What is eyelid surgery?

There are two types of eyelid surgery. You may have one or both types of surgery. These surgeries can be done on one or both of your eyes.

Surgery for ptosis lifts droopy upper eyelids. Ptosis (say "TOH-sus") is the name for eyelids that droop. The eyelid muscles or tendons do not work as they should. This can affect your vision and your appearance. It can be caused by aging, nerve or muscle problems, eye surgery, or an injury. You can be born with this problem, or you can get it later in life.

The doctor makes a small cut in the crease of your upper eyelid. The cut is called an incision. The doctor then lifts the eyelid by tightening the muscle that raises your eyelid. In rare cases, the muscle is too weak to tighten. In that case, the doctor will connect your forehead muscles to your eyelid muscles. After fixing the problem, the doctor closes the incision. Minor cases may not need a cut in the skin.

Blepharoplasty (say "BLEF-uh-roh-plass-tee") is surgery to remove baggy, extra tissue on your upper or lower eyelids. In most cases, this extra tissue forms as you age. It may affect your vision. But more often, it affects how you look. This surgery is usually considered cosmetic, or plastic, surgery when it is done to improve your appearance. But this surgery is considered reconstructive surgery when it's done to improve your field of vision.

The doctor makes small incisions in the creases of your upper eyelids and just below the lashes of your lower eyelids. The doctor removes extra tissue through the incisions. The doctor then closes the incisions.

During either surgery, you will get medicine so you will not feel pain. You may get medicine that relaxes you or puts you into a light sleep.

Eyelid surgery takes about 1 to 2 hours. You will probably go home on the same day as your surgery. After surgery, you will have tiny scars. These scars will fade over time.

Most people feel ready to go out in public and back to work in about 7 to 10 days. After either surgery, you may be able to see better. You may like how the surgery affects your appearance.

Activity

• Rest when you feel tired. Getting enough sleep will help you recover.
• Keep your head raised for several days after surgery. Sleep with your head up by using 2 or 3 pillows.
• Drink plenty of fluids (unless your doctor tells you not to).
• Ask your doctor when it is okay to drive.
• Your eyes will get tired easily. Limit reading, computer work, and TV for the first few days.
• Do not wear contact lenses for about 2 weeks or until your doctor says it is okay.
• Do not wear eye makeup for 2 weeks. You may also want to avoid face cream or lotion.
• You can shower or wash your hair the day after surgery. Keep water, soap, shampoo, hair spray, and shaving lotion out of your eye, especially for the first week.
• Do not rub or put pressure on your eye for at least 2 weeks.
• Do not get your hair colored or permed for 10 days after surgery.
• Do not bend over or do any strenuous activities, such as biking, jogging, weight lifting, or aerobic exercise, for 2 weeks or until your doctor says it is okay.
• Avoid swimming, hot tubs, gardening, and dusting for 1 to 2 weeks.
• Wear sunglasses on bright days for 1 year after surgery.

Medicines

• Your doctor will tell you if and when you can restart your medicines. Your doctor will also give you instructions about taking any new medicines.
• If you stopped taking aspirin or some other blood thinner, your doctor will tell you when to start taking it again.
• Follow your doctor's instructions for when to use eye drops and antibiotic ointment. Always wash your hands before you put your drops in. To put in eye drops:
  • Tilt your head back, and pull your lower eyelid down with one finger.
  • Drop or squirt the medicine inside the lower lid.
  • Close your eye for 30 to 60 seconds to let the drops or ointment move around.
  • Do not touch the ointment or dropper tip to your eyelashes or any other surface.
• Follow your doctor's instructions for taking pain medicines.

Incision care

• If you have a bandage on your eye, wear it for as long as your doctor recommends.
• Keep the area clean and dry.

Surgery can be stressful. This information will help you understand what you can expect. And it will help you safely prepare for surgery.

Preparing for surgery

• Be sure you have someone to take you home. Anesthesia and pain medicine will make it unsafe for you to drive or get home on your own.
• Understand exactly what surgery is planned, along with the risks, benefits, and other options.
• If you take a medicine that prevents blood clots, your doctor may tell you to stop taking it before your surgery. Or your doctor may tell you to keep taking it. (These medicines include aspirin and other blood thinners.) Make sure that you understand exactly what your doctor wants you to do.
• Tell your doctor ALL the medicines, vitamins, supplements, and herbal remedies you take. Some may increase the risk of problems during your surgery. Your doctor will tell you if you should stop taking any of them before the surgery and how soon to do it.
• Don't smoke. Smoking can delay recovery. Stop smoking for at least a month before surgery. If you need help quitting, talk to your doctor about stop-smoking programs and medicines. These can increase your chances of quitting for good.
• Make sure your doctor and the hospital have a copy of your advance directive. If you don’t have one, you may want to prepare one. It lets others know your health care wishes. It’s a good thing to have before any type of surgery or procedure.

You had an eyelid surgery. The doctor made small cuts in an eyelid to do the surgery.

After surgery, your eyelid may feel tight and sore. Your eye may be watery, dry, sticky, itchy, or sensitive to light. Your vision may be blurry for a few days. Your doctor will give you medicines to help with pain and discomfort.

It's important to keep your eyelid clean and to avoid rubbing it. Follow your doctor's instructions on how to clean and care for your eye.

If your doctor closed your incisions with removable stitches, the stitches will be taken out in 5 to 10 days. Your eyelid may be swollen and bruised for 1 to 3 weeks after surgery. The appearance of your eye may continue to get better for 1 to 3 months.

Most people feel ready to go out in public and back to work in about 10 to 14 days. This may depend on your job and how you feel about people knowing about your surgery. Even after 2 weeks, you may still have some bruising around your eyes.

After surgery for a droopy eyelid, or ptosis (say "TOH-sus"), you may find that your lid doesn't lower as much when you look down. Or you may find that your lid doesn't close fully when you sleep. If this occurs, tell your doctor. You may be able to put drops or gels in the eye to keep it moist.

For the first few weeks, your eye will be swollen. When the swelling is gone, you'll be able to see the changes in how it looks.

• Follow the instructions exactly about when to stop eating and drinking. If you don't, your surgery may be canceled. If your doctor told you to take your medicines on the day of surgery, take them with only a sip of water.
• Follow your doctor's instructions about when to bathe or shower before your surgery. Do not apply lotions, perfumes, deodorants, or nail polish.
• Do not shave the surgical site yourself.
• Take off all jewelry and piercings. And take out contact lenses, if you wear them.

At the hospital or surgery center

• Bring a picture ID.
• The area for surgery is often marked to make sure there are no errors.
• You will be kept comfortable and safe by your anesthesia provider. The anesthesia may make you sleep. Or it may just numb the area being worked on.
• The surgery will take about 1 to 2 hours.
• You may have a bandage over your eye. If you had surgery for ptosis, your lower lid may be taped to your forehead. This protects your eye from the bandage. You may also have an ice pack over your eye to prevent swelling.