What to Expect After Eyelid Surgery

What you’ll learn

Listen to the audio version below.

Audio Transcript:

Dr. Undavia:

Hey guys, it’s Dr. Undavia from NJENT and Facial Plastic Surgery. Today I wanted to talk to you about what it’s like to recover from eyelid surgery. So patients often want to know what it’s like to recover so they can plan for work or for family or for events. And so the first thing I tell patients is that most often, if we’re just doing eyelid surgery by itself, whether it’s upper or lower eyelid surgery, we can do it in the office under local anesthesia. Some patients want to have Xanax or some kind of anxiolytic on board, but not everybody wants to do that because they want to be able to drive themselves home. So you can choose either of those options or if you want to be fully asleep, you don’t want to know what’s happening, you can be asleep for that. That’s totally fine. But after eyelid surgery depends on what happens after eyelid surgery depends on which eyelids we’re doing. We’re doing upper or lower.

So let’s start with upper eyelids first. So with upper eyelids, you typically have an incision that goes inside the crease right here, and then at the edge of the eye, it comes out just a little bit. And the reason is we can get all this extra skin out here. So when you have the upper eyelid incision and we take out all the skin and sometimes mold some of the fat, sculpt some of the fat that’s there, you have a blue suture going through that incision and you have a knot on either end. And those knots and the sutures will stay in place for about a week.

When you go home, you will have some bruising that will start to follow gravity. So it’ll follow the upper eyelid. It’ll go around the lower eyelid and come down onto your cheek a little bit. And that’s fully normal. We care about it if one side is much worse than the other, then we want to know about it right away. And my patients always get my cell phone. So if there’s anything that’s even mildly concerning, they usually just shoot me a text or call me right away. And I like that so we can prevent any problems that might happen. But, when you will have bruising, typically that’s for about a week. Sometimes it’s 10 days, but it’s usually on the shorter side for upper eyelids. We have our patients take Arnica and Bromelin preoperatively and postoperatively. Arnica is a rose extract and Bromelin is actually from pineapples. And the two combined together can reduce swelling and bruising by a small percentage, but it’s still nice because it can get patients back to their activities faster.

So typically your eye will swell for the first couple of days and come down quickly. It will, you will have days where one eyelid looks different than the other and that’s totally normal. It kind of depends on how you slept that night, what side you slept on, whether you had a lot of salt in your food, whether it was really hot outside or just normal post -operative stuff. But it can be asymmetric at times and that’s not something to worry about. We usually see you at one week and we usually cut the sutures out. It’s a process that feels very weird, but it’s done like that. Each suture gets just pulled through and it’s about 20 seconds at most. I think about 10 seconds to be honest. Once we take the stitches out, I usually have patients apply the basset trace anointment that they’ve been doing for that week for one more day. And then I just have them do a moisturizer with sunblock.

Typically, I see them again at the one month mark and at three month mark. But after about a week, they’re looking pretty good. Their eyelid margin right at the eyelash line can be a little thickened. But when their eyes are in the open position, you’re not going to see it as much. They can return back to work at one week. Exercise is about three weeks, especially for weight bearing exercises because we don’t want any bleeding events.

I don’t think you really get your full result for three to six months, although you’re pretty much there at three weeks or so. You’re looking really good. You can usually wear makeup around two to three weeks, depending on how the incision’s healing. But once you take your makeup off, you can see that there is a little redness to the incision, and that can take several months to go away. Now, the only time you really see that is when you’re sleeping or when your eye is shut, because when your eye is open, it’s actually covering the incision. So that’s a nice thing about the eyelids. For your lower eyelids, the incision is typically right underneath the lash line here, and then it comes out a little bit. For your lower eyelids, you have an absorbable suture that we use. It’s yellow, not blue. In this instance, we still take it out, even though it’s absorbable, just so that it’s less likely to leave any track marks.

Your lower eyelid definitely gives you a little bit more swelling and a little bit more bruising. It’s very normal, especially if we’re taking out a lot of fat, like a little, a lot of bulging skin. When we’re done, you will have eyes that are slightly pulled like that because there’s a deep suture underneath there preventing the eyelid from coming down like that. Even with that, because the cheek and the lower eyelid gets heavy sometimes in the in the first week, sometimes even 10 days, it can look like you can see a little bit more of the eyelid like that. Very, very normal not to worry about. Obviously let us know if it happens, but it’s a totally normal thing and it’s really just because of the weight of the cheek because of the swelling. Typically, again, we see you at one week where we take out the sutures. I like to do a small steroid shot right at the edge of the incision here, almost.

100 % of patients will have a small bulge right there at the end. And again, that has to do with that suture that’s suspending the eye in the up position. And it just causes some inflammation and some swelling there. So typically we do a small steroid shot at one month, one week, and then I might repeat that again at one month just to get it to smooth out fully. Again, we do have patients restrict their exercise for about three weeks and their makeup for about two weeks.

Usually the eyelid margin is a little thicker here, so it’s maybe a little bit easier to see because in the open position you can see the incision as opposed to the upper eyelid. But it’s still with, like patients usually wear eyeliner or makeup and you can’t see it at all. Again, by three to six months you’re really looking nice, but until then you do have minor little bits of swelling throughout the process.

If you have any questions, please message us at info at njent .com. I hope to see you in the office.