I would like to get upper and lower blepharoplasty but am considering doing uppers first, lowers later or fillers.

To be honest, I'm scared. Realistically, how much time off work will I need? It would be difficult for me to take more than one full week. How many days are enough time to look somewhat decent upon my return? Also, I currently smoke 5 cigarettes a day and use nicotine products. How soon before surgery must I be off all nicotine? Can I use an electronic cigarette w/o 0 nicotine content during this time? Lastly, Is it standard to use stitches that dissolve? I appreciate all your replies!

Doctor Answers 12


First, you will need to quit smoking for at least a month prior and a month past your surgery. Second, you will need to take between 3-5 days off work. And third, you can do both the upper and lower together if you'd like. The advantage of the latter is that you have one recovery. 
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Dr. Sheila Nazarian
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Beverly Hills Plastic Surgeon
5.0 out of 5 stars 44 reviews

Upper and Lower Blepharoplasty

Hi Ravengrl

Thanks for posting your question.

It would be advisable, of course, to stop smoking, as this will not help with healing and recovery.

It is fine to have them done together as then you only have one lot of down time but would need between 1-2 weeks. You can take Arnica which would help with bruising and swelling, however everyone heals at different rates so it hard to tell when you could go back to work without anyone knowing. Generally speaking, the surgery is done with dissolvable stitches.

Do your research and find a qualified and experienced surgeon who can talk to you about your options.

Amir Nakhdjevani, MBBS, MRCS, FRCS (Plast)
London Plastic Surgeon
5.0 out of 5 stars 44 reviews

Blepharoplasty recovery

You have asked a lot of great questions.  I completely understand your trepidation with your upcoming surgery.  The whole concept of having your eyes operated on is a scary thought so I suggest becoming very comfortable with the surgeon who will be operating on you.  I would suggest stopping all nicotine products for about two weeks prior to your surgery and two weeks after surgery.  Nicotine negatively affects the microvascularity of your skin so without going into detail, the fewer negative issues you have going on around the time of surgery, the better you will heal.  I have stopped using dissolvable sutures in the upper eyelids as I felt that there was too many patients who had mild inflammatory reactions to the sutures which resulted in slightly prolonged redness of the incision site.  You will likely be able to return to work one week following your surgery but will likely need to apply makeup in order to help cover up residual bruising and redness.  Good luck!

Philip S. Schoenfeld, MD, FACS
Chevy Chase Facial Plastic Surgeon
4.6 out of 5 stars 23 reviews

Recovery after blepahroplasty

Hi. You have many good questions. It would be best for you to schedule a consultation with a surgeon that has expertise in eyelid surgery. Here are a few of my opinion regarding some of your questions:

-I typically tell patients hat they need 1-2 weeks before they look decent enough to return to work after upped blepharoplasty. Lower blepharoplasty (or all 4 lids) takes longer. You will still have some signs of recovery at 2 weeks, but you should be decent enough to go to work.

-I ask patients to stop smoking at least 2-3 weeks before surgery, but the longer the better. Cigarette smoke probably causes poor wound healing and scarring. In most circumstances, I will not perform cosmetic surgery on active smokers. The effects of e-cigarettes on wound healing has not been well studied, but I feel confident telling patients that it probably is not good for the healing process. 

-I typically use removable sutures because I feel they leave a nicer incisional scar. This is my opinion. I am sure there are surgeons that have good results with dissolvable sutures.

Hope this helps. Best regards, Ira Vidor, M.D.

Ira Vidor, MD
Newport Beach Oculoplastic Surgeon
5.0 out of 5 stars 6 reviews

I would like to get upper and lower blepharoplasty but am considering doing uppers first, lowers later or fillers.

You have many good questions that can best be answered after an in person evaluation. In many cases, if you are considering a lower blepharoplasty, it makes sense to do it at the same time as the upper. 

Karol A. Gutowski, MD, FACS
Chicago Plastic Surgeon
4.9 out of 5 stars 63 reviews

I would like to get upper and lower blepharoplasty but am considering doing uppers first, lowers later or fillers


Blepharoplasty is a very well tolerated surgery. You will bruise on your upper and lower eyelids regardless of whether you have just your upper lids done or both. Everyone bruises to a different degree but the bruising typically lasts 1-2 weeks. The type of work you do makes a difference as to how long you take off. If you do any sort of manual labor or heavy lifting you will want to take off longer than if you have a desk job (probably closer to 2 weeks). If you have a desk job or a job with light activity you can easily go back to work in one week but you may still have some swelling and bruising. You can cover this with makeup but you should be careful what kind and how much makeup you apply to the surgical incisions. Mineral makeup is usually well tolerated.

I recommend at least 4 weeks off all nicotine products prior to surgery and at least a couple weeks afterwards. As long as there is no nicotine in your electronic cigarette, then it probably all right. However, I don't know much electronic cigarettes. Nicotine interferes with healing and increases your risk of complications.

There is no standard suture to use for a blepharoplasty. Talk to your surgeon and express your preference. Many surgeons are flexible if you have a strong preference.

In general, I would recommend having both the upper and lower lid surgery performed at the same time. This way there will only be one down time. And the results will look harmonious. 

Good luck!

Jennifer Boll, MD
Tempe Plastic Surgeon
5.0 out of 5 stars 7 reviews

Recover From Blepharoplasty

Depending on what is done the recovery could be slightly different. Most patients can go back to work after a week with tinted glasses following upper eyelid surgery. With upper and lower blepharoplasty it may take 10 days to 2 weeks before the patient looks presentable.Rarely, brushing may last longer. Absorbable sutures are great for the eyelid surgery since the lids become very sensitive and removal sutures could be uncomfortable. We ask the patients to stop smoking for a month before surgery.
Doing upper and lower blepharoplasty would require only one anesthesia and recovery rather than 2, the accumulated cost would be less and there will be more harmonized rejuvenation of the eyelids thus the satisfaction would be greater. For all of these good reasons it would be more advisable to do upper and lower eyelid surgery at the same time.

Bahman Guyuron, MD
Cleveland Plastic Surgeon
4.8 out of 5 stars 20 reviews


You will likely be bruised for 1-2 weeks. I ask my patients to stop smoking 3-4 weeks prior to surgery and to stay off for 3-4 weeks after as well.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 24 reviews

Upper and lower blepharoplasty

 realistically, most patients need about 10 days to 12 days before the swelling and bruising gets better enough that they can be out without makeup.  If you are willing to wear eyeglasses or apply makeup, that number might be around 7 days.  Smoking is bad for any kind of surgery, but the skin of the face has great blood supply, and so as long as the patient understands that there is a slightly increased risk of complications, I have in the past performed blepharoplasty on patients who are smokers.  Some doctors used sutures dissolve and some do not, there are no standard because each Dr. will use their judgment and experience to do the best they can   For the patients.

Upper blepharoplasty

Upper blepharoplasty is a simple operation that is mostly done under local anesthesia.  I rarely do an isolated upper bleh under general anesthesia.

The procedure takes about 1 hour.  My patients normally have a bit of bruising and swelling for 7-8 days, but are comfortable returning to work with a bit of makeup in 5-7 days.

I usually use a permanent subcuticular closure, and remove the suture approximately 5-7 days after surgery.  My patient coordinator had the procedure done and returned back to work the same afternoon.  

Raghu Athre, MD
Houston Facial Plastic Surgeon
4.7 out of 5 stars 80 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.