Doctor, what to prepare before and after eyelid surgery?

After you have decided to undergo an eyelid surgery, it would be helpful to know what preparation you can do to facilitate the procedure/ surgery. Also, what you can do after the procedure/ surgery to enhance the recovery.

The following is a list of before (pre) and after (post) procedure/ surgery instructions. Please note these instructions may vary between doctors.

PRE-OPERATIVE INSTRUCTIONS:

A. Medications:

The following medications, oil and herbs have blood thinning properties and should be stopped prior to surgery to reduce bleeding during surgery and thus will also reduce swelling and bruising after surgery .

Please STOP the following 2 weeks before and 1 week after procedure/ surgery:

1. Anticoagulants :- 1. Aspirin
                                 2. Clopidrogel (Plavix)
                                 3. Warfarin (need physician clearance)

2. Fish & Liver oil :- Omega-3, Cod Liver Oil, Salmon fish oil, Krill Oil
3. Flax Seed Oil
4. Vitamin E
5. Pain Killer :- Non Steroidal Anti Inflammatory Drugs (NSAIDs)
                          1. Ibuprofen (Brufen)
                          2. Mefenamic Acid (Ponstan)
                          3. Indometacin (Indocin)
                          4. Naproxen (Naprosyn)

6. Herbs / Traditional Medicine :- 1. Ginseng
                                                       2. Gingko Biloba
                                                       3. Dong Quai
                                                       4. Jamu etc
7. Smoking
8. Reduce Ginger and Garlic intake

If you have high blood pressure, diabetes and high cholesterol, please CONTINUE the medications like normal.


B. Preparation from home:

1. The day before surgery, shampoo your hair. Before heading to your surgery, wash you face with cleanser and water. Do not apply any moisturizers, lotion or make-up.

2. Do not wear jewelries, including rings, bracelet, earrings.

3. If you wear contact lens, be prepared to remove them. Preferably, wear your glasses.

4. Bring a hat/ cap/ scarf and sunglasses to be worn after surgery to cover your eyes.

5. No need to fast as most eyelid procedures are performed under local anesthesia with or without sedation. You may take light meal on surgery day and resume normal meal or as tolerated after surgery.

6. Prepare ice or eye pack for compression after surgery.

7. If you have opted for sedation, please have someone accompany you after surgery.

8. Start supplement Vitamin C 2000-3000mg (Brand Ester C by Kordel available in pharmacy or Ester C by American Health in GNC)

POST-OPERATIVE INSTRUCTIONS:

1. Rest with your head elevated about 30 degrees.

2. Use ice packs immediately after surgery and for the first 2 days on the operated area as frequent as possible. You may alternate cold and warm compress after 2 days when the bruise begin to appear. Ice compression helps with swelling while warm compression helps to disperse the bruising.

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3. Please take pain medicine if in pain. If there's sharp, pricking pain, please contact your doctor.

4. Do not exercise or lift any heavy objects or bend down for the first week. You may walk around without exertion as mobility will improve blood circulation and helps with wound healing.

5. Apply the ointment prescribed as instructed.

6. Take high dose vitamin C (2-3gm/day) to enhance wound healing.

7. You may take shower and wash your face but be very gentle with the incision site. You may dap dry the incision area but please do not rub.



THINGS TO KNOW ABOUT POST-OPERATIVE RECOVERY:

1. The swelling will worsen for the first 48 hours before it gradually resolves.

2. Occasional discharge including blood, tears and mild oozing is normal. However, if there's continuous fresh blood discharge, please contact your doctor.

3. Sutures are removed 1 week after surgery

4. Avoid direct sunlight to your eyelids esp if incision was made on the skin. Cover the incision site with the ointment prescribed.

5. 70-80% of swelling and bruising is usually gone at 2 weeks, it may take several months for the remaining swelling to completely dissipate. Final results usually take upto 6 months. This is normally applied to incision on the eyelids. Suture method for double eyelid usually take shorter downtime.

6. Numbness, swelling, tingling sensation, itching, discoloration, bumpiness, crusting, tightness and redness around the incisions are normal and should resolve with healing.


If you have further questions, kindly call 03-22846090 or email alicegoh@isec.my

How do I preserve my natural double eyelid crease when undergoing eyelid surgery?

The medical term used to address the excess upper eyelid skin is called Dermatochalasis. This is commonly seen in patients in their 40's onwards when the underlying soft tissue loses volume and the skin loses its elasticity. This causes the skin to hang over the eyelid margin and makes the eyes appear droopy and tired. Blepharoplasty is the surgery performed by most surgeon to remove the excess upper eyelid skin. The traditional blepharoplasty surgery utilizes an incision in the eyelid to remove the excess skin and creating a double eyelid crease. This invariably leaves behind a faint scar on the eyelid after surgery. 

What happens when patients have existing double eyelid crease and wish to preserve their natural crease? In such cases, a surgical approach called infrabrow blepharoplasty can be used to address the excess upper eyelid skin without creating a surgical scar on the eyelid. This way, the natural eyelid crease can be preserved. A faint scar will be seen underneath the eyebrow which can be tattooed over after surgery and the scar will no longer be visible. 

Infrabrow blepharoplasty can be combined with medial epicanthoplasty to increase the vertical and horizontal aperture of the eyes to make it even bigger and brighter!

This patient underwent infrabrow blepharoplasty and medial epicanthoplasty. 

The scar below the eyebrow and inner corner eyelid is almost invisible 

even only 2 weeks after the surgery. 

这名患者接受了提眉和眼角手术。

眉和内眼角眼皮下面的疤痕几乎看不见手术后即使只有2个星期。

Google Translate:

用于解决过剩上睑皮肤医学术语称为Dermatochalasis。这是常见于患者在他们的40年代开始，当底层的软组织损失量和皮肤失去弹性。这会导致皮肤挂在眼睑缘，使眼睛看起来下垂而疲惫。眼袋是由多数外科医生进行，以除去过量的上眼睑皮肤的手术。传统的眼袋手术利用一个切口在眼睑以除去多余的皮肤和创建双眼皮折痕。这往往会留下淡淡的疤痕在手术后的眼睑。 

当患者有现有的双眼皮折痕，并希望保持其自然折痕，会发生什么？在这种情况下，手术方法称为infrabrow blepharoplasty (提眉手术)可以用来解决多余上睑皮肤不会造成上眼睑手术疤痕。这样一来，自然双眼皮得以保存。一丝淡淡的疤痕会被视为可手术后刺过来，疤痕将不再可见眉毛下方。 

Infrabrow blepharoplasty (提眉手术) 可以与内侧epicanthoplasty (眼角手术)被组合以增加眼睛的纵向和横向的孔，使之甚至更大更亮！

Cosmetic lateral canthoplasty and its potential complications

Lateral canthoplasty is a common cosmetic procedure whereby the outer corner of the eye is split to widen the horizontal aperture of the eye. It can be performed together with double eyelid surgery and medial epicanthoplasty to achieve longer and wider eye that makes the eye appear larger, wider and more attractive.


However, if not properly performed can give rise to complications. One of the complications that may arise from lateral canthoplasty is lacrimal ductule fistula, as seen in this patient. She had the lateral canthoplasty surgery done elsewhere a couple of months ago. She was referred to me for uncontrollable tearing. She started tearing a few weeks after the surgery. It has become a nuisance as she needs to wipe her eyes frequently and her eyeliner would not stay and smudge. 


The treatment for the fistula is called fistulectomy surgery whereby the tiny passage connecting to the lacrimal gland is excised and sutured.  

This patient underwent fistulectomy surgery and the tearing subsided immediately after the surgery.

Google Translate:

眼尾手术是一种常见的化妆品程序，使眼睛的外角被分割加宽眼睛的横向孔。它可与双眼皮和内眼角手术实现更长更宽的眼睛，使眼睛显得更大，更广泛，更具吸引力的进行。 

然而，如果没有正确地进行可产生并发症。一个可能产生的横向canthoplasty的并发症是下泪小管瘘，如在本例看出。她有横向内眼角手术别处做了几个月前。她称我为无法控制的撕裂。她开始在手术后撕裂了几个星期。它已成为一个麻烦，因为她需要经常擦拭她的眼睛和她的眼线不会留下污迹。 

为瘘的治疗被称为瘘管切除手术从而微小通道连接到泪腺切除和缝合。

这名患者接受了瘘管切除手术，手术后立即消退撕裂。