Some people have eyelid surgery to correct problems that are a result of aging, while others have inherited traits such as under eye bags that cause them to seek treatment in their 20s or 30s.
If the upper eyelid condition is accompanied by sagging of the eyebrows, then a forehead lift may be recommended. Smoothing of crow's feet may require chemical peeling or laser resurfacing procedures. Circles beneath the eyes caused by dark pigmentation may be treated with a bleaching solution, chemical peel, or laser resurfacing. Alternatively, sinking around the bony orbit below the eye can be addressed with fat grafting or a mid cheek lift.
Preparing for Surgery
2 Weeks before surgery
- Avoid all aspirin containing products, all anti-inflammitory medications (ie: Ibuprophen such as Advil or Motrin), all products containing 400 IU's of vitamin E and all herbal products. These products can increase bleeding both during and after surgery and may lead to increased post-operative bruising, swelling and recovery time.
- Stop or at least cut down on smoking. Smoking constricts small blood vessels causing delayed healing, increased scarring and increased recovery time.
- Begin taking a multivitamin tablet daily, which can speed healing and shorten recovery time. It is recommended to continue your multivitamin for one month following surgery.
- Arrange for transportation to and from surgery. You must have someone responsible pick you up and remain with you for a minimum of 24 hours. You cannot take a taxi home on your own.
- It is recommended to restrict activity for approximately 2 weeks following surgery. It is advisable to make arrangements for assistance.
- Avoid dental appointments 2 weeks prior to your surgery as well as 2 weeks post operatively.
- Arnica capsules or pellets can be taken orally starting 2 days before surgery and can continue for 5 days post op. This homeopathic medication can assist in decreasing bruising and swelling due to surgery.
24 hours before surgery
- Avoid alcohol or smoking.
- Nothing to eat or drink after midnight the night before your surgery (no water, no gum). If surgery is booked after 12 noon, clear fluids may be allowed up to 6 hours before surgery (ie: black coffee/tea, clear juice, water). Our nurse will advise you on this when you are given your time for surgery.
Day of surgery
- Wear loose, comfortable button-up/zipper clothing (ie: jog suit, slip on shoes).
- Leave valuables at home (remove contact lenses, jewellery or piercing of any kind).
- Take any regular prescribed medications (ie: blood pressure medications) with a small amount of water.
Step 1 - Anesthesia
Medications are administered for your comfort during the surgical procedure. The choices include intravenous sedation or general anesthesia.
Step 2 - The Incision
Dr. Waslen will discuss two different approaches to lower lid surgery: one uses an external incision and the other is performed from inside the lower lid. Your age and the extent of the fatty deposits you have will determine which approach is used.
An incision is hidden within the natural fold of the upper eyelid for upper eyelid surgery and it is through this incision that excess skin and fat are removed. Because the incision follows the natural contour of the upper eyelid, it will be well camouflaged when it is healed.
For lower lid surgery the incision is usually hidden below the lower lashes. Through this incision, excess skin, muscle and fat are removed. Fat may also be redistributed to eliminate puffiness or bulges. Other adjustments such as canthopexy may be made to correct special problems such as muscle laxity or droopy lower eyelid.
You and Dr. Waslen may decide that the best approach for removing excess fat is a technique that needs no external incision. This procedure is called transconjunctival lower blepharoplasty. While it is a good approach for younger patients, it cannot be used to remove excess skin so a laser may be used in conjunction with this method to tighten the skin under the eyes.
Step 3 - Closing the incisions
Eyelid incisions typically are closed with:
- Removable or absorbable stutures
- Skin adhesives
- Surgical tape
Your surgeon may use a laser chemical peel ot erase dark discoloration of the lower eyelids.
Step 4 - See the results
The results of eyelid surgery will appear gradually as swelling and bruising subside to reveal a smooth, better-defined and surrounding region, and an alert and rejuvenated appearance.
- Some pain and nausea can be expected. This can be relieved with anti-pain and anti-nausea medications. Take them as directed. If you are coming from out of town, please have these medications with you.
- Begin taking antibiotic medication once home from surgery and continue until the prescription is finished.
- Any bandages worn post-operatively should be comfortable and not too tight. Adjust as necessary.
- Use cold compresses 20 min on and off during waking hours. Use a facecloth soaked in ice water and drape over face. Never place ice directly on skin.
- Maintain a regular fluid intake during the day. Gatorade is a good option. Restrict fluids after supper; increased fluid intake will increase swelling.
- Rest is important to minimize pain, nausea and swelling.
- Try to maintain an upright sitting position at all times (ie: 25-45 degree angle) for the first 2-7 days post-op. This will assist in the reduction of post-operative swelling and speed healing time.
- Begin a light nutritional regime and increase food intake as tolerated.
- Take anti-pain medications with food to avoid an upset stomach. Begin taking antibiotic medication once home from surgery and continue until prescription is finished. Eat yogurt while taking antibiotics. If diarrhea occurs, stop antibiotics and call our office for further direction.
Call (403) 228-1313 if you have any questions or concerns.
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Post-operative Day 1
- You may remove the bandage and shower if you wish. Remove all gauze.
- Be aware of any unusual swelling or a sudden increase in pain. If either of these are noted, phone the office as soon as possible.
- Continue to maintain a regular fluid intake during the day, decrease after supper.
- Continue to maintain an upright position.
- Use cold compresses for 72 hours to decrease swelling (ie: ice cubes or ice chips in a bowl of cold water with facecloths).
- Be aware of decreased skin sensation. Do not apply excessive heat or cold to the operative areas.
- Do not smoke.
- Rest as much as possible.
- A nurse will call you by noon to assess how you are doing. At this time, you will be given further post-operative instructions as well as an appointment for your first post-operative visit.
Post-operative Days 2-7
- Continue to maintain an upright position.
- Gradually increase your activity level after 7 days post-operatively. As individuals, everyone's post-operative healing phases will differ. Generally speaking, gentle exercise may resume at 10 days with moderate exercise resuming after 3 weeks. It is advisable to abstain from a full exercise regime until 6 weeks post-operatively.
- Scar tissue (firmness or hardening of operative tissues) may increase up to 6 weeks with the resultant softening of the tissues.
- Approximately 75% of swelling will diminish within 3 - 4 weeks. Any remaining swelling can take from 6 months to 1 year to absorb.
- Best results are usually not seen until 3 months following surgery.
- The final stages of healing are usually not complete until 1 year post-operatively.
High blood pressure, thyroid problems or diabetes are some of the conditions that can increase the risks of eyelid surgery. Dr. Waslen will ask if you have allergies and if so, how they affect your eyes. We will also need to know if you have been told that you have "dry eye" or any other eye problems.
After your surgery, you may have a feeling of temporary dryness or irritation in the eye. This may require treatment. There is also a chance of a temporary reduction in eyelid sensation or impaired eyelid function. Impaired lid function can be treated with additional surgery.
Mild swelling persists for several weeks in some cases while others see swelling resolve in just seven days. Bruising normally disappears in seven to ten days and you may use makeup within the first week to hide discoloration.
You may find your eyes are temporarily sensitive to light. You may also experience some excess tearing or dryness. Dr. Waslen may recommend eye drops to relieve burning or itching. You may want to wear dark sunglasses for a couple of weeks to protect your eyes from the wind and sun.
Every surgical procedure involves a certain amount of risk. It is important that you understand the risks involved with this procedure. An individual's choice to undergo a surgical procedure is based on the comparison of risk to potential benefit. Although the majority of patients do not experience these complications, you should understand the potential complications.