The following guidelines about blepharoplasty will help you prepare for your surgery and recover from it. Pre-Surgery Guidelines Maintain proper skin care: this includes daily use of a broad-spectrum SPF 30 sunscreen, regardless of whether there is outdoor sun exposure or just the general exposure of daily life. Lanjun Nie, Department of Burns and Plastic Surgery, The Second Affiliated Hospital of Nanjing Medical University Maintain a balanced diet: this is necessary for optimal healing from subsequent surgery. Special vitamins and supplementation prior to surgery will also be recommended by your physician. Stop ingesting the following items 2-3 weeks prior to surgery as they can increase your risk of bleeding and other complications: Aspirin and aspirin-containing medications; Ibuprofen and anti-inflammatory factors; Vitamin E; Ginkgo; Garlic supplements; Green Tea or Green Tea Extract; Estrogen supplements. Stop smoking: Smoking adversely affects your ability to heal. You must leave nicotine and cigarettes 3 weeks before your surgery. This includes any nicotine-based products (e.g., nicotine tablets, gum, and chewing tobacco). Nicotine reduces blood flow to the skin and can cause significant complications in the healing process. Stay healthy: Maintain optimal health and hygiene prior to surgery. Colds, viruses or other illnesses may delay your surgery. Contact your physician if there is any illness or change in health status. Plan accordingly: Discuss with your physician the time you need to stop working and other restrictions such as driving, lifting, housework and exercise. Create a safe environment at home. Familiarize you with post-surgery guidelines before the procedure. Arrange for a responsible adult to drive you to surgery and stay with you for at least 24 hours afterward. PRE-SURGERY EXAMINATIONS: Any pre-surgical tests and drug clearance tests ordered by your physician. Prescriptions: Your physician will provide you with prescriptions for your medications for the days leading up to your surgery and the day of your surgery. You will have pain medication and possibly antibiotics and other supplements. SUBSEQUENT PRE-ANESTHESIA INSTRUCTIONS: You will not be allowed to eat or drink anything after midnight. This includes no candy, gum or mints. On the morning of surgery take only the removal medications your physician has given you. Any more than 1 sip of water as swallowing medication or brushing your teeth could result in an unwanted surgery cancellation. Bathe the night before and the morning of surgery: use antibiotic soap. Do not use any lotions, cosmetics or hair products on the day of surgery. Wear comfortable clothing: wear comfortable, loose-fitting clothing that does not require a head covering. The best thing to wear is button-down or to-the-top zippered and elastic waistband pants. You will need flat shoes that are easy to put on. Wear or bring a pair of warm socks as it is cooler in the operating room. Do not wear makeup, any style of jewelry, contact lenses, hair clips or body piercings: if this has any items that cannot be removed, it is recommended to get permission from the nurse Relax: some anxiety is normal before surgery, try to get enough rest and avoid unnecessary stress. If you have a severe stress or adverse reaction to the procedure or have difficulty sleeping, please contact your physician. Post-Surgery Guidelines To help you achieve optimal results and healing, follow the instructions given to you by your physician. Here are normal reactions to eyelid surgery and possible experiences that may require further attention from your physician. Expected Post-Surgical Experience These include: Swelling and bruising around the eyes and cheeks. You may have a “tight” feeling in these areas. Dry, uncomfortable and irritated eyes. There may be tenderness and decreased sensation at the incision site. Temporary, mild blurred vision. Please take pain medication for any immediate discomfort. If you have continuous pain that is not relieved by pain medication, contact the clinic immediately. Apply 1 cold compress to the eye for 20 minutes. Avoid applying pressure or any ice in direct contact with the skin or around the eye. Avoid applying hot compresses. Contact the clinic quickly if you feel any of the following: sudden visual changes, pressure or pain in 1 eye more than the other. Pain that prescription medications don’t work. Bleeding or drainage from the incision site that is worse than expected. Temperature over 101°F, severe nausea and vomiting, persistent dizziness or erratic behavior. , Day of Surgery Rest and still stay active: rest is important during the healing period, but so is brief indoor walking (5-10 minutes every 2 hours while awake). Keep your head elevated while resting: resting with 3-4 pillows on your back, or a recliner will keep you more comfortable and reduce swelling. Avoid any bending, reaching or lifting heavy objects (anything over 10 pounds). FLUIDS AND GOOD NUTRITION: It is important to drink enough fluids after surgery. Avoid sodium, caffeine, hot, cold and alcoholic beverages. Try to drink a minimum of 8oz every 2 hours. it is best to eat very soft foods or nutrient solutions for the first 24 hours. Take all prescription medications straight away. Pain medications can cause constipation, so increasing your fiber diet or stool softeners may be helpful. Sutures: if you have external sutures, corneal contact sheets/straps, or scabs at the eyelid incision, do not remove them. You can perform direct cleaning or apply ointment to these areas. Avoid contact lenses: they are usually maintained for 1 week after surgery, however they need to be checked by your physician. Don’t smoke: Smoking affects your ability to heal. You must not smoke for 3 weeks. This includes any product that contains nicotine (e.g. nicotine tablets, gum and chewing tobacco). Nicotine reduces blood flow to the skin and can cause significant complications in the healing process. Remember, same day surgery does not mean same day recovery. Healing is a gradual process. It is normal to feel frustrated while waiting for swelling, damage, discomfort and numbness to return. It is important to think of yourself as a patient! Adequate rest, a nutritious diet and avoiding stress are important for recovery. 2 to 7 Days After Surgery During this period, you will be improving from day to day. Slowly increase your daily activities.? Once you return for your post-surgery visit, your physician will advise you on when you can drive, return to work or your daily routine at home. A consistent well-balanced diet: you may experience discomfort with chewing. Shade: This includes daily use of broad-spectrum SPF 30 sunscreen, with or without outdoor sun exposure or just general exposure from daily life. Bring 1 hat to limit exposure to cover your nose. Skin Care: Avoid hydroxyacetic acid, retinoids, or other potentially irritating skin care products until your physician has considered them. , ? -Continuous antibiotics or other medications recommended by your prescription: at this point, you can gradually switch your prescription painkillers to paracetamol. Keep your head elevated when you sleep. Continuously avoid any bending, straining, lifting weights or anything that increases pressure on your head and neck. Avoid exercise other than walking: daily walks can help you prevent blood clots forming. Continuously limit smoking and alcohol. 1 to 4 Weeks After Surgery As you return to your daily life, you need to remember that you are still in the healing period and that defined restrictions and proper care are still the focus.? Damage and swelling begin to improve significantly during this period. Maintain proper skin care: this includes daily use of a broad-spectrum SPF 30 sunscreen, regardless of whether there is outdoor sun exposure or just the general exposure of daily life. The nose and surrounding areas are more sensitive to sunburn or increased hyperpigmentation. Bringing 1 hat will help protect you. Maintain a well-balanced diet: this is necessary for optimal healing after surgery. Continuously limit smoking. Rest or sleep semi-reclined. Avoid lying flat or prone. If you must sleep this way, place 2 pillows on your head/face. 4 to 6 weeks after surgery All swelling continues to subside and you will begin to “settle” into your natural appearance. Tenderness, tightness or numbness of the skin will continue to subside. Once your surgeon has cleared you, you will be able to begin your daily routine with confidence. Discuss any contact with sports and further protection with your practitioner prior to recovery. The First Year After Surgery Your eyelid performance will continue to refine for several weeks to 6 months until complete healing has occurred. Once healing is complete, your physician will determine if further refinement needs to be recommended. Your appearance will continue to change as you age. Just as the rest of our face and body changes with age, so do our eyelids.