Cold vs. Warm Compresses After Blepharoplasty?

Dear Rookshire

First the use of cold and warm compresses have much more to do with surgical tradition than evidence base medicine.  We as surgeons recommend these physical treatments not because we have a large body of scientific evidence demonstrating their effectiveness but rather, we recommend them because that is the way we were taught.  You can see that there is a general consensus that early on, cool compresses are used then later warm compresses.  

Do cool or cold compresses reducing swelling?  It is a good question.  Certainly many patients find the cold comforting.  This may be reason enough to recommend this treatment.  I personally believe that involving the individual in their own care is a helpful part of the healing process.  The fact is there are no great studies that answer these questions.  We do not know how effective cold compresses are or if they are effective at all.  There are reports of individuals over doing cold compresses and causing frost bite to the skin.  There is also a study of cold urticaria following eyelid surgery.  This is swelling and inflammation triggered by the cold compress.  

The same uncertainty exists for warm compressing after surgery.  

What to do?  Don't ask the pharmacist.  Please listen to your surgeon and follow their advice.  If you end up doing less compressing than recommended, remember the recommendations are intended to make you more comfortable.  If you are too cold and choose to to do less compressing, it is not likely to have much bearing on your ultimate outcome.

This is a great question! You will likely find a wide range of answers to this question and the biggest reason is there is not a significant amount of evidence that would dictate an exact recommendation for ice vs warm packs. In general, ice is best for the first several days to a week after surgery as this will help with inflammation. The reason that warm compresses are not recommended initially is that this will dilate the blood vessels which can bring more fluid into the area. These may become helpful later in the recovery process when the acute inflammatory phase has passed and you want to open the lymphatic channels to allow fluid to leave the operative area. At the end of the day, alot of the recommendations are surgeon preference more than exact science!
Hope this helps!Kyle Kimura, MD Facial Plastic and Reconstructive Surgery

Hi @Rookshire,
Thanks for the question! 
After a blepharoplasty, you can expect a week of bruising followed by another week of swelling. Adding other procedures may add a few days to recovery.
If you’re slow to recover with swelling try adhering to a diet rich in fresh fruits and vegetables, avoiding any salt whatsoever. This, combined with a few lymphatic massage treatments can do wonders for reducing facial swelling after an eyelid lift.

K. Chopra, M.D.

Plastic Surgeon

Johns Hopkins Trained

Face, Body and Breast Expert