Recovery and Return to Social Life After Upper Eyelid Surgery
26 November 2019 onur
The most important variable affecting the healing process and duration in operations around the eyes is the scope of surgery.
The scope of the surgery varies according to the level of aging around the eyes, the level of change desired by the person, and the anatomical features specific to the individual. As the scope of surgery expands, the recovery time, bruising, edema, temporary deformations and the time it takes to resume social interactions will increase.
I will give you information about the healing processes of upper eyelid surgeries in a flow from the simplest to the most comprehensive.
Isolated Upper Eyelid Surgery
Perhaps the most frequently performed surgery around the eyes is “upper blepharoplasty” or, in other words, upper eyelid plastic surgery. When this surgery is performed alone, it is often performed under local anesthesia. The operation time is between 30-60 minutes. After the surgery, you will have fine sutures on your upper eyelid. Since these sutures are hidden in the eyelid fold, they do not attract much attention even in the early period. Sometimes we use absorbable and sometimes non-absorbable stitches. Absorbable sutures dissolve on their own within 8-10 days, while non-absorbable sutures need to be removed at around the same days. I do not apply any dressing on the upper eyelid after surgery. We just apply some eye ointment over the sutures and the wound remains open throughout follow-up. There may be a slight leak of liquid/blood from the edges of the wound for the first few hours, and as it leaks, you use a piece of gauze to clean this leak manually. It is more comfortable to follow up the eyelid when it is not covered than to carry a dressing on the eyelid.
The surgery is not painful and usually does not require routine use of painkillers. We still prescribe a mildly effective pain reliever that our patients can use if needed. You should not drive your car on your way home after the surgery. It is not recommended to drive for the first 3 days after the operation.
In the first 48 hours after the procedure, your eyelids will gradually swell and some bruising may occur around the eyelid. Bruising can be very noticeable, particularly in individuals who use blood thinners or whose blood clots late. In principle, swelling and bruising move towards the lower parts of the face under the gravity effect. Swelling peaks at 48 hours and gradually decreases from the morning of Day 3. Bruises will heal within 7-10 days.
Postoperative swelling and bruising go away only “in time”. Although there are various creams and drugs that allegedly reduce such swelling, I have not seen any of them work. In our routine, we do not apply ice around the eyes, either. Patients receiving and not receiving ice treatment recover at the same time. Plus, it is troublesome to put ice on that area. You can eat whatever you want after the surgery. But if it is the cherry season, don’t overconsume it and drink no more than 2-3 cups of linden/sage tea. I recommend that you lie and sleep in the supine position, i.e. on your back, on the evening of the surgery. The absence of pillow pressure on the eyelids for the following 10 days will provide an advantage in the wound healing process.
You will be able to take a bath the morning after the surgery. It is okay if water and foam contact the sutures during bath. You can clean between and around the sutures very gently with wet cotton balls. You should not contact the operated area too harshly for the first 3 weeks and you should not scratch or rub it. Otherwise, the wound lips joined by very fine sutures may separate and the scar may enlarge. Wearing slightly larger sunglasses after surgery will help you when you are going out. In the postoperative period, protect your eyes and the surrounding area from the sun, preferably for life. La Roche Possay’s 50 SPF, colorless, ultra-thin sunscreen is a very good product for the eye area. You can use it.
After the sutures are removed, edema and bruises around the eyes can be camouflaged with light, water-soluble make-up that running water will take care of in the shower. In the meantime, you can easily resume social life. People who look carefully will notice that you are operated around your eyes, but you will not look too strange.
You can put on any make-up you want and participate in all social events 21 days after the operation. In postoperative month three, even without make-up, the surgical scars will not be visible.
After the surgery, we may recommend antibiotic treatment in some cases and drops or gels that keep the eye moist in others. After certain kinds of surgery, it is completely normal that the upper eyelid cannot completely cover the eye. The ability to cover the eye reaches its normal level usually within 2 weeks. In the meantime, before going to bed at night, we may need to apply a gel that will keep the eye moist for a long time. After upper eyelid surgery, there may be temporary changes in your eye number. Infection after upper eyelid surgery is rare, but possible. In particular, absorbable sutures increase the possibility of infection. In case of increased swelling, redness or discharge on the eyelid after the operation, you should definitely contact and inform your doctor.
Asymmetry between the eyelids is inevitable after upper eyelid surgery. Particularly in the first 6 weeks after surgery, significant asymmetries may emerge due to reasons such as edema, bleeding, scar tissue and muscle laziness. Asymmetries will usually regress to a level that we are used to seeing in normal people around post-op Month 3.
Upper Eyelid Surgery and Ptosis (Droopy Eyelid) Repair
In this procedure, the deep layers of the eyelid are accessed to during upper eyelid surgery and the muscle structures that open the eyelid are corrected. Again, during this surgery, the upper eyelid fold is redesigned. It is basically an eyelid surgery but is different because it has a broader scope, and surgery is performed in the deep layers of the eyelid.
After this procedure, swelling is more common and lasts 5-10 days longer. Following surgical procedures which also includes ptosis repair, the asymmetry between the eyelids will be more pronounced and will last longer. To date, I have not seen any patient who had ptosis surgery and recovered completely symmetrically. When droopy eyelids are surgically corrected, eyes remaining open in the postoperative period is more common and may take 1-2 weeks longer than the routine process. In this procedure, we use some absorbable sutures that remain inside the eyelid while recreating the upper eyelid fold. Until these sutures are absorbed, millimetric recessions may occur on the eyelid fold.
The revision rates in combined surgery for upper eyelid and droopy eyelids are perhaps 10 times higher than standard surgery. Following this surgery, it may be necessary to stabilize the levels of the eyelids via secondary procedures, touching up with the upper eyelid fold or skin distribution. Therefore, possible revisions should be considered when deciding on surgery, and returning to social/professional life should be planned in consideration of these risks.
When upper eyelid surgery is combined with other procedures such as brow lift, forehead/temple lift, lower eyelid and fat injection, the recovery time, pain, swelling and bruising levels may increase significantly.
Like all other facial aesthetic surgeries, lower eyelid surgery is a procedure that should be planned individually. The postoperative period may also present variations depending on these individual differences. Please feel free to contact us to learn how this process will unfold for you and to get detailed information.
Take good care…
… of yourself and your beauty.