What happens before, during and after eyelid surgery?
General advice about eyelid surgery
Most of our eyelid operations are performed under a local anaesthetic. Before surgery, you’ll receive a small injection just under the surface of the eyelid to make it go numb. It’s a bit like the injection you might have at the dentist. If you work, I usually recommend that you take at least a week off after your operation. It’s sometimes necessary to take two weeks off, but we’ll review this when you come to see us a week after the procedure for your first post-surgery assessment.
Preparing for your operation
Prior to surgery, a member of staff will welcome you and perform some routine checks before they take you to the operating theatre. In theatre, the team will help you into a reclining seat. This allows you to lie in a fairly flat position. (Don’t worry if you can’t lie completely flat: we can help you get into a position that feels comfortable for you.)
The surgical team will introduce themselves and make a few final checks. We may make some marks on the skin of your eyelids with a soft pen. After that, we’ll administer the local anaesthetic. This can sting for a few seconds, but the sting very quickly disappears. After that your eyelid will be numb. You may still feel some soft touches and pressure, but it won’t be sharp or painful. The team will then clean part or all of your face with an antiseptic solution and wrap your head with a drape. The drape rests under your chin; it doesn’t cover your face.
During the operation
Most unilateral (single eye) procedures take about 30mins. Bilateral (both eyes) cases can take 45-60mins. During surgery we may ask you to open your eyes or look in certain directions at various points. However, for most of the operation, you’ll be able to lie back, close your eyes and relax. You won’t be able to see what’s going on because the procedure takes place very close to your face. If you feel that the operating lights are too bright, we can cover your other eye with a soft cloth.
After the operation
When surgery is complete, the team will clean your face. In some cases we may apply an eye pad to your eye. If this happens, it will stay in place for between 24 and 48 hours. In most cases, however, you won’t need a pad. After surgery, we often advise our patients to apply an ice pack for 20 minutes. You can do this as soon as you get back to the recovery room; it will help to minimise any post-operative bruising. In the recovery area, the nursing staff will also give you information about how best to manage your eyes once you leave the hospital. When they’ve given you a final check, you’ll be able to go home.
Reviewing your progress
We see all our patients one week after surgery to review how things are healing and to remove any sutures. We’ll see you again for a final assessment after about two to three months.
Managing your recovery after eyelid surgery
Once surgery is complete, the local anaesthetic begins to wear off after about an hour. Most patients don’t experience much post-operative pain; but if you do feel any discomfort, it’s fine to take some paracetamol (as long as you don’t have an allergy to this medication).
Eyelids have a very good blood supply. This is helpful because it means they heal very quickly, though it does mean they can get quite bruised and swollen after surgery too. Every patient will respond to the surgery and heal in different ways and at different speeds. But as a rule of thumb, I tell patients that during the first week after eyelid surgery there will be swelling and bruising, and that this will be visible to other people. In the second week this begins to settle, and it’s usually not so easy to tell that any surgery has taken place. Any scars are designed to blend into the normal creases of the skin around your eyelids.
After surgery, there are some simple things you can do to help your recovery and reduce the chances of swelling and bruising:
- Apply ice packs: using ice and gentle pressure on the eyelids after surgery can help to reduce the swelling. The simplest way to do this is with a bag of frozen peas wrapped in a tea towel. You can press this onto your closed eyelids for 20mins. This can be repeated at regular intervals, ideally five to six times a day for the first three days.
- Keep your head elevated: eyelid swelling is affected by gravity, so keeping your head above the rest of your body during the first few days can help to reduce swelling. Try sleeping with a few extra pillows, or put a few books under the head of your bed. This will keep your head a little higher when you’re asleep and reduce any extra swelling you may get overnight.
- Keep strenuous activity to a minimum for two weeks: it’s important to give your body time to heal and recover, so we always recommend avoiding any strenuous activity for at least two weeks following your surgery. Light exercise such as walking is fine, but you should avoid anything that raises the heart rate too much or that involves putting your head below your body. You should also avoid swimming for two weeks. You can wash your face and take showers, but we recommend that you try to avoid getting the eyelid too wet.
Smoking and recovery times
Smoking is known to affect the healing process and we always advise our patients to stop smoking for at least two weeks before their eyelid operation.
As part of the consent process, I’ll ask how you would be happy for me to share any of the images I take. We define these according to three ‘levels’ of consent:
Level 1: Medical records only. The images will be in your medical record and only you or I will have access to the images.
Level 2: Medical records and face-to-face patient education. As for Level 1, but I may wish to use the images alone to show other patients who are considering similar procedures, to allow an idea of pre and post operative appearance.
Level 3: Medical records, face-to-face patient education and publication online. As for Level 2, but I may use the images on my website (in this situation, I will contact you again to confirm that the images may be shared more widely, and to confirm you are still happy for me to use the images in this way).