Immediately after upper eyelid surgery.
When my patients wake up after eyelid surgery, they will see a small piece of medical tape called a Steri-Strip on each eyelid. Underneath the Steri-Strip are sutures that have been placed in the crease of each eyelid.
Additionally, due to intraoperative swelling, some patients may have a Frost suture placed. A Frost suture is a temporary “string” that helps keep the eye closed while sleeping.
Immediately after lower eyelid surgery, there may be no visible sutures (if performed exclusively transconjunctival) or there may be external sutures (often if a lateral retinacular suspension suture is placed). Whether a patient has sutures inside the eyelid and/or outside the eyelid depends on the type of lower eyelid surgery performed. If there is a suture on the outside, it is generally a running Prolene suture placed in the undereye crease of each eyelid or immediately under the eyelashes. A small piece of medical tape called a Steri-Strip is typically placed over suture.
My policy is that after eyelid surgery – whether upper or lower blepharoplasty – patients must have a friend or family member drive them home. Car services such as Uber and Lyft are not a safe substitute for having a friend or family member drive a patient home. It can be helpful to have a friend stay with you for at least a few hours after surgery or overnight.
Whether upper or lower eyelid surgery, I have my patients ambulate for basic activities such as going to the bathroom or getting water. However, apart from light ambulation, I instruct my patients to rest comfortably for the next 24 hours with their head elevated at 45 degrees. Keeping the head elevated helps minimize swelling.
You should follow your own doctor’s instructions regarding medications unrelated to the eyelid surgery. In terms of the medications related to the eyelid surgery, I have my patients start their medications immediately after getting home from the procedure. Commonly, this includes oral antibiotics and medicated eye drops to decrease inflammation. My patients also generally use over-the-counter rewetting drops such as Alcon Refresh drops during the day and an over-the-counter eye moisturizing gel such as Systane Night-time Ointment at night.
I generally inform my patients to drink plenty of fluids after surgery. It is easy to become dehydrated after surgery. Dehydration may cause nausea and dizziness. Likewise, generally I instruct my patients to resume food as tolerated.
To help minimize swelling and discomfort, my patients generally use cooling gel face masks which can be purchased online. For example: https://tinyurl.com/2cxcmhy6.
For patients concerned about pain, we also provide prescription pain medicine. However, most patients do not have appreciable pain after eyelid surgery – especially after upper eyelid surgery.
For the first 3-4 days, I have my patients sleep on their back with 3 to 4 pillows behind the head. The degree of swelling depends on the extent of the surgery as well as the individual’s tendency to bruise. However, elevating surgical areas helps reduce edema (swelling) and ecchymosis (bruising).
After the first 3-4 days, some patients may resume sleeping on one pillow; however, sleeping on the back for 6 weeks following surgery can help optimize cosmetic results. This helps ensure that patients do not inadvertently put pressure on the surgical site during the night when sleeping on their side or stomach.
Each surgeon’s protocol is different. However, I generally remove any external eyelid sutures 3 to 5 days after surgery. Less often, I may leave 1-2 key stitches until day 7. Generally, any internal sutures do not need to be removed.
Steri-Strips – a small piece of medical tape – may be placed on the suture line for 7-14 days. The exact time depends on how quickly the patient heals.
Each surgeon’s directions are different. However, the day after surgery, I generally allow my patients to wash their face – but not their eyelids – with baby shampoo and a clean cloth or a facial wipe. After the first post-operative appointment, I commonly instruct patients to wash the face and the eyelids with baby shampoo twice a day.
Typically, I inform my patients to plan to avoid any strenuous activities for 4-6 weeks after surgery. This is because exertion elevates blood pressure, and this can cause bleeding. Also, sweat / wiping sweat from the eyes can potentially increase the chance of infection. However, many patients are cleared sooner than 4-6 weeks; the timing of clearance to resume exercise and swimming depends on how quickly patients heal their wounds.
It depends. We clear patients on an individual basis to resume use of contact lenses. However, I clear most of my patients to resume contact lens wear in one week or less. Patients are instructed to avoid maneuvers that place excessive tension on the eyelid during contact lens insertion. This is particularly important after certain types of lower eyelid surgery.
Typically, I inform my patients to plan to avoid using any eye makeup and eye creams for 4-6 weeks after surgery. The exact time depends on the healing process. The wounds must be sufficiently closed and strong.
When I clear patients to resume wearing eye makeup and eye creams, I have patients use all new products – i.e., never previously opened makeup and creams. Old makeup/creams can harbor bacteria. For the same reason, it is very important to clean all your makeup brushes well with soap and water and then spray with alcohol and allow to dry.
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