Blepharoplasty Post-Operative Patient Instructions

(Outpatient Surgical Facility)

NIGHT OF BLEPHAROPLASTY SURGERY

Movement is Important: Make sure to get out of bed and be up and walking around immediately after your surgery. When lying down in bed or on the couch, make sure you are moving your legs and ankles. Take deep breaths frequently to keep your lungs clear.
Sleep: Sleep on your back with your head elevated about 30-40 degrees (2-3 pillows). Do not sleep on your side. Keeping your body more upright will minimize swelling. Continue this for one to two weeks.
Ice Compresses: Apply ice compresses made of gauze sponges that are dipped into iced water (not an ice bag) to your eyes for 15-20 minutes every hour for the first two days while you are awake.

MEDICATIONS FOR BLEPHAROPLASTY

Antibiotic: Start your antibiotic tablet the night of surgery and take all tablets as prescribed until finished.
Pain: You will be prescribed a pain medication for post-operative pain control. If your discomfort after surgery is not strong you are welcomed to take Tylenol in place of the prescribed medication. Do not take Tylenol with the pain medication, often the medication you are prescribed will have Tylenol in it. Do not exceed 4,000 mg of Tylenol in any 24-hour period. Take medication with food to minimize risk of nausea.
Nausea: A common side effect after general anesthesia and strong medications. If you are experiencing nausea, we advise that you take your nausea medication.
Constipation: You will experience constipation if taking narcotic pain relievers. MiraLAX or other over the counter laxatives are recommended. Do not wait to take until you are constipated. Begin treatment with narcotic use.
Medications to Avoid: Take only those medications approved or prescribed by your surgeon. Avoid medications containing aspirin or ibuprofen (Advil, Motrin, Naproxen, others) for two weeks before and after surgery. These medications may increase bleeding.
Substances to Avoid: Avoid alcohol, nicotine, and caffeine, for these will dramatically slow the healing process.

NUTRITION AFTER BLEPHAROPLASTY

Diet: Eat foods that are soft and require minimal chewing for one week. Do not eat salads, tough meats, or chew gum. Chewing can cause an increase in pain and swelling.
Hydration: Stay hydrated by drinking 8-10 glasses of water a day. Try to use straws when drinking fluids. Avoid alcohol while you are still taking pain medications.

BATHING AFTER BLEPHAROPLASTY

Showering: You may wash your hair and face the next day after your eyelid surgery. Do not cleanse eye area and avoid submerging your face in water.
Hot Tubs/Baths/Swimming Pools: No tub baths or Jacuzzi until your incisions have healed, and approved by your surgeon, which is usually around 2 weeks. It is best to wait one month for hot tubs as they tend to have more bacteria than regular chlorinated swimming pools.

HOW TO TAKE CARE OF YOUR INCISIONS AFTER BLEPHAROPLASTY

Cleaning your incisions: Occasionally, crusting will occur around the sutures. This is normal and will resolve. Do not try to pull off any crusts. Showering daily will minimize crusting. Apply your bacitracin ointment daily to keep incision sites moist.
Sutures: At your first post-op office visit we will remove all necessary sutures. All remaining sutures will be dissolvable. Sutures are usually removed 5-7 days after your procedure.
Sun Exposure: Avoid and minimize sun exposure. Use an SPF of 30 or greater when outdoors. Even a mild sunburn can worsen swelling, irritate an incision that is healing, and cause permanent scar discoloration.
Scar gel: Each individual varies with respect to healing, but it takes approximately a year for these changes to occur and the scars to look their best. After your incisions have completely healed and when your doctor has told you it is safe, you can begin to use a silicone-based gel on your scars to improve healing.

WHAT TO EXCEPT AFTER BLEPHAROPLASTY

Swelling and Discoloration: It is completely normal for your eyes to appear swollen as well as have purple-bluish bruising around the eye and eyelid. The bruising will be greater on the second and third day after your surgery. This is temporary and over the course of the next six weeks this will improve. Cool compresses will minimize swelling and bruising.
Mild Bleeding: Some mild bleeding is not unusual at the incision sites the first few days after surgery. If you try to do strenuous activity, increase your blood pressure by straining on the toilet, sneezing, heavy lifting or bending forward you will aggravate the bleeding and swelling.
Numbness around the eyes: Parts of the eyelids may feel “numb” or lumpy after the eyelid operation. This is temporary and to be expected and may take months to feel normal again.
Pain and Itching: It is normal to experience tightness, pressure, shooting pain, itchiness, soreness, and fatigue for several days to weeks following surgery as you recover. You may use artificial tears or lubricating eye drops to reduce itchiness.
Blurry Vision: Patients often experience some blurring of vision for 2-3 days after surgery. This is generally due to swelling and/or ointments that have been used during surgery.
Weak or Dizzy: You may experience some weakness or dizziness. This may be more evident if you try to stand up too quickly. Take a minute to go from lying down to standing. The sensation of feeling lightheaded will get better in a few days and by staying well hydrated.

ACTIVITY AFTER BLEPHAROPLASTY

Physical Activity: Normal daily activity may be resumed a few days after surgery. No bending over, straining, or lifting more than 5lbs for the first week after surgery. Be extremely careful if wearing any “pull-over the head” clothing.
Glasses: You may wear sunglasses and eyeglasses the day after surgery.
Limit Strain on the Eyes: The less time you spend on screen devices (TV, phone, computer, and tablet) the less strain on your eyes and better your healing and recovery will be.
Driving: Do NOT operate a vehicle or make important decisions until you have been off narcotic pain medications for 24 hours. Use good judgment.
Return to work: Most patients require approximately 5-7days off work depending on their job responsibilities and the amount of physical contact your job involves.
Exercise: You can resume an exercise regimen in approximately 3 weeks after surgery, though start easy and build back up to your previous exercise levels. Just know that swelling may transiently be worse with exercise.
Travel: Automobile travel can resume immediately though frequent breaks are needed, approximately every 2 hours to prevent blood pooling and clots. Airline travel is restricted until 1 week postop. You will notice increased swelling with airline travel which can happen even 6-8 weeks postop due to the pressure changes that occur. Do not operate a vehicle if you are on narcotic pain medications.

DO NOT’S AFTER BLEPHAROPLASTY

DO NOT place anything frozen directly on the skin, make sure it is wrapped in gauze pads, a towel, etc.
DO NOT soak in baths, jacuzzies, or hot tubs, or submerge your face in water until all incisions have fully healed.
DO NOT take Aspirin, Ibuprofen, Naproxen, or other blood thinners until your surgeon advises you it is safe.
DO NOT apply make-up to the incision lines or the eyelids for at least 10 days.
DO NOT wear fake eyelashes or contact lenses for two weeks.

EMERGENCY SITUATIONS AFTER BLEPHAROPLASTY

WHEN TO CALL THE OFFICE (703-481-0002) OR GO TO THE HOSPITAL

Signs of Infection: Spreading of redness, worsening of swelling, increased drainage or drainage of pus, worsening pain, warmth at incision site and temperature over 101°F.
Excessive Bleeding: If the dressings are saturated with bright red blood and you are having to make very frequent dressing changes, or the incision sites appear to be oozing blood excessively.
Other Emergency Situations: Shortness of breath or difficulty breathing, chest pain, lightheadedness that does not quickly resolve, severe vomiting, pain, or asymmetric swelling in your legs.

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