COLIN D. PERO, M.D.
North Texas Facial Plastic Surgery
BLEPHAROPLASTY/EYELID SURGERY
The following information is designed to answer questions regarding your
pre and post-operative care concerning your eyelid surgery. In order to
achieve the most satisfactory results, you should follow these instructions
closely and familiarize yourself with these instructions. Please attempt to
follow this instruction faithful.
Pre-Operative Instruction: Before Surgery
1. Do not take any Aspirin, Aspirin containing compounds, or Non-
steroidal Anti-inflammatory medications (Motrin, Ibuprofen,
Advil, Aleve, Vioxx, Celebrex, Naprosyn, etc.) 4 weeks prior to
and after your surgery.
2. If you require pain medications, you may safely take Tylenol
products in the peri-operative period. Do no take Vitamin E, C,
herbal supplements such as Ginko, Ginseng, Fish oil, Garlic,
St.John’s wart, etc. 4 weeks prior to your surgery.
3. Avoid alcoholic beverages 48 hours prior to surgery.
4. To reduce post-operative discoloration/bruising, consider drinking
8 oz of pineapple juice daily beginning 2 weeks prior to surgery
and continuing for 2 weeks after surgery. Some patients have
shown benefit from this regimen. Alternatively, some patients take
Arnica Montana, an herbal supplement, to reduce post-operative
bruising. The lower eyelids are known to bruise deeper and
longer than other parts of the face.
5. If you smoke tobacco or use smokeless tobacco products, stop
smoking at least 4 weeks prior to surgery and continue cessation
for at least 4 weeks after surgery. Smoking is directly related to
poor wound healing and possible skin loss and must be avoided.
6. A diet high in salt may lead to prolonged post-operative swelling.
To reduce post-operative swelling consider reducing your salt
intake beginning 1 week prior to surgery and continuing 4 weeks
post-operatively.
7. Do your pre-operative lab work 3 weeks prior to surgery.
Someone must accompany you to and from the surgery center the day
of surgery
Post-Operative Instructions: After Surgery
1. Post-operatively expect localized swelling and bruising to your
face and neck. Swelling usually peaks by the third day after
surgery and then slowly resolves over the following weeks.
Bruising usually resolves near the end of the second week of
healing. Often swelling will be worse when you arise in the
morning and usually decrease throughout the day.
2. It is not unusual after surgery for a person to go through a brief
period of depression for a few days after surgery. This is partly
due to the effects of the medications and also because it is
disturbing to see the swelling and bruising on your eyelids. Please
realize that this is a temporary condition and will subside shortly.
The best “treatment” consists of busying oneself with the details of
postoperative care and trying to divert one’s mind to other
activities.
Diet:
1. Resume your normal diet. Keeping in mind that, high salt diets
may result in increase or prolonged postoperative swelling.
Excessive chewing may cause discomfort.
2. Drink plenty of fluids.
Restrictions:
1. Do not take tranquilizers or sleeping pills for 24 hours after
surgery.
2. Do not smoke or use tobacco products.
3. Do not drink alcoholic beverages while taking pain medications or
antibiotics.
4. Do not wear contacts for 10 days to 2 weeks. Sunglasses are
recommended to alleviate light sensitivity.
Activity:
1. Rest the day of surgery. Then slowly resume non-exertional quiet
activity.
2. Avoid bending over or lifting heavy objects for one week. Besides
aggravating the swelling, this may raise your blood pressure and
cause bleeding.
3. Avoid exertional activity for at least 7 days. NO athletic activities,
intercourse, or straining when going to the bathroom. If you
become constipated check over the counter for a stool softener.
4. Excessive exertional activity in the 3-6 months following surgery
may result in recurrent and intermittent swelling. This can occur
intermittently throughout the post-operative course.
5. Keep your head elevated on 2-3 pillows for the first 48 hours to
reduce swelling in the early post-operative period. Continued head
elevation over the next 2 weeks aids in reducing swelling.
6. Take care not to stand suddenly from a seated position as often
after surgery you may feel weak or dizzy with such activity. This
sensation usually subsides within a few days after surgery. Rise
slowly and hold onto something to improve your stability.
7. Do not drive an automobile until you have regained normal
mobility in your neck. Most people can resume driving after 2
weeks of recovery.
Wound Care:
1. You will have sutures in the crease of your upper eyelids and under
the lash line of your lower lids. There also may be tape placed on
the outside corners of your eyes.
2. Use cold compresses for 20 minutes every hour during the first 24
hours after surgery.
3. Clean the eye area with warm water on a Q-Tip to remove
crusting.
4. Apply bacitracin ophthalmic ointment to sutures twice a day for 7
days.
5. Permanent sutures and tape will be removed 5-7 days after surgery
by the doctor in the office. Self absorbing sutures will dissolve on
their own.
6. If bleeding occurs, elevate your head, apply direct pressure and
apply cold compresses. If bleeding does not stop within 10
minutes call your doctor. Excessive swelling or bruising or
increasing pain on one side of your face may represent blood
trapped under the skin and should be reported to your doctor
immediately.
7. Camouflage make-up to disguise bruising can be applied to areas
without surgical incisions 2-3 weeks after surgery. Make-up
should never be applied to any areas of crusting or incomplete
wound healing.
8. Avoid sun exposure post-operatively for at least 6 months. After
your incisions have healed appropriately (usually around 2-3
weeks post-op), begin wearing sun block (SPF30 or greater) and
wide brimmed hats to prevent sun exposure.
Bathing:
1. You may shower 48 hours after surgery.
Pain Management:
1. Surprisingly, there is little pain following this type of surgery.
Often people have a bruised sensation that tends to be worse at
night or when trying to sleep.
2. Should you have discomfort, apply cold compresses as the first
line of therapy. If the pain continues you may use Extra-strength
Tylenol or the pain medication you have been prescribed.
Rx:____________________________________________
3. Continue to avoid aspirin and non-steroidal anti-inflammatory
medications, as they may increase the risk for bleeding.
Other Medications:
1. Resume your pre-operative out patient medications unless
otherwise instructed.
2. Do not take any Aspirin, Aspirin containing compounds, or Non-
steroidal Anti-inflammatory medications (Motrin, Ibuprofen,
Advil, Aleve, Vioxx, Celebrex, Naprosyn, etc.) for 4 weeks after
your surgery.
3. If you have been prescribed post-operative antibiotic therapy,
please begin taking them the day of surgery and take them until
gone. Rx:___________________________________. If you feel
you are having an allergic reaction to the medication, stop the
medicine and call our doctor.
4. Apply Bacitracin or Neosporin (unless allergic) twice daily to your
incisions until sutures are removal.
Please Call For The Following Concerns:
1. Continuous or heavy bleeding.
2. Fever/chills/redness/increased pain/drainage
3. Difficulty breathing or chest pain.
4. Continued nausea and vomiting.