A small amount of bloody oozing or blood-stained tears are normal in the first few days after surgery.
It is alright to use your operated eye for reading, watching television, and using your computer. This will not hurt your eyes.
Eye irritation, scratchiness, or the sensation of an eyelash in the eye is common in the first few days after surgery. This will improve with time. Over the counter artificial tears can help with this. If the eyes are painful, please contact your doctor immediately.
Mild to moderate itching is common during the first week or two and is a normal sign of healing. This type of itching often improves with a cool compress. Severe itching accompanied by worsening of swelling and redness may be an allergic reaction to the ointment or eye drops. Allergic reactions to ointments and eye drops usually start 3-5 days after surgery. If you have severe itching with redness and swelling, please contact your doctor. There are things we can do to help you feel better.
Numbness around the scar is common but typically resolves. Even the most delicate surgery creates controlled trauma to the skin including injury to the small nerves that provide sensation to the skin. This usually improves over the course of 6 weeks to 6 months.
Bruising and Swelling Concerns
Bruising and swelling is usually at its worst the day after surgery and should gradually get better each day.
Swelling follows gravity. It is usually worse in the morning after having your head reclined at night. Swelling gradually improves throughout the day with ice and sitting upright.
For most patients, swelling is about 80% resolved at 4 weeks after surgery, 90% resolved at 8 weeks, and can take up to 6 months for all the swelling to resolve. This is because it takes time for the body’s drainage system (lymphatics) to heal after surgery. You will notice more swelling after sleeping with your head flat, after eating salty food, or drinking alcohol.
It is common to still have some bruising at 1 week after surgery. Bruising should be mostly gone after 2 weeks.
After upper eyelid surgery, it is common to have bruising and swelling of the lower eyelids down to the cheeks and even sometimes down to the jaw (this is from gravity)
Information About Your Stitches
The incision lines are fragile for 2 weeks, treat them carefully and do not rub them.
Stitches that are clear or skin colored will dissolve on their own in 1-2 weeks and do not need to be removed.
Stitches that are purple, blue or white will be removed by your doctor in the office.
Information About Scars
Eyelid scars typically heal very smoothly compared to scars elsewhere on the body. It is very rare for an eyelid to develop a keloid or hypertrophic scar (even in patients who have had keloids elsewhere on their body).
Scars are most pronounced at 1 month after surgery. The scar may be elevated and red or hyperpigmented at this time. This is normal.
Your doctor will evaluate your scar at each follow-up visit. If needed, a small injection of steroid directly into the scar can help improve the appearance.
There are many “scar creams” that promise to improve the appearance of scars. I have not seen any good scientific evidence that they work well on the eyelid area, so I do not routinely recommend them. Keeping the incisions moist, initially with your prescribed antibiotic ointment and then with a small amount of Vaseline at bedtime for 1 month after surgery, can help keep them supple and promote healing.
To prevent hyperpigmentation of your scar, it is important to protect it from the sun with sunscreen every day (SPF 30+) and sunglasses when you are outside. You may apply sunscreen to your incision line starting day 14 after surgery. I recommend mineral based formulations (containing zinc oxide and titanium dioxide) as they are less irritating than chemical sunscreens.
Please remember that healing wounds take many months to mature. With each passing month, you will notice improvements in scar appearance and texture. It may take up to a year for your scar to become as soft and unnoticeable as desired.