Post Blepharoplasty

What to Expect During Recovery

The following are common and expected during early healing, and typically improve over weeks to months:

• Swelling, bruising, and tightness around the eyes; mild light sensitivity; mildly blurred vision from eye drops and/or eye ointment; a foreign body or “gritty” sensation; tearing, burning, and small amounts of blood-tinged tearing during the early recovery period
• Swelling and bruising often peak 2–3 days after surgery
• Dryness and irritation of the eyes that improve with frequent lubrication

Eye Care and Lubrication

• Daytime — preservative-free artificial tears. Use preservative-free artificial tears frequently throughout the day, typically 1–2 drops in each eye every 30–60 minutes while awake for the first several days, then as needed for comfort. Dryness, tearing, burning, watering, mild blurred vision, and a foreign body sensation are common after blepharoplasty and usually improve with frequent lubrication.
• Bedtime and rest — lubricating ophthalmic ointment inside the eyes. Before sleep and anytime you rest, apply eye ointment (such as Refresh PM, Systane Nighttime, or generic lubricant eye ointment) inside both eyes. Place a small ribbon of ointment inside the eye, then close your eyes to help the ointment spread. Be careful not to touch your eye with the tip of the tube. Your vision will be blurred afterward. In the morning, warm washcloths and artificial tears can help flush the ointment out for clearer daytime vision. You may receive a prescription for eye ointment; use it as directed. If/when you run out of the prescription eye ointment, you can transition to the over-the-counter lubricating ophthalmic ointment and use it before sleep and anytime you rest.
• Incision line — thin layer of eye ointment. If you have an incision of the upper and/or lower eyelid with sutures, apply a very thin layer of eye ointment directly to the incision lines 3–4 times a day. Continue this until your 1-week postoperative visit. Note: this is separate from the ointment you apply inside your eyes at bedtime. Do not pick at crusts along the sutures.
• Rest your eyes. For the first several days after surgery, rest your eyes as much as possible. Avoid activities that strain your eyes, including texting, emailing, reading, computer or phone screens, and watching television. When you focus on a screen, your blink rate drops significantly, which worsens dryness. For entertainment during recovery, we recommend podcasts, audiobooks, or music instead of visual media.
• For the first month, avoid direct sun exposure to the incision lines. If you must be outdoors, cover the area with sunglasses. Sun exposure within the first month of surgery may result in hyperpigmentation of the scars. The sunglasses also protect your eyes from sun, wind, and dust, all of which can aggravate dryness and irritate your eyes.
• Once fully healed at approximately 1 month after surgery, apply a broad-spectrum SPF 30+ sunscreen to the incision lines for 6–12 months to minimize hyperpigmentation of the scars.
• Silicone-based scar gel can be used 1 month after surgery.

Showering, Hygiene, and Daily Care

• Showering. Please use a gentle shampoo (e.g., baby shampoo) for the first week after surgery, as it is less irritating to the eyes. Let water run gently along the sutures. Do not aim a direct stream at the sutures, and do not scrub along the suture lines. Pat dry gently with a clean, soft towel, then perform your wound care as described above.
• Do not rub your eyes.
• Do not submerge incisions (no baths, pools, hot tubs, or ocean) for 3 weeks.
• Makeup and false lashes. No makeup on or near the incisions for 2 weeks after surgery. Do not wear false eyelashes for 2 weeks after surgery.
• Contact lenses and glasses. Do not resume contact lens wear until cleared by your surgeon, typically around 2–4 weeks after surgery. You may wear glasses during the first week of recovery.
• Help at home and driving. Arrange for someone to stay with you for the first day or two in case swelling affects your vision or you need assistance. Do not drive until your vision is clear, you are no longer taking narcotic pain medication, and you feel able to react quickly behind the wheel.

Swelling, Bruising, and Head Positioning

• Swelling and bruising often peak 2–3 days after surgery. This is expected.
• Apply cold compresses (for example, a washcloth soaked in ice water) gently to the eyelid area — without pressure on the eyes themselves — as much as possible for the first 72 hours after surgery to reduce swelling and bruising. Do not apply ice directly to the skin.
• Keep your head elevated at all times during the first 2 weeks. Sleep on 2–3 pillows or in a recliner. A travel neck pillow may help maintain a neutral head position during sleep.
• Sleep on your back, not your side, for approximately 2–4 weeks after surgery. This lessens pressure-related asymmetric swelling.
• Most visible swelling improves over 2–3 weeks, but subtle swelling can persist for a few months as the tissues continue to settle.

Blood Pressure, Nausea, and Vomiting

Keeping your blood pressure well controlled in the first 2 weeks is one of the most important things you can do to minimize bleeding, bruising, and/or swelling. Vomiting and forceful retching can significantly raise blood pressure and increase the risk of bleeding.

• Take all prescribed blood pressure medications exactly as directed.
• Avoid stress, straining, and sudden exertion.
• Take anti-nausea medication as prescribed, even preventively if you feel queasy.
• Take pain medications with food or a small snack to minimize nausea that can occur when taking pain medication on an empty stomach.

Activity and Recovery Timeline

• Take short, gentle walks around the house starting the day of surgery. This helps reduce the risk of blood clots.
• For the first 2 weeks, avoid bending forward, lifting anything heavier than 5 pounds, and any form of straining — including heavy coughing, forceful sneezing, and excessive straining with bowel movements.
• Avoid sexual activity for 2 weeks, as this can raise blood pressure and increase the risk of bleeding.
• Weeks 1–2: you may gradually resume light, non-strenuous activity, as tolerated. Avoid any activity that increases your heart rate or blood pressure, as that may increase the risk of bruising, swelling, and/or bleeding.
• Week 3 onward: you may gradually resume strenuous activity. Begin slowly and work up to more strenuous activity. It is normal to experience some temporary swelling and tightness with increased activity at this stage.
• Do not drive while taking narcotic pain medication. You may drive once you are off narcotic pain medication, and your vision has returned to normal.

Medications and Pain Control

• DO NOT TAKE ASPIRIN, IBUPROFEN, OR OTHER NSAIDs (such as Advil, Motrin, Aleve, Naproxen, or Excedrin) during the 2 weeks before surgery or the 2 weeks after surgery. These can increase bleeding risk. If you are on Aspirin under the guidance of a cardiologist, you must ask your cardiologist if it is safe to be off Aspirin for your elective cosmetic procedure.
• Tylenol (Acetaminophen) is safe and a good medication for discomfort after surgery. Do not exceed 3,000 mg of Acetaminophen in 24 hours and remember that most narcotic pain medications already contain Acetaminophen — do not double-dose.
• We may prescribe Celebrex (Celecoxib) to take twice a day for the first week after surgery. Take this on a fixed schedule, not as needed, even on days you feel comfortable. Celebrex is a COX-2 selective anti-inflammatory that reduces pain and swelling without the bleeding risk of ibuprofen or aspirin. Taking it consistently helps you need less narcotic pain medication.
• If you experience discomfort, take Ativan (Lorazepam) as prescribed. This may help alleviate your discomfort.
• If you are still experiencing pain after taking Celebrex, Tylenol, and Ativan, you may take the prescribed narcotic pain medication. Take it with food to minimize nausea and wean off the narcotic pain medication as soon as possible.
• To minimize constipation from pain medication, stay hydrated, eat fiber-rich foods, and use a stool softener (such as Colace or Docusate) as needed while taking narcotic pain medication.
• Take any antibiotics prescribed by Dr. Batniji until the full course is finished.

Diet

• Start with light, soft foods the day of surgery. Soft foods (yogurt, eggs, pasta, soups, smoothies) are best for the first day. We recommend a diet that is high in protein to help with the healing process.
• Advance to your normal diet as tolerated.
• Stay well hydrated.
• Avoid very salty foods for the first few weeks after surgery, as excess sodium can worsen swelling.
• Include fiber-rich foods to help minimize constipation.
• We recommend using throat lozenges such as Cepacol or Ricola if you have a sore throat.

Nicotine, Alcohol, and Supplements

• Absolutely NO smoking, vaping, nicotine patches, nicotine gum, any nicotine products, or secondhand smoke exposure for at least 4 weeks before surgery and 4 weeks after surgery. Nicotine constricts blood vessels and can cause skin loss, poor healing, and worse scarring.
• AVOID ALCOHOL for at least 2 weeks before surgery and 2 weeks after surgery. Alcohol use significantly increases the risk of bleeding, bruising, and swelling.

Questions or Concerns?

Please do not hesitate to contact our office at 949.650.8882 (Newport Beach) or 310.467.2180 (Beverly Hills) during business hours. For life-threatening symptoms, always call 911 or go to the nearest emergency room first.

Healing is a gradual process. We are here to guide you every step of the way.