Eyelid Surgery (Blepharoplasty) » Post operative blepharoplasty questions and concerns. When to have the doctor paged after hours.

Blepharoplasty concerns and questions. When to have the doctor paged.

This is probably your first time with blepharoplasty surgery and you may have a few concerns. Here are some common concerns after surgery. In most cases, these concerns can wait until regular office hours but sometimes it’s best to call the office and have the doctor paged.

Swelling: It is normal to have swelling for a couple of weeks after surgery. Swelling often peaks at about 2 days after surgery and then starts getting better. Also the swelling and bruising travels south with gravity.  You may be swollen and bruised as far down as your cheeks. If your swelling has been gradual and if it involves both sides, it is likely not a serious problem. Have you been over active? If so, get some rest. Cold packs will also likely help.

If you have the sudden onset of swelling or if you have a lot more swelling one one side than the other or if you have the sudden onset of severe eye pain, this may indicate a bleeding problem. Give the office a call at (206) 467-1101.

One more thing about swelling: It takes up to six months for the swelling to totally resolve. Usually this residual swelling is very subtle.  You and I will be aware of it but casual observers will not.

Incision issues: It’s normal for incisions to be tender and red for a couple of weeks after surgery. It is also normal for there to be a ridge along the incision. This is called a “healing ridge” and is caused by collagen accumulating as the incision heals. It’s also normal for there to be a little seepage from incisions for the first few days after surgery.  If you had your lower lids done, you likely have a tiny incision inside the eyelid next to the eyeball (creepy, huh?) and this can ooze a little.  Also, itching is part of healing.  If the itching is really a bother, it’s okay to take some over the counter Benedryl.

If your incisions are getting more tender and more red as the days pass or if there is persistent drainage, it may indicate a problem. Call (206) 467-1101.

Sometimes tiny little cysts form along the incision line.  These are called milia.  They can be easily treated at you next postoperative appointment.

Blurred vision:  It is not unusual to have blurry vision for a few days after surgery.  I often use protective corneal shields during this surgery and they can cause your cornea to swell a little and cloud your vision.  This is temporary.  Don’t strain your eyes.  Over-the-counter eye drops are fine if they provide comfort.  If I have prescribed prescription eye drops, make sure you use them.  If you have a sudden change in your eyesight or severe eye pain or swelling, that is an emergency.  Call me.  (206) 467-1101.

Eyelid asymmetry or position problems.  It is common to have some asymmetry as the eyelids may not heal at exactly the same rate.  You may find you have a good side and the “evil twin”.  And they may switch roles!  Sometimes the lower lid is pulled down a little with swelling.  This almost always gets better with time and a little massage.  Also, sometimes it is not possible to completely close your eyes for the first day or two after surgery.  This almost always gets better within a few days.  Make sure to have some eye drops on hand if your eyes feel dry or scratchy.  Concerns like this can usually wait until your next postoperative appointment.

Medication issues:  It is common to have nausea if pain medication is taken on an empty stomach.  Make sure you have something light to eat when you take your pain meds.  It also common to have some mild itching with pain medication.  This is caused by histamine release and can be treated with an over-the-counter antihistamine like Benadryl.  A rash or hives could indicated an allergic reaction.  If this happens, quit taking the suspected medication and call the office.  If the pain medication is making you constipated, get on an over the counter stool softener and drink some prune juice.  Really.  Prune juice works very, very well.

Post-operative depression:  It is not unusual to be a little down in the dumps the first few weeks after surgery.  There are several reasons for this:  Your face hurts, you look bruised and swollen, you are hiding out and avoiding most social contact, you are not exercising, you are worried about healing, and you may be thinking you made a big mistake.  Hopefully, I remembered to warn you about this prior to surgery.  Do not despair.  It will all get better.  It just takes a little time.  Try to keep busy with easy tasks, listen to some relaxing music, take a warm (not too warm) bubble bath.  Put on a scarf and some dark glasses and go for a walk outside.  And stay away from the Internet and all the disinformation to be found there!  And don’t hesitate to call me.  I’m good at giving pep talks.

I hope this helps!