Postoperative Instructions & Information Eye Lid Surgery


BLEPHAROPLASTY (eyelid surgery)

 

Postoperative Instructions & Information

 

Preparation Before:

PlasticFace225x300The surgery will take between 45min to an hour although it could take longer depending on each individual patient’s needs. You will be lying down during the procedure, and although the operating room is much cooler than the rest of the building, you will be under some bright lights and could get warm, so please dress comfortably. Ladies, please leave jewelry at home and do not wear any makeup or lotions/creams on your face. You may eat lunch/dinner as usual before the surgery. If you take Aspirin or other blood thinning medications, you may be asked to leave these off 10 days prior to your surgery (refer to medication section.) Prior to Surgery, be sure you have picked up all of your prescribed medications you will need after your surgery. This way you will be able to go straight home afterwards and begin resting with ice packs on your eyes.

*Helpful Hints to Decrease Bruising/Inflammation:

You can markedly lower your risk of bruising and swelling by avoiding blood-thinning agents for a week before your procedure. You may be on prescription blood thinners prescribed to you by your family doctor such as Coumadin, Ticlid, Plavix, etc. Please ask your doctor if you are unsure if you take a blood thinning medication. Over the counter painkillers, such as aspirin, ibuprofen (Motrin & Advil), and naproxen (Aleve), should be avoided; Acetaminophen (Tylenol) is considered safe. Alcohol and supplements containing Vitamin E, ginseng, garlic, ginger, kava kava, celery root, glucosamine, fish oil and chondroitin may also thin the blood.

Some patients report that Arnica Pills (available at Health Food Stores), and pineapple juice (which contains bromelain, a natural anti-inflammatory agent) help speed healing or reduce bruising after a procedure. You may also buy the Bromelain tablets to take the place of the fresh pineapple if you do not like pineapple.

**If you wish to use these natural products, please begin taking the arnica pills 1 week prior to your surgery. Take 1 pill 2-3 times daily for 1 week prior to surgery and then continue for 1 week after surgery. The pineapple juice or Bromelain tablets can be taken as directed on the bottle for 1 week prior to surgery and 1 week after surgery.

Topical Anesthesia

You will receive topical anesthesia in the form of Lidocaine. Lidocaine is a numbing medicine which will be injected into different areas of the eyelid. You will not be able to feel any pain during the procedure once this is done. Even though you are only receiving a local anesthetic, prior to the surgery you should arrange for someone to take you home.

During the Procedure: You will be asked to lie down on a stretcher. We will make every effort to make you as comfortable as possible. Your head must be flat, but we will put a pillow under your knees and can also elevate your legs a little to make you comfortable. Dr. Baynham will make some measurements before administering your topical anesthetic. You will not feel any pain after receiving the topical anesthetic. Dr. Baynham and his assistant will begin the procedure and should last approximately 45 min. to an hour. Occasionally it may take longer if you have been a long term user of blood thinning medications. During the surgery you may smell the use of a cautery instrument. This is used to help stop the bleeding of blood vessels in your eye. This will also help to decrease the amount of swelling and bruising you would have had otherwise. Dr. Baynham and the assistant may ask you a few questions or instruct you to open and close your eyelids. You will have sutures and will be given an appointment prior to surgery for suture removal 1 week after surgery.

Swelling/Discoloration

After this type of procedure, the eyelids are usually swollen and may show noticeable bruising. Most swelling usually resolves quickly over 2-3 days (more slowly if you suffer from allergies), while the discoloration will diminish more gradually over 7-10 days. You may notice that one eye will be slightly more or less swollen than the other and this is not a cause for concern. The feeling of tightness is normal. Occasionally, swelling may cause the eyelids to not close completely for a few days. Both of these conditions will resolve once swelling diminishes. Tearing or eye irritation, if present, will usually resolve as swelling decreases and eyelids close. Some patients may experience discoloration in the whites of their eyes. This is painless, and generally subsides within 7-10 days, and will not harm your vision. Following, are some recommendations directed as relieving discomfort and speeding the recovery process:

  1. SLEEP IN A BED OR CHAIR for the first 24 hours following surgery. Be sure to keep your head elevated.
  2. USE YOUR EYE DROPS (artificial tears) OR EYE OINTMENT, to help ease any discomfort or irritation caused by incomplete eyelid closure.
  3. AVOID HITTING OR BUMPING YOUR FACE & NECK. It is wise not to pick children up for 1 week after your operation.
  4. APPLY ICE PACKS (dry paper towel over your eyes with baggies of ice over that) as often as possible in the first 48 hrs.
  5. KEEP SUTURE LINE DRY. You may put the ointment on as directed, but avoid getting too much water on the suture line. The sutures are very fragile and will become dry and break if exposed to too much water. You may shower after the initial first 2 days but be careful not to get the water or soap on your eyes. Tilt your head back and let the water run down your back. A little bit of water is not going to hurt, just be careful not to expose your suture line to excessive water.
  6. AVOID BENDING, STRAINING, HEAVY LIFTING for the first week following your surgery. In addition to aggravating swelling, these activities may elevate your blood pressure and start bleeding.
  7. AVOID PULLING OR PUSHING ON FACE. Be careful when washing your face not to use excessive pulling or pressure.
  8. AVOID EXERCISE for 2 weeks.
  9. AVOID eye makeup for 2 weeks.
  10. DO NOT SMOKE AND AVOID ALCOHOL CONSUMPTION for 3 weeks after surgery. These activities can significantly slow the healing process.
  11. REPORT ANY SUDDEN SWELLING OR INCREASED DISCOLORATION to Dr. Baynham.
  12. SLEEP IN AN UPRIGHT POSITION (preferably on your back) by elevating your head on extra pillows for at least 1 week after surgery.
  13. AVOID STRAINING DURING ELIMINATION . If you need a laxative, we recommend Correctol (your pharmacist will give it to you without a prescription). Drinking plenty of water and walking are strongly recommended to avoid constipation.

Medication:
You will be given 3 prescriptions:

  1. An oral antibiotic to take AFTER the surgery
  2. An antibiotic ointment to apply to the suture line AFTER surgery
  3. A mild sedative (Valium) to take a couple of hours before surgery. (optional)
  4. Be diligent about taking all of the oral antibiotics until completely gone. If you experience dry eyes, you may use artificial tears (obtained without a prescription) to keep the eyes moist. There is little, if any, pain with blepharoplasty surgery; However, it is recommended that you use Tylenol if you have any discomfort. Under no circumstances should Aspirin or medication containing aspirin or salicylates to be taken (Advil, aspirin, Motrin, Aleve, etc.)

Pain:

As mentioned above, there is little, if any, pain associated with blepharoplasty. You may experience a dull ache and tightness in the eyelids, but it is very unusual to feel significant, sharp pain. You may feel a burning sensation. This is almost always relieved by cold compresses. If cold compresses do not provide sufficient relief from the discomfort, take Extra Strength Tylenol according to package instructions.

Ice Packs:

Crushed ice placed in Zip-lock bags, provide the most effective cold compress to reduce swelling, discoloration, and discomfort after surgery. Pre-made ice packs and frozen bags of peas do not provide enough coldness to sufficiently reduce swelling. During your waking hours, apply the packs to your eyes as often as possible for the first 48 hours following surgery. You may continue to use the ice packs as you like for up to 7 days after your surgery.

Visual Disturbance
You can expect to have very slight blurring of vision for a few days due to the ointment in your eyes and also as a possible side effect from dry eyes.

Bleeding:
If you experience oozing or bleeding along the suture line, do not rub the area. You may apply gentle pressure to the area using a clean pad or tissue for 10 min. DO NOT RUB OR WIPE THE SUTURE LINE. Follow this with a cold compress. This should be effective; however, if these measures do not stop any oozing/bleeding, please inform Dr. Baynham.

Daily Wound Care
Gentle cleansing of the suture line along the eyelid should be done as directed by Dr. Baynham. DO NOT use Hydrogen Peroxide as this is very drying to the sutures. Only use a small amount of water to help loosen any crusting or debris that forms. Do not pick or pull on any crusting or debris around the eye. After cleansing, a small amount of ointment should be applied to the suture lines.

Resuming Activities

  1. PERSONAL GROOMING. In order to improve and speed wound healing, We recommend the following:
    • You may SHOWER AND WASH YOUR HAIR, allowing an indirect flow of warm water over the wounds. (Do not let water directly strike the wound and do not soak the wound.)
    • EYE MAKEUP should not be used for 2 weeks.
    • DO NOT PULL OR STRETCH THE EYELIDS for the first 10 days following surgery.
  2. HOUSEHOLD ACTIVITIES. Two days after your surgery you may be up and around the house with light activities except those specifically outlined (no bending, no heavy lifting, etc.). No strenuous activity.
  3. AVOID EXERCISE for 2 weeks following surgery
  4. AVOID PROLONGED EXPOSURE TO SUNLIGHT. Following surgery, your eyes may be sensitive to bright light for a few days. Wearing sunglasses is recommended.
  5. RETURNING TO WORK AND RESUMING SOCIAL ACTIVITIES. When you return to work depends on the amount of physical activity and also the amount of swelling and discoloration you develop; the average person is ready to return to work or go out 2-3 days following surgery.

Scars

During the first several days following surgery, the scars will be imperceptible. They will go through a period of slight swelling and reddening, especially at the outer corners. Once this subsides, the scars become virtually invisible again. This is the normal maturity of scars. Any unevenness of the edges of the incisions or lumpiness of the scars is temporary and will subside with the passage of time.

Your Postoperative Office Visits

Sutures will be removed at your first postoperative visit, generally 7 days after surgery. Following the suture removal, you will be asked to return to the office for evaluation at different intervals depending on your progress in healing. Please arrange your schedule to accommodate these appointments, which we usually at your one week appointment.

Summary:

  • Do not be discouraged by swelling and discoloration. These conditions are a part of the blepharoplasty procedure and will subside within 2 weeks.
  • Call Dr. Baynham’s office if you experience:
  • Sudden swelling or increased discoloration
  • Increasing eye pain
  • Any progressive or one-sided decrease in vision
  • Persisitent temperature above 101.5 degrees that is not relieved by
    Tylenol.

 

Your surgery, recovery and ultimate result is very important to us. Please read this carefully and keep it readily accessible as a reference after your surgery. If you have any questions or problems not addressed in this handout, please do not hesitate to call us anytime: 770-267-4561.