Home Care Instructions
Uncomplicated and ideal healing depends on how well you care for yourself. Please read these instructions carefully before your eyelid surgery and ask us about any questions you may have.
The most important things to do for eye care in the first 4 days are:
- Keep your head elevated on 2 to 3 pillows (minimum) to help bring down swelling.
- Use lots of cold compresses or gel packs on your eyes to help prevent bruising and swelling
- Use lots of Saline/lubricating eye drops/artificial tears to moisturize your eyes – 5 to 6 times a
- day is a minimum. Saline eye drops can be used as much as needed, even every several
- Take Arnica montana pills starting 1 to 2 days before your surgery and continuing until
- bruising is gone to help minimize and decrease the lifespan of the bruise.
- Wear sunglasses when outside during the first 2 weeks.
Use cold compresses as much as possible for the first 4 days after surgery. Gel Packs, or face cloths & gauzes soaked in ice water, squeezed out, and folded to cover the forehead and eyes work well. Gel packs and/or cold compresses can be used continuously. Do not use ice packs for longer than several minutes at a time. Ice cannot be used for longer than several minutes at a time due to the risk of frostbite.
Stay upright as much as possible starting the morning after the operation. Lying down flat in bed aggravates swelling. Sitting up and walking around is advisable. Use at least 2 to 3 pillows to elevate the head while resting or sleeping, and try to stay on your back rather than on your side for the first two weeks.
Apply saline/lubricating/artificial tears eye drops a minimum of 5 to 6 times daily. Refresh eye drops is a good brand. If you have any sensation of irritation in the eye use the eye drops even more frequently. The eye drops can be used every several minutes since they are only saline. You must use the eye drops even if you do not have the sensation of a dry eye. You must use the eye drops even if you have tears rolling down your cheeks. The eyelids may be slightly open for some time after surgery due to swelling and the eye needs lubrication with lots of eye drops to prevent dryness.
Apply Lacrilube/GenTeal ointment/gel (Overnight Eye gel) to the eyeball at night when you go to sleep for the first 1 to 2 weeks after your surgery to prevent a dry eye. Lacrilube ointment can be placed on the eyeball during the day if your eyes feel especially dry or if you have the sensation that something is in your eye.
Take Arnica montana in pill form starting 1 to 2 days before your procedure and continuing until bruising is gone. Our brand of Arnica is taken: 3 pills under your tongue 3x a day. Other brands have different dosing instructions. Arnica montana cream or gel can be used after the surgery on bruising located on the cheeks. Do not place Arnica Montana cream or gel on the eyelids as it may cause eye irritation.
Wear sunglasses when outside during the first 2 weeks. Wearing sunglasses protects your eyes from sun exposure, prevents dust or debris from getting into your eyes, and acts as good camouflage for bruising.
No lifting, bending, straining, exercising, or aerobic activity. Incision lines should be cleaned 1 to 2 times per day with Water and a Q-tip to remove any crusting that may build up.
Vaseline (a thin layer) should always be a kept on the incision line to help the skin heal. Apply Vaseline at least 2-3 times per day or more to keep the incision line moist.
Prior to surgery, arrange for someone to take you home (and stay overnight if you are having outpatient surgery) and bring you to the office for your first post-operative visit the next day. You may also need a ride to the office on the 4th day after surgery.
Your first office visit will be on the first post-operative day (or you will be seen in the hospital if you were admitted over-night). There will be two visits in the first week (the day after surgery and the 4th day after surgery) and several further visits within the first few months.
Eyelid sutures are removed 4 to 5 days after surgery. Surgical staples for the forehead lift are all removed within 10 days.
Bruising and swelling can increase for up to 4 days after your surgery. Everyone gets some degree of bruising and swelling. Cold compresses help decrease bruising and swelling in the first 4 days after surgery. Warm compresses help dissolve bruising after the first 4 days. Make sure the warm compress isn’t too hot and cause a burn. Because the skin has temporary decreased sensation in the region of the surgery, please test how warm the compress is somewhere else on your body.
Fluctuating eyelid swelling is common in the first 2 months after surgery. You may wake up with eyelid swelling in the morning that goes away over the course of the day. Keep your head elevated. Use a cold compress if necessary.
Avoid sunburns and tanning your facial skin for 3 months. You do not want to injure the healing incision lines. Use sun block with an SPF 30 or more if staying outside in the sun or snow.
Avoid bending over, heavy lifting, straining, exercising and aerobic activity for 3 weeks after your surgery.
Be careful no to bump your eyes or face – beware of restless children, bedmates or pets.
Take Dr. Brunner’s prescriptions as advised. Ask Dr. Brunner when to resume other routine medications you were taking before the surgery.
Use sleeping pills and analgesics only if absolutely necessary, as they sometimes make people feel dizzy or weak and delay your return to normal function. Do not take aspirin or ibuprofen (Aleve, Advil, Motrin), for two weeks after your surgery as it may cause bleeding. Try extra strength Tylenol before taking Tylenol with codeine.
Any progressive or one-sided decrease in vision should be reported immediately. Also report any progressive or severe pain, swelling, bruising or bleeding. Tell the nurse if you are in the hospital, or call our office if you are at home.
If you have any questions or concerns, call the office at 921-9497. We have a 24-hour answering service, which will contact Dr. Brunner. Should you feel it necessary, go to the Emergency Department at The Medical Center At Princeton and identify yourself as Dr. Brunner’s patient.
List of Supplies to Purchase
- Refresh Eye drops or saline/lubricating eye drops also called artificial tears
- Lacrilube or GenTeal Eye gel or any Overnight Eye Gel/Ointment
Bathing, Showering, Shampooing: After eyelid lift (blepharoplasty) you can shower and wash your hair the day after surgery. Do not take a hot, steamy shower. Have someone assist you and be gentle. Pat the suture lines dry afterwards and apply Vaseline. Do not rub the incision lines.
After forehead lift (brow lift) you can shower and wash your hair after the dressing is removed four days after your procedure.
Sunglasses, eyeglasses: Should be worn immediately after surgery. Wearing sunglasses protects your eyes from sun exposure, prevents dust for debris from getting into your eyes, and acts as good camouflage for bruising.
Contact lenses: Can be worn two weeks after surgery. Make sure to have your glasses as back-up. You may not tolerate contact lenses all day initially.
Make-up: Cover-up/camouflage make-up can be applied on the cheeks for any bruising after 3 days. Mascara, eye shadow and false eyelashes should not be used for two weeks.
Hair coloring or permanent: 3 weeks after forehead lift.
Return to work or school: Usually 1 to 2 weeks, although light, non-stressful work and be done at home after several days.
Recreational swimming, tennis, jogging, aerobics, light weight-lifting, light cycling, sexual activity: 2 to 3 weeks.
Contact sports, squash, competitive sports, diving, hiking, skiing: 6 weeks. Driving: 4 to 7 days
Smoking or Alcohol: 2 weeks. This is a good time to break the habit. Anything Else: Please ask.
Eyelid, Eyebrow, and Forehead Surgery
What to Expect After Surgery
Swelling and Discoloration: This in normal after surgery and will subside gradually over ten days. Cool compresses and head elevation will minimize this.
Pain: There is usually minimal pain after surgery. It is worsened by nervousness and anxiety. The swelling sometimes causes a bruised feeling. Pain medications sometimes cause dizziness and may prolong convalescence, so try mild remedies first (cold compresses, Extra Strength Tylenol). If these are ineffective after 45 minutes, use the stronger medications we gave you.
Blurred & Double vision: Swelling may cause a blurring of vision for a few days after surgery. Occasionally, you can have double vision in the first 24 hours. Any progressive loss of vision should be reported immediately.
Temperature: The body temperature may rise to slightly over 101 F after surgery. If fever persist after 24 hours despite drinking liberal amounts of fluid report it promptly. Do not estimate your temperature, use a thermometer.
Sutures: Some slight redness around individual sutures is common. However, notify the office if the redness extends along the entire line of the incision, or if the suture line becomes tender and swollen. These are signs of early infection and antibiotics might be needed.
Eyelids May Stay Open At Night: Swelling may cause the eyelids not to close for a few days. It may also cause the lower lid to separate form the eyeball. Both of these things clear up as the swelling subsides. Tearing or eye irritation, if present, will usually subside as swelling decreases and eyelids close.
After The Eyebrow Lift: Occasional shooting pains into the forehead may occur. These result from irritation of small sensory nerves in the operative area, and soon subside without treatment.
Scars: As your scars mature, they go through a lumpy and pink stage. This will resolve over several weeks, but final scar maturation – to obtain a flat, smooth, fine line scar – will take upwards of a full year. Patience is required.
Cysts: Occasionally, small cysts which resemble whiteheads appear beside the upper eyelid incisions. These are easily removed in the office.
Depression: Some people become mildly depressed after surgery. One must be patient during this time, and remember that the swelling and discoloration are only temporary. It is best to adopt a positive attitude, and look forward to resuming normal living as soon as possible. Sleeping pills and pain pills may delay rapid convalescence.
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