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Blepharoplasty basics:

Blepharoplasty is a very commonly performed plastic surgery on the face, and it results in a youthful appearance above and below the eyes. The eyes are the centerpiece of your face. As such, they can lead to first impressions of a tired or aging appearance. 

Eyelids can sag for various reasons, such as photodamage, genetic factors, aging, and even placing contact lenses in on a daily basis over several years. The net result is the gradual descent of skin, fat and/or muscle. This can lead to large bags under the eyes, or ‘hooding’ as the upper eyelid obscures part of your visual field. A good blepharoplasty surgeon will need to identify what aspects of the skin, fat and muscle are contributing to the unwanted appearance and safely guide you through the surgical process.

Blepharoplasty is performed either in the office or operating room, depending in part on your preferences and Dr. Ashbach’s preferences for your exact needs. Dr. Ashbach and his team will also assess your eyebrow position, as many inexperienced surgeons may misinterpret your need for blepharoplasty when indeed you really need a brow lift. Don’t let that happen! You won’t be satisfied.   

Sometimes blepharoplasty is combined with other treatments, such as chemical peels, laser resurfacing, or even fillers to fine tune your results. 

Prepare for your blepharoplasty

The goals of preparation are to minimize the risk of complications, bruising, and to expedite your healing process. 

Two weeks prior to surgery, stop taking agents that can impede your body’s ability to clot.  Do not take products containing aspirin, ibuprofen (ex. Advil, Motrin), or Vitamin E.  Tylenol is okay to take. If you take Coumadin, plavix or other prescription medications to prevent clotting, be sure to discuss this with Dr. Ashbach. 

You should also not smoke for two weeks prior to surgery. Other products that contain nicotine, such as ‘the patch’ or nicotine gum, should also be avoided. These all tend to impede the healing process and increase the risk of complications.

One week prior to surgery, it is advised that you do not drink alcohol, as it also contributes to additional bleeding. If you color or perm your hair, hold off for one week prior to surgery and for three weeks after surgery.

At your local pharmacy, buy a bottle of artificial tears as well as an eye ointment called lacrilube. You will need this in the postoperative period to keep your eye moist. You will be given ice packs at the time of surgery to take home, but having a few extra or some bags of frozen peas to use at home is a good idea.

On the day of surgery, make plans for someone to drive you to and from the surgery location. If you are having general anesthesia or sedation for your procedure, do not eat or drink anything after midnight the day prior. If you need to take medications, do so on the morning of surgery with a sip of water.

Blepharoplasty post-operative instructions

Plan to take it easy for the first three days after surgery. This means getting plenty of rest, and avoiding any strenuous physical activity such as running, lifting or trying to fully manage a household. It is advised to go for a short and easy walk the day of surgery to help with circulation. Sleeping at a 30 degree angle, such as in a recliner, for the first night will also help with swelling and bruising.

For the first 48 hours, try to keep the ice packs on your eyes for at least five minutes every hour while you are awake. Use a few drops of artificial tears into both eyes every hour while you are awake. Use the thicker lacrilube eye ointment at night before you go to bed to keep the eyes good and moist. It is okay to put this over any sutures you make have, too. 

Take pain medication as prescribed. Do not take aspirin or any products containing aspirin unless approved by your surgeon. Do not drink alcohol for a few weeks, as it can lead to additional swelling and bruising. If you are taking vitamins with iron, resume these as tolerated. Do not smoke, as smoking delays healing and increases the risk of complications.

You can shower the day after surgery. Just let the water run over your face. It is okay if shampoo accidentally washes over the incision area. Avoid scrubbing the eyes with your hands or a washcloth.

Sometimes the incisions accumulate some dried blood or crusting around the edges. Keep the incision area clean with q-tips that have been moistened with clean water. After cleaning, apply a thin layer of Vaseline or lacrilube over the incision line to keep it moist.

If you have sutures, they will be removed around postoperative day 5. This is an uneventful and essentially painless process. 

It is important to avoid sun exposure to the incision area for at least six months after surgery. Use an eye-safe sunblock that is SPF 30 or greater for this.  We have options available for this in the office.

When to Call

Call our office if you are concerned, or if you have any of the following:

  • Increased swelling, redness or bruising after a few days
  • Pain not relieved by medication
  • Adverse side effects to medications; such as, rash, nausea, headache, vomiting
  • Fever over 100.4 degrees. 
  • Yellowish or greenish drainage from the incisions or a foul odor. 
  • Bleeding from the incisions that is difficult to control with light pressure.  If you have loss of feeling or motion.


If you would like to discuss this procedure with Dr. Ashbach, call the office and set up a consultation.