In a previous blog, we discussed the importance of a pre-operative evaluation in guaranteeing the best possible outcome. With a good grasp of the patient’s expectations, the doctor can choose a surgical approach that addresses those expectations and achieves a natural and long-lasting result.
However, the success of the operation doesn’t stop in the operating room. The patient [1] shares in the responsibility of a favorable outcome! This responsibility begins before the surgery. Patients must follow the surgeon’s instructions to prevent complications during, and after, the procedure. These instructions include a list of medications that should be discontinued a week before the operation.
Once the patient leaves the operating room, he or she is responsible for ensuring that the healing process flows smoothly by protecting the operated areas from the harmful effects of the sun and by preventing unnecessary inflammation of the incisions.
Post-surgery instructions can be divided into two categories: the things you should do and the things you must avoid doing. We refer to these as the do’s and don’ts of postoperative eyelid care.
The DOs after eyelid surgery
These are several things you should DO after your surgery to ensure the best possible outcome:
DO have all post-operative supplies available at home. You can purchase these a few days before your surgery. These include sterile gauze, cotton tip applicators, distilled water, alcohol swabs and gloves. A bag of frozen peas and a u-shaped pillow (the kind used for travel) are also very useful.
DO apply cold compresses over the operated areas the first day of surgery. You will be instructed to do this for 5 to 10 minutes of every hour while awake during the first 24 hours. Your bag of frozen peas in the freezer serves as a great cold compress over a clean gauze.
DO keep your incisions clean and protected. Wash the incisions with baby shampoo and warm water twice a day, pat them dry with a clean towel, and apply a very small amount of ointment with a cotton-tipped applicator. It is not necessary to apply lots of ointment; a little bit goes a long way in protecting your incisions.
DO take all medications as prescribed by your doctor after your surgery. This includes putting drops in your eyes, as needed, and applying ophthalmic ointment over the incisions with a cotton applicator.
DO sleep with your head in an elevated position the first week after the operation. This is perhaps the most difficult thing to do for most patients, especially for those who are used to sleeping on one side. A u-shaped pillow comes in handy as you can place it around your neck while sleeping to help prevent your head from rolling over on its side. Sleeping with your neck supported by a pillow in a recliner is a good, comfortable option and should be tried the first postoperative week in order to prevent excessive swelling in the operated areas.
DO protect your eyes from UV light. Wear a loose hat and UV protected sunglasses when outdoors, even on cloudy days. This will ensure the incision does not take on a dark pigment.
DO rest after your surgery. Take at least 24 hours to rest before taking up light work such as answering emails, etc. When taking up activities such as watching tv, working on the computer or reading the first couple of days after the surgery, limit these to no more than 2 hours at a time in order to prevent eye fatigue.
DO keep your post-operative appointments with your doctor. It is important that your doctor remove your sutures within 7-10 days after surgery and evaluate your healing process. Follow-ups generally include next day, one week, one month and three month appointments.
The DON’TS after eyelid surgery
One of the main reasons that postoperative complications occur is that patients don’t follow their doctor’s instructions regarding postoperative care. Here are several important things you must NOT DO after your eyelid operation:
DON’T lift heavy objects the first 3 to 7 days after your surgery. Depending on the procedure, heavy lifting and prolonged bending over the waist may cause excessive swelling and bruising. It may also cause bleeding from the surgical sites. You should avoid lifting more than 5 pounds the first week for most surgeries, although with some procedures, you may do so after a couple of days.
DON’T touch the incisions, unless you have washed your hands or are using clean gloves. Avoid stretching or pulling on the incisions at all costs. If the skin itches, you can gently massage it with a wet gauze. If there is oozing through the incision you can dab it with a wet gauze; avoid doing so with a dry gauze, as this will cause the gauze to stick to wound.
DON’T take medications or apply any cream to your incisions that was not prescribed by your doctor. This includes creams and lotions that are supposed to help reduce scarring. You should only take medications and apply ointment as instructed and prescribed by your doctor.
DON’T enter pools or ocean water until the wound has properly closed, usually a week to ten days after the operation. This point is important for preventing infections.
DON’T hesitate to contact your doctor if you have questions or concerns after your surgery. Especially if you experience unusual pain or bleeding, contact your doctor immediately.
A successful outcome in eyelid surgery is only possible when the surgeon and the patient work together in unison. Your surgeon has the responsibility to plan the surgery, to choose the right procedure and handle the tissues with care, and to give you appropriate post-operative instructions. As the patient, you have the responsibility to follow his instructions and to care for the operated site after he has done his job. Keep in mind that what you do to protect the tissues while they heal will directly affect the result of your surgery.
Remember, YOU play a big part in the final result of your operation.
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