Social Downtime After Blepharoplasty?

Great question.
It depends on whether you're doing just upper lids or considering either lower lids alone or upper and lower lid together.
Upper lid surgery typically has a quicker recover than any surgery involving the lower lids.
In our San Francisco area practice we explain to patients that upper lid blephs are usually done as outpatient surgery meaning patients go home the same day. The first 24 hours cool compresses and head elevation help reduce swelling. Typically some pain medication may be required for the first day or two. We recommend reduced levels of activity for the first week to lower possibility of bleeding complications.
There are sutures that are typically removed day 4-5.
Patients usually are a bit bruised and swollen for about two weeks. The incision line may be slightly red and raised as it heals for the first month.
Socially patients are usually fine to go out and about shopping with sunglasses after the sutures come out.
Most patients can camouflage any residual bruising with light makeup at 10 days.
Lower lid blepharoplasty can involve more swelling and bruising and has a larger occurrence of black eyes. We usually explain to patients that having the lower lids done will add about a week to the recovery milestones (other than the timing of suture removal) listed above.
I hope this helps!

Blepharoplasty recovery varies from patient to patient and depends upon a large number of variables. Most patients feel pretty good in about two to three days following surgery, but their primary concern is when they will look good enough to go out in public. Recovery following blepharoplasty surgery may last for months, but most patients feel they can go out in public in about a weekIt's important to emphasize that recovery periods are variable and depend not only on the patient's wound healing characteristics and the surgical techniques utilized, but also the patient's tolerance for changes that may occur following blepharoplasty surgery.

Usually the downtime is 7-10 days, but it may be longer depending on how one bruises and the type of blepharoplasty you have.

I tell my patients not to plan any big social events (weddings, reunions, etc.) for 2 weeks after eyelid surgery. Most patients can go back to work within 5-7 days depending on the type of work.
Sutures will be removed around day 5 and most of the bruising and swelling will be resolved by day 7. Each patient is different and these times may vary by a day or two either way.
Not taking any medications that can cause bleeding, head elevation, cool compresses and taking it easy can help you have a speedy recovery.

Your downtime will depend on which eyelid procedures you end up having done . Most of my upper blepharoplasty patients have their sutures remove after 5 to 7 days and are back to work in a week. Lower blepharoplasty recovery will vary from one to two weeks. Bruising can last one to two weeks, but Arnica Montana has been shown to shorten this period.

Dear Brdlvr
Remember that that are several time frames for healing after eyelid surgery. The one we are talking about is when will you be ready for social activities. This means at what point can you go about socially without most people noticing that there is something about your eyes. Generally bruising following eyelid surgery resolved at the one-week time frame but the eyelids are generally quite swollen. After a few more days this begins to settle down. Steroids can speed up this process but there are also significant downside risks with steroids including but not limited to mood disorders. So except for usual professional circumstances (actors, judges, etc) we avoid steroids.
However, this does not mean that you are fully healed from your eyelid surgery. I generally allow my patients to go for a walk (under 3 mph and less than an hour) on the day after surgery but no vigorous activity (including vigorous sexual activity) for 3 weeks. It is generally about 6 to 8 weeks for much of the eyelid swelling to resolve but this type of swelling will only be visible to you and your doctor.
Regarding the claim that you should only go to a board certified plastic surgeon, beware that there are actually several specialties that offer cosmetic eyelid surgery: General plastic surgeons, facial plastic surgeons, oculoplastic surgeons, and some cosmetic dermatologic surgeons. There are no studies establishing that one of these specialties does better surgery than another. Also credentials alone do not make for a good surgeon. I think that it is helpful if your surgeon is board certified in ophthalmology, general plastic surgery, or otolaryngology and fellowship trained in oculoplastic surgery, facial plastic surgery, or cosmetic surgery.
However, these qualifications do not guarantee the quality of the work. Contact the medical board that licenses the surgeon to learn if there are any disciplinary actions against this doctor. Any doctor that has been in practice long enough may have been sued for medical malpractice. In particular, you should be concerned if the surgeon has been sued successfully multiple times. Also, is there a history of a criminal conviction? Often these individuals regain their medical license but what does a history of a criminal conviction say about the basic honesty and integrity of you doctor? Is your doctor proposing to do your cosmetic surgery as a medically necessary surgery? This may help you financially but what does this criminal behavior say about your doctor? And no-not everyone does this. Does your doctor have hospital privileges at a reputable hospital near their office? Has the doctor ever lost hospital privileges because of disciplinary action? Upstanding surgeons have no trouble answering these types of questions and they also wash their hands before touching you.
Next, consider the before and after photos of your surgeon. If you don't like what you see, remember this is what the doctor feels is their very best work. If you don't like what you see, don't assume your results will be any better. Ask yourself how you were treated at your consultation. Was the staff courteous and informative, or did you feel like you were a burden. Who did you see during your consultation? Was it just the surgical counselor or did you actually get to see the surgeon? Your surgeon should not be so busy that they have not time to personally meet with you. There are offices that operate this way and it is not appropriate. Did you get all of your questions answered? Did your surgeon make sense? Did your potential surgeon make you feel comfortable?
I am a board certified ophthalmologist and have completed multiple fellowships in both eye plastic surgery and cosmetic surgery. My bias is that the board certification in ophthalmology and fellowship training in eye plastic surgery are invaluable for performing eyelid cosmetic surgery at the highest level. I also think that it is helpful to look for a surgeon with a university appointment who also is involved in teaching other surgeons, contributes to the scientific literature, and develops new procedures. We are out there; you just need to know what you are looking for.

Lower eyelid blepharoplasty can be performed from both the outside (transcutaneous) or inside (trans conjunctival) of the eyelid. 99.9% of the 3000 cases I have performed as an Ocular Plastic Surgeon in Sterling Heights, Michigan have been transconjunctival. The advantage of my technique is: NO stitches; NO skin incision, and NO Scalpel blade. I perform the procedure with the MIXTO laser.
This carbon dioxide (CO2) laser allows me to gently remove the fullness ( fat) from the inside of the eyelid. The beauty of this laser is that it stops bleeding as it removes this tissue so the surgery is faster and my patients have less swelling (than traditional methods) and get back to work faster. Instead of removing skin, which can leave a tell tale scar line underneath the lashes, I tighten the skin with the Mixto laser! The Mixto is phemomenal to resurface (refresh) the skin. Smoothing of the skin with the laser is a perfect accompaniment to lower eyelid surgery.
The use of the laser allows my upper eyelid patients to return to social activities within 3- 7 days. This depends upon many factors: what type of social activities; medications or disease conditions that the patient may have that increase swelling; what their work activity is ( are they at a desk or in a dirty environment). As the other doctors note even if things go perfectly, you could cough or sneeze after surgery and cause significant swelling that requires 2 weeks to resolve.

You will have swelling and bruising after blepharoplasty. Often, upper eyelid lifts tend to heal a little faster than the lower eyes, but not always. In general, I would recommend to give yourself 10 days before easing back into life. If it is quicker, you will be happy. It may be a bit longer, especially if you are prone to easy bruising.
But in general, talk to your blepharoplasty surgeon to learn about his experience.

While every patient is different, most people return to an office job 7 to 10 days later. I had a blepharoplasty on both my upper and lower lids 26 years ago, and went to a party on the 8th day.

I did wear glasses and a tiny bit of makeup, but only one person at the party noticed the remaining bruise. At 14 days, I returned to work, and did not tell my future wife what I had done until a few days later. Her response was "I thought your eyes looked brighter, but as I had not seen you for 2 weeks, I just thought you finally had some rest!"

In general, I believe the recovery is a bit shorter when only the upper lids are done, however if you have puffiness on the lower lids my suggestion would be to have it taken care of at the same time.

The recovery time for a blepharoplasty varies from patient to patient and depends a great deal on you, since everyone heals differently.  The most significant swelling and bruising occur in the first few days and then subside fairly rapidly. Typically, patients take off from work anywhere from 3 days to 1 week if they are not concerned about people knowing that they had surgery. Others wait until 10 days to 2 weeks following surgery to return to work. Healing will continue and swelling will further diminish after that time. Cosmetics can help camouflage any bruising or redness that remains. After surgery, wearing sun glasses that block UVA and UVB rays and using sun screen are important.

 

Recovery time after eyelid surgery depends on a number of factors:


A history of bruising easily.

Overall medical status.

Whether surgery is on the upper lids alone, lowers alone, or both.

The surgical approach: Laser resurfacing may prolong the recovery.

Smoking which delays healing.

Blood-thinning medications and supplements should be stopped 8-14 days prior to surgery. This includes prescription medications, low dose aspirin, anti-inflammatories, non-prescription supplements like vitamin E and fish oil. Discuss with your surgeon the medications and supplements that should be stopped and those that need to be continued.

Use of post-operative herbal supplements such as arnica montana and bromelain may promote healing and reduce bruising and swelling.

Following all instructions: iced compresses, head elevation, exercise restrictions.


 

Your specific concerns should be discussed with your plastic surgeon at a consultation.

 

 

Robert Singer, MD  FACS



La Jolla, California