Eyelid Surgery Pre And Post Care Instructions

Offered at our convenient location in Raleigh, NC

Items To Obtain Prior To Surgery

  • Cotton tip applicators
  • Arnica gel tabs (these are on line or available in our office). This helps with discomfort, bruising and swelling after surgery.
  • Sterile gauze sponges
  • Lubricating eye ointment. Bacitracin Ophthalmic Ointment Refresh PM or Lacrilube ointment is recommended.
  • Artificial tears. Preservative free is recommended if you are prone to dry eyes. 
  • Ice pouches/frozen vegetables to use as compresses

Two Weeks Before Surgery

 • Do not take any products containing aspirin, ibuprofen (Advil, Motrin), non-steroidal anti-inflammatory medication or Vitamin E. Tylenol is acceptable.

 • Refrain from all nicotine products, including cigarettes, pipe tobacco, chew or Nicotine patch. Nicotine interferes with healthy circulation and may affect the result of your surgery. It also places you at higher risk of complication when receiving anesthesia.

One Week Before Surgery

• Do not drink alcohol for 1 week before and after surgery.

The Day Before Surgery

• You will receive a phone call informing you of your arrival time for surgery. 

  • Wash the with anti-bacterial soap the night before and the morning of surgery.  You may want to wash your hair the night prior to surgery.

The Day Of Surgery

  • Wear something comfortable the day of surgery.  
  • Ensure to bring all your medicines for which you were written. We want to ensure you receive a pain medication prior to departure from our facility.
  • You may eat a light breakfast the morning of surgery. 

Post-Operative Instructions Following Surgery

•  Sleep on your back with your head elevated at least 30 degrees for one week after surgery. This can be accomplished by using 2-3 pillows to gain satisfactory elevation. This will help to minimize the amount of facial swelling and bruising around the eyes after surgery. 

• To help minimize swelling and discomfort, you may apply ice cold compresses to the eyes for twenty minutes every hour while awake for the first 48 hrs after surgery. For compresses, obtain a small clean bowl full of ice and cold water, soak large gauze pads in the cold water, then squeeze out the excess water and place on the eyes. Keep pads on eyes until they lose their coldness, and repeat. NEVER place ice cubes or ice packs on the eyes directly. 

• Limit your activities for the first 24 hours after surgery. Walk for short distances during the first 24 hours after surgery. Avoid bending over or lifting heavy things for one week. Besides aggravating the swelling, this may raise your blood pressure and cause bleeding. 

• Carefully cleanse your incisions with dilute peroxide or gentle soap starting the second day following surgery. Use a cotton tip applicator to gently cleanse, but take care to NOT apply directly into the eye.  Apply Bacitracin Ophthalmic Ointment or other lubricating ointment to the eyelid incisions at least twice to three times daily or as needed to keep the incision sites moist. The moist environment will allow better healing and prevent crusting at the incision sites. 

• If you experience pain, take the prescribed pain medications as directed. It is important to NOT take this medication on an empty stomach because it can cause nausea. You may ONLY take Tylenol in place of the prescribed pain medication, but be sure not to take both at the same time. 

• If you experience nausea, do not hesitate to call and we can provide anti-nausea medication.  If you are sensitive to narcotics, please let Dr. Allen know and one can be sent to your pharmacy pre-operatively. 

• Do not tweeze your eyebrows for two weeks

• A responsible adult must provide transportation for you after surgery if you are having IV sedation or oral sedating medications, such as Valium (public transportation is not permissible).  You may want to have someone with you the night of the procedure to aid in after-care.

• Avoid making major decisions or participating in activities that require judgment for 24 hours.

 • Do not drive for approximately 5-7 days and while you are taking pain medication. 

• Avoid rubbing your eyes following the procedure. If you find you rub your eyes in your sleep, you may need to wear a mask or protective eyewear as to not disrupt the incisions

• Take all medications as instructed.

• Avoid direct sunlight to the incision for at least 1 year. Use a sunscreen with zinc oxide with SPF 20 or greater to help decrease the visibility of the scar.

• Please avoid all forms of nicotine for two weeks before and after surgery. Use of nicotine may increase the risks of unnecessary postoperative complications. In general, be aware that smoking or the use of unauthorized medications can lead to complications and jeopardize the results of your surgery.

What To Expect During The Healing Process

Swelling and bruising are normal. It is expected to take between 3-6 months to see your final results. The swelling should be soft to the touch. If the swelling is tense or firm, please contact Dr. Allen’s office. Elevation of the head of the bed and ice packs should help diminish swelling. Do not sleep on your side or face down until most of the swelling has subsided. Many patients elect to sleep in a recliner for the first few to several days after eyelid surgery. 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.

Discoloration: It is expected to have varying amounts of discoloration around the eyes. You may also notice discoloration of the whites of the eyes. Like swelling, this is temporary and varies from person to person. You can camouflage the discoloration to some extent with makeup, and we will tell you at your office visit when cosmetics can be applied. DO NOT apply makeup until all your sutures have been removed, and you have been given approval by the nurse or doctor.

Pain:  If you have discomfort after your surgery, the application of iced compresses should be effective. You will be given a prescription for a pain medication which you should take according to the instructions on the label. If this does not relieve your discomfort, or if the pain is greater on one side than the other, please notify the office. 

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 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. For severe visual loss (ex/ unable to count fingers) or any vision concerns please contact our office immediately

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 redness will begin to fade around 3-4 months and by 6 months or so most of the redness will be gone. The appearance of the scar will then slowly change and often improves for up to 1-2 years following surgery. If a prominent scar requires revision this is not usually recommended until at least one year after surgery.

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.