How long should I be icing if swelling is still present after an upper and lower eyelid surgery?

Question

Should ice be applied 20 minutes out of every hour? Should the ice bag be directly applied to the incision or should there be a cloth between the ice and incision?

Ritchie Younger, MD · Answer

There is no absolute right answer to your question as topical ice following facial surgery is not really a perfected science-but indeed we recommend to our patients that they will minimize swelling and bruising following blepharoplasty if they start out with frozen small vegetables (corn or peas works well in a plastic bag), over the counter iced gel bags or loosely filled plastic bags filled with ice cubes.  Place a small bathroom or kitchen face cloth between the bag and your skin to prevent actual freezing of the skin, and think about applying the icy cocktail on your face for twenty minutes every three hours for the first 48 hours.  After 48 hours you could then reduce the ice application to twenty minutes every 6 hours-continue that until you see your surgeon-generally at about one week following surgery.

Jacqueline T. Cheng, MD · Answer

Icing or application of cool compresses is a common recommendation by plastic surgeons after eyelid surgery. If you use ice, in the form of a bag of small frozen vegetables, a gel pack or a plastic bag of ice cubes, make sure to place a cloth between your eye and the ice to prevent damage to the skin. If you prefer a cool compress, simply soak a cloth in a bowl of ice water, wring it out well and place it over your eyes. The protocol for icing varies from surgeon to surgeon. Most advise patients to ice for 20 minutes every hour or two during the first 48 hours after surgery. If you are still experiencing significant swelling, you can continue the ice for an extra day or two. After the fourth day, we generally recommend warm compresses instead of ice, unless the ice offers greater comfort. You can also reduce swelling after eyelid surgery by resting with your head elevated for a number of days.
Thank you.
Best,
Jacqueline T. Cheng, MD

Elba Pacheco, MD · Answer

Hi and thank you for your question. The rule of thumb is that icing or cool compresses are most effective in the early post-op period, while the swelling is still evolving. Once the swelling begins to turn the corner, usually on day 4, then using warm compresses is recommended. That said, icing will not hurt your results if you prefer it over warm compresses beyond the third day. Best of luck!
Dr Elba Pacheco

Steven Wallach, MD · Answer

Each doctor is different, I have patients use frozen peas or ice with a barrier for 20 minutes on and 20 minutes off for the first night.  Best to review with your surgeon.

Sara A. Kaltreider, MD (retired) · Answer

You will hear many opinions on timing and technique... but this is what I tell my patients. Fill a bowl with clean water and float a few ice cubes. Use a face cloth dipped and wrung out. Fold twice to form a rectangle and place over both eyes. Dip the cloth when it becomes warm. The cloth conforms to the contours of the eyelids, providing cool wetness, and is not heavy on the eyes or lids. If you are bored, do one eye at a time and watch a good movie.
Frozen vegetables may be heavy and too cold for comfort. You don't need to have ice or frozen veggies on your eyelids - just a cool wet cloth. I have my patients use the cool compresses continuously while awake. Take breaks for food and rest room. Stop when you go to bed. Do this for 48 hours - or more if it makes you comfortable and you want to continue. After 48 hours +/-, use warm compresses in the mornings to partially remove the old ointment and any debris, dabbing lightly - don't wash or scrub! The closer my patients adhere to these instructions, the less swelling and bruising they will have when they come back to the office for followup.
The cool compresses also serve to keep patients occupied so they do not try to get back to their activities. It is important to avoid aerobic activity, lifting, bending, straining... so if you are doing compresses for 48 hours, you are not getting into trouble!
Best wishes with recovery!

How long should I be icing if swelling is still present after an upper and lower eyelid surgery?

Answers (5)

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