A staff member from the office will call you 24 hours prior to your appointment to confirm the time of your procedure.
If you are scheduled to arrive at 6.00am please ensure you allow for traffic conditions, rain etc and arrive punctually at 6.00am.
Please note that for morning procedures, you must be nil by mouth from midnight the night before, although you should take your normal medications with a mouthful of water.
If you have an afternoon procedure you may have a light, early breakfast but no coffee.
Please note that if you have a cold sore on your face your procedure will need to be cancelled.
You will remain drowsy for up to 24 hours following the procedure. For this reason, you must arrange an adult to care for you during this period.
We also ask that you do the following:
1. Due to the sedation, you will legally not be able to drive for 24 hours. Please arrange for transportation home after your procedure and for transportation back to the surgery the next day for your check up. The person who you arrange for this must be nominated with their contact details at the end of this form. This must be an adult that you know and cannot be an Uber or taxi driver.
2. If you live alone and are unable to arrange a carer for the 24 hours following surgery, we can recommend that you contact Right At Home – In home care and assistance.
Phone: 1300 362 609 1300 363 192 0478750192
www.rightathomeaustralia.com.au
3. Furthermore, you should also not operate machinery or sign any important documents in the 24 hours following surgery. Also avoid being in a situation where you will need to negotiate stairs or an unfamiliar environment.
4. Avoid aspirin, aspirin-containing or aspirin-like medications (eg: arthritis medicines, some cold and flu remedies, Nurofen or Ibuprofen), Vitamin E, (or multi vitamins that contain Vitamin E) fish oil, glucosamine supplements, gingko biloba, ginseng, valerian, black cohosh and chondroitin sulphate, These have been known to thin the blood and prolong bleeding. Avoid these for 2 weeks before surgery.
5. If you use prescription “blood thinners” such as Warfarin, be sure to discuss this with your doctor well in advance of your surgery.
6. Apart from those items listed above, continue using all of your regular medications in their normal dosages. Be sure to discuss this with your doctor.
7. Try to minimize smoking in the two weeks prior to surgery.
8. Avoid alcohol for two weeks prior to your surgery and for three weeks following your surgery. This also acts to thin the blood and prolong bruising.
9. Remove all nail polish prior to surgery.
10. Supplies that may be handy in the immediate post-op period:
· Ice cubes, ice packs or packs of frozen peas
· Several clean washcloths or “Chux” type cloths
· A small supply of sterile gauze pads
· Paracetamol
· A pair of dark, wrap around sunglasses.
11. In addition, you will be sent a prescription for antibiotics and antibiotic ointment. Please also purchase arnica spray or tablets from a pharmacist or health food store and use under the tongue 4 puffs or tablets 3 times daily commencing 2 weeks prior to the procedure.
This helps minimise bruising.
ON THE MORNING OF SURGERY
· Shower and shampoo. Wash your eyebrows and thoroughly remove all cosmetics. Do not reapply cosmetics to your eyelids or face.
· Do not wear jewellery, wristwatches, hairpieces, false eyelashes, or contact lenses. Do not bring articles of value with you. Wear loose-fitting comfortable clothes. Avoid tight collars or belts.
· If you use prescription medicine or eye drops on a regular basis, take your regular dose on the morning of surgery. This is especially important with blood pressure medicines.
THE OPERATION FROM THE PATIENT’S PERSPECTIVE
Following signing of the surgical consent form, you will be taken to a room to be prepared for surgery.
While the nursing staff should already have a copy of your medical history and physical examination from your doctor, be sure to discuss any special or unusual medical requirements or concerns with the staff, including allergies to medications, problems with abnormal bleeding, or asthmatic reactions.
You will be asked to put on a surgical gown and then a small intravenous cannula will be inserted into your hand. All your particulars will be double checked by the nurse.
You will then be moved into the operating room and monitoring equipment will be attached to you. You will be given some sedation into the cannula in your hand to help you relax and drift off.
Bandages are not applied after blepharoplasty. A pair of dark wrap-around sunglasses are protective.
On the drive home, it is preferable to recline your seat back lightly and keep your eyes closed.
If you prefer to keep your eyes open, don’t be surprised if your vision is blurry. Your eyelids will feel puffy and will not blink very well.
ON THE AFTERNOON AND EVENING OF SURGERY
You should rest as much as possible. A bandage over the eyes is not necessary. In the evening, you may have a bath if someone is there to help you. Watching television is acceptable.
Apply clean cold compresses to the eyelids as much as possible until you go to sleep. We recommend a frozen gel pack or a bag of frozen peas placed over a moist gauze or towel.
Pain after surgery is generally mild and controlled with Panadol. Severe pain should be reported.
If your stomach is not upset, you may resume your normal diet immediately.
It is normal for the eyelids to become red, swollen and bruised. A small amount of bloody fluid draining from the wound is typical. Brisk bleeding not responsive to pressure should be reported.
Discomfort or pain will occur, post procedure. In this instance, Panadeine Forte (for strong pain) can be taken every 6 hours. Alternatively, Mersyndol (for mild pain) can be taken every 6 hours. Do not take both together as both preparations contain paracetamol. Also, do not take these medications closer together than every 6 hours because excessive paracetamol is dangerous. The maximum combined dose of these 2 tablets in 24 hours is 8. ie: if you have taken 4 Panadeine Forte in 24 hours you can only take 4 Mersyndol in 24 hours.
Excessive Paracetamol is dangerous, please follow these instructions carefully.
BEGINNING THE NEXT MORNING
Swelling usually reaches its maximum on the morning after surgery. Bruising may increase for several days.
Moderate activity may be resumed, although bending and straining should be avoided for at least three days. Moderate exercise (easy walking) may be resumed in about three days. Avoid vigorous exercise (jogging) for ten days or more and swimming for three weeks.
Reading or computer work may feel difficult, but such activity is not harmful to your surgery.
Keep the incisions clean by gently cleansing with moistened cotton tips or gauze. If water alone is insufficient, a mixture of 3% hydrogen peroxide diluted half and half with water may be used. If bleeding is activated, apply pressure.
You may shower and wash your hair, but avoid getting soap in the incisions.
If you are still nauseous from the operation let us know. Also tell us if you are not keeping down fluids or only passing small amounts of urine.
In this case we may need to give you some intravenous fluids.
LATER INSTRUCTIONS AND INFORMATION
It is not unusual for some of the sutures to untie after several days. As long as the incision remains closed, this is not cause to worry.
Sutures are removed 7 days after surgery.
After the sutures have been removed, use the ointment that evening and then discontinue. Warm compresses should be used for three or four more days.
The eyelids may not close fully during the first weeks after surgery. During the day, the use of any over-the-counter artificial tear preparation may feel soothing. At night, a lubrication ointment may be placed directly on the eye.
After three days, the light application of a concealer make-up to the upper cheek area may help to camouflage bruising. Regular eyelid cosmetics may be resumed after ten days.
Most of the bruising looks the worst on the second or third day, after which improvement is rapid. Most bruising and swelling is gone by two weeks, although some might remain for six to ten weeks.
Contact lens wear may be resumed in about one week.
The incision may turn red, elevated, or bumpy in the weeks after surgery. The scar will then continue to fade and soften for about six months or more.
The incision may feel slightly tender for a few months. Itching is common. Any tight feeling or eyelash numbness will disappear over several months.
Do not try to evaluate the success of your surgery during early recovery. Imbalances between the two sides are common at first due to swelling and variable rates of recovery. Full recovery of any incision on the body can take six to nine months or more in some cases.
HEALING AFTER BLEPHAROPLASTY
One concern with healing after blepharoplasty is that your face and eyes are always on display. Not only does this encourage you to monitor every change, but it also makes the process seem to last a lot longer.
Healing during the immediate post-operative period has been summarized elsewhere. Expect to wake up the day after surgery, study yourself in the mirror, and then question why you voluntarily did such a thing to yourself.
Swelling can be marked. Fortunately, improvement is rapid. Once you are upright, gravity will drain some of the swelling into your cheeks. Normal blinking pumps away some of this initial inflammatory swelling.
The difference between eyelid bruising and most other bruises is that the eyelids don’t require very much blood to become discoloured. A few drops mixed in with tissue fluid can tint the thin skin of the eyelid region.
The intense redness of the first few days will give way to a purple and finally a yellow discolouration that appears just prior to full disappearance. The last area to clear is at the top of the cheek.
If itching becomes a nuisance, switch back to cold compresses.
Numbness of the lashes on the upper eyelid is a temporary nuisance. Sensation will begin to return at around one month.
While most bruising is gone in about two weeks, about 10% of the swelling will persist much longer. You will notice that your eyelids continue to “thin out” for four to six months.
All scars go through phases as they heal. At first the scars will look red and slightly thickened. Small cysts may appear but almost always disappear without treatment. Once a scar is well-healed, it will appear as a thin white line.
You will notice day–to-day improvement at first, then week-to-week improvement for a month, then month-to-month improvement for six months or more.
While scientific evidence is lacking, many patients know other patients who have experienced superb healing while applying Vitamin E. You should wait about ten days before applying Vitamin E to prevent the oil from getting between the wound edges and interfering with initial closure. Some people may be allergic to Vitamin E applied topically, so it is wise to “skin test” your arm for a few days before placing it on your eyelids.
Just as the surface scars take time to soften, so do the “internal” scars. Until this process is well underway, the eyelids may feel a bit stiff and not “drape” freely. Time is usually curative.
Most patients feel comfortable about facing the general public again in about 10-14 days. How long before you look your absolute best? About four to six months.
Please write the arrangements you have made for someone to drive you home following the procedure:
Dr. M Szalay 