Eyelids and Face
Repair of Eyelid/Facial Defects following Skin Cancer Removal
Surgical excision is the gold standard for management of most eyelid and facial skin cancers. A majority of skin cancers in the eyelid area are either basal cell carcinoma or squamous cell carcinoma. Other cancer types (such as sebacous cell carcinoma, malignant melanoma, and Merkel cell carcinoma) occur more infrequently and generally require wider excision, more specialized resection and reconstruction techniques, and a comprehensive oncologic (cancer) evaluation.
There are two basic approaches to basal cell and squamous cell carcinoma excision. Skin cancer removal can be performed at the time of reconstruction and the tumor margins examined ("Frozen Sections") by a pathologist to ensure complete removal. Alternatively, microscopic-assisted resection may be performed by a dermatologic surgeon ("Mohs' Surgery"). This technique offers the potential advantages of less tissue removal and slightly greater confidence of complete cancer resection.
Following Mohs’ skin cancer resection, reconstruction is typically performed within 1 to 2 days but may be delayed up to a week after the Mohs' procedure. The complexity of reconstruction will, of course, depend on the size and location of the defect and if there is tear duct involvement. The main goal of repair is to restore adequate eyelid, brow, or facial function. Every attempt is also made to maximize the resulting cosmetic performance.
Occasionally, secondary surgical procedures are necessary to modify excessive scarring, improve the position of the eyelid(s), correct tear duct abnormalities, or resect recurrent cancer.
**Recurrent disease can occur with any type of resection, so patients should have periodic examinations following their surgery.**
Dr. Klapper has extensive experience in eyelid and upper and mid-facial skin and soft tissue reconstruction. Dr. Klapper works closely with several Mohs's surgeons throughout Indiana.
To see some of Dr. Klapper's patients, please go to the list of links above to visit our photo gallery. The images are divided into a few categories to simplify your search. Eyelid margin defects involve the margin or edge of the eyelid (the eyelash and tear duct location) and require different surgical techniques than non-marginal wounds.
The results shown are for educational purposes only and do not represent a guarantee of surgical results or postoperative appearance. All patients respond differently to surgical reconstruction.
View Before/After Photos