Recovery Expectations After Eyelid Surgery (Blepharoplasty)

While not a guarantee for an individual's experience, this description may inform you on the usual recovery timeline after eyelid surgery (blepharoplasty).

 

Blepharoplasty removes extra skin, and sometimes a small amount of muscle or fat, from the eyelids. Upper eyelid surgery is often done to improve vision blocked by drooping skin, and may be done under local anesthesia with or without sedation. Lower eyelid surgery is more often cosmetic and has a somewhat longer recovery. Patients go home the same day. Pain is usually mild and most patients need only acetaminophen. Swelling and bruising peak around days 2–3 and are mostly gone by about 2 weeks, when most patients feel comfortable returning to work and social activities. Final results take several months as swelling fully settles.

Immediate Postoperative Period (Day 0–2)

Expect swelling, bruising, and a tight feeling of the eyelids. Eyes may water, feel dry or gritty, be sensitive to light, or have mildly blurred vision from ointment and swelling. Some patients cannot fully close the eyes for the first few days because of swelling; this usually improves quickly.

Cold compresses (clean gauze soaked in ice water, or a cold pack wrapped in cloth) applied for about 15–20 minutes at a time, often while awake for the first 48 hours, help limit swelling and bruising. Sleep with the head raised on 2–3 pillows or in a recliner for about the first week. Pain is usually mild; acetaminophen (Tylenol) is typically enough, and opioids are rarely needed. Avoid aspirin, ibuprofen, and other blood thinners, as well as fish oil and vitamin E, unless your surgeon tells you otherwise. Apply prescribed antibiotic ointment to the incisions as directed. You may eat a normal diet.

First Week (Days 1–7)

Bruising may spread down the cheeks and turn yellow or green as it fades. Gently clean crust from the incisions as instructed. Showering and gentle hair washing are usually allowed after 24–48 hours, keeping the face out of direct spray. Use lubricating eye drops as needed for dryness. Avoid bending over, heavy lifting, straining, and strenuous exercise for 1–2 weeks to reduce the risk of bleeding. Reading and watching screens are fine, but rest your eyes if they feel tired or dry.

Stitches are commonly removed around 5–7 days after surgery, unless dissolving stitches are used.

Weeks 2–4

Most visible bruising is gone by about 2 weeks. Many patients return to work in 7–14 days, depending on their job and comfort with their appearance. Eye makeup can usually resume about 2 weeks after surgery once incisions are well healed, using fresh products. Contact lenses are usually avoided for about 2 weeks, or until the eyelids are no longer swollen and lenses feel comfortable. Light exercise can usually resume after about 2 weeks and full exercise after 3–4 weeks. Wear sunglasses outdoors to protect the eyes and incisions.

Months 1–3 / Long-Term

The incisions are pink at first and fade over several months, and the upper eyelid scar usually becomes well hidden in the natural crease. Mild swelling, tightness, or numbness of the eyelid edge can last for weeks to a few months. Most of the final result is seen at about 3 months, with subtle improvements up to 6–12 months. Results are long-lasting, but aging continues, and eyebrow descent can affect the upper eyelid over time.

When to Seek Urgent Attention

Most problems after blepharoplasty are minor, such as dry eye, small cysts along the incision, or slight unevenness. Rare but serious problems include infection, wound separation, the lower lid pulling down or away from the eye (ectropion), trouble closing the eye, and bleeding behind the eye (retrobulbar hemorrhage). This last complication is very rare: vision loss after eyelid surgery is estimated at about 1 in 20,000 cases, and permanent vision loss at about 1 in 30,000, but bleeding behind the eye is an emergency.

Go to an emergency department or call your surgeon immediately for:

  • Sudden, severe, or worsening eye pain, especially on one side

  • Decreased vision or loss of vision

  • A bulging or hard-feeling eye, or rapidly increasing swelling on one side

  • Double vision that does not go away

Also contact your surgeon for fever over 101°F (38.3°C), increasing redness or pus-like drainage, incisions that open, or an inability to close the eyes that persists beyond the first several days.