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Eyelid Surgery (Blepharoplasty)

Eyelid surgery (blepharoplasty) is a type of cosmetic surgery. It is most often done to improve the look of the eyelids. Both the upper and lower eyelids can be treated during the surgery. Discuss your treatment goals with your doctor. He or she can tell you more about what to expect.

Front view of eye showing dotted line on top eyelid and dotted line underneath lower lashes for eyelid surgery.

Preparing for Surgery

Prepare for the surgery as you have been told. In addition:

  • Tell your doctor about all medications you take. This includes herbs and other supplements. It also includes any blood thinners, such as Coumadin, Plavix, or daily aspirin. You may need to stop taking some or all of them before surgery.

  • Do not eat or drink during the 8 hours before your surgery, or as directed by your surgeon. This includes coffee, water, gum, and mints. (If you have been instructed to take medications, take them with a small sip of water.)

The Day of the Surgery

The surgery takes about 1-2 hours. You will likely go home the same day.

Before the surgery begins:

  • You’ll remove any makeup from your eyes. You’ll also remove contact lenses if you wear them.

  • An IV line is put into a vein in your arm or hand. This line supplies fluids and medications.

  • You’ll be given medication to keep you free of pain during the surgery. You may have general anesthesia, which puts you into a state like deep sleep during the surgery. (A tube may be inserted into your throat to help you breathe.) Or you may have sedation, which makes you relaxed and sleepy. With sedation, local anesthesia will be injected to numb the areas being worked on. The anesthesiologist will discuss your options with you.

During the surgery:

  • For the upper eyelids, an incision is made along the eyelid crease.

  • For the lower eyelids, an incision is made inside the lower eyelid. Or it is made in the skin just under the lower lash line.

  • With either the upper or lower eyelids, fat may be shaped or removed. Skin may be removed. If muscles are loose, stretched, or torn, they may be tightened or repaired.

  • Incisions are closed with stitches (sutures). In some cases, surgical glue is used.

After the Surgery

You’re taken to a recovery room to wake up from the anesthesia. You may feel sleepy and nauseated. If a breathing tube was used, your throat may be sore at first. If needed, you’ll be given pain medication to relieve any discomfort. You’ll sit semi-inclined or with your head propped on pillows, and may have cold packs on your eyes. These measures help reduce bruising and swelling. When you are ready to leave the hospital, an adult family member or friend must drive you.

Recovering at Home

Once at home, follow all instructions you are given. Your doctor will tell you when you can return to your normal routine. You may have some bruising and swelling around your eyes and your vision may be blurry. This is normal and should improve within a week or two. And you may notice your eyes burning or feeling strained during certain activities, such as watching TV, reading a book, or using the computer. While this persists, avoid doing such activities for too long at a time. Be sure to:

  • Take all medications exactly as directed. These may include applying eye ointment or using eye drops.

  • Apply an ice pack or cold compress to the eyes as directed, for the first 12-24 hours after surgery.

  • Care for your incisions as instructed.

  • Wear protective sunglasses as directed.

  • Avoid wearing eye makeup and contact lenses as directed.

  • Avoid swimming or placing your head under water as directed.

  • Avoid heavy lifting and strenuous activities as directed.

  • Avoid driving until your doctor says it’s okay. Do not drive while taking medications that make you drowsy or sleepy.

Call the Doctor If You Have Any of the Following:

  • Chest pain or trouble breathing (call 911 or other emergency service)

  • Fever of 100.4°F or higher (or as directed by your doctor)

  • Increased redness, tearing, or itching of the eyes

  • Changes in vision, such as double vision, blurry vision, or loss of light perception

  • Symptoms of infection at an incision site, such as increased redness or swelling, warmth, worsening pain, or foul-smelling drainage

  • Discomfort or swelling that’s worse in one eye than the other

  • Pain that cannot be managed with medications

  • Other signs or symptoms as indicated by your doctor

Follow-Up

You’ll have follow-up visits with your doctor. During these visits, your doctor will check the results of your surgery and how well you’re healing. If stitches need to be removed, this is done in about 5-7 days.

Risks and Possible Complications Include:

  • Bleeding

  • Infection

  • Problems with vision, such as blurry or double vision and trouble closing the eyes

  • Dry or teary eyes

  • Changes in sensation, such as numbness or pain

  • Skin discoloration

  • Damage or injury to the eyes

  • Vision problems (including blindness)

  • Displacement of the lower eyelid margin (ectropia), which can be temporary or permanent

  • Not happy with cosmetic results

  • Risks of anesthesia (the anesthesiologist will discuss these with you)

 

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