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Relax. There's a lot going on.

Topic 34 - 1
Blepharoplasty Aftercare Instructions 1:
On the Afternoon & Evening of Surgery
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"When I buy a camera, I have no tolerance for the instructions. I'm ready to make some mistakes using it and get some bad pictures back until I've figured it out for myself."
-- Sean Penn


Recovery and Healing Are Different

Although the terms healing and recovery are often used interchangeably, they do not describe the same processes.

Just as a "recovery room" is a place where a patient is taken to get over the immediate effects of anesthesia and bodily upset after having undergone an operation, recovery time after blepharoplasty is that interval between the end of surgery until about a week or so out during which the eyelids and face are responding to the immediate trauma of the procedure.

Healing, on the other hand, is a much more gradual process during which the superficial and deep tissues and wounds develop strength, mature, and finally soften. Full healing after blepharoplasty can take up to a full year or longer.

While there may be some overlap, Module 34 is devoted to early surgical recovery while Modules 35 through 39 focus more on the progression to a final result.

What might work out fine with a new camera or iPhone does not work at all for eyelid surgery. Following your doctor's aftercare instructions is crucial because winging it may get you far more than a few bad pictures.

Surprisingly, there are patients who don't follow their doctor's suggestions or follow only some of them and then wonder why their eyelids are not healing the way they should. The first few days after surgery are critical to both safety and cosmetic outcome.

While exact instructions will vary procedure to procedure and surgeon to surgeon, the pages that follow provide a comprehensive example.

pillows for recovery

• Once back at home, you should rest as much as possible, preferably in bed with your head propped up on a few pillows or in a recliner. A bandage over the eyes is not necessary.

• Avoid straining, bending over, reaching down, or coughing, all of which may generate a sudden spike in blood pressure and initiate dangerous bleeding. The surgical wound is especially vulnerable during the first six hours after surgery.

• Avoid rubbing your eyes or pulling on the incisions.

• Watching television or using a computer is acceptable.

• To help limit swelling, apply clean cold compresses to the eyelids as much as possible until you go to sleep. Gauze pads or a clean towel may be soaked in a basin of ice cubes and applied directly. Alternatively, a large Ziploc bag may be partially filled with ice cubes or a bag of frozen peas may be placed over a moist gauze or towel. Commercially-available gel-filled vinyl masks may also be used.

• Pain after surgery is usually mild and able to be controlled with Tylenol. If you were given a stronger narcotic to take home, use it sparingly and only if needed. Severe pain should be reported.

Sudden Symptoms

While local anesthesia medications wear off quickly, the effects from some drugs used in general or intravenous anesthesia may be slower to disappear.

Call your doctor immediately if you note sudden new symptoms like shortness of breath, chest pain, or an irregular or rapid heart rate.

• If your stomach is not upset, you may resume your normal diet. If you do feel some nausea, limit your first meal to liquids such as soup or juice.

• It is common for the eyelids to become red, swollen, and bruised. A small amount of bloody fluid draining from the wound is normal for a even as long as a week. Occasionally, the eye may turn red and swell. Brisk bleeding not responsive to sitting up and applying pressure should be reported immediately.

• Vision may be slightly blurry from eye ointment, a drop of blood in the tears, or excess tearing. Significant vision problems, especially if new or one-sided, should be reported immediately.

• Avoid using aspirin or ibuprofen for three days.

• In the evening, you may take a bath if someone is there to help you. Do not shower or wash your hair until tomorrow.

• If you were given an antibiotic ointment, gently apply a small amount to any stitches before going to bed, and then twice a day thereafter. Use a clean fingertip rather than a dry Q-tip, which may leave behind cotton in the stitches. If your eye feels irritated, the ointment may be applied directly to the eye surface.

• If you have no stitches (lower lid surgery done through the back of the eyelid), it is not necessary to use an ointment.

• Try to sleep on your back until a day or two after your stitches are removed. If you're a restless sleeper who tends to "fight the pillow" at night, take precautions to prevent this.

• If your cat or dog likes to sleep in your bed at night, consider babysitting it elsewhere for the first few days. Teddy bears are fine.

teddy bear

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Next: Blepharoplasty Instructions
Beginning The Next Morning

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Frank Meronk, Jr., M.D.
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