Frequently asked questions and answers about upper eyelid surgery

 

Will insurance cover my eyelid surgery?

Insurance covers ptosis repair in most cases because the eyelids are obstructing vision.  Insurance may cover blepharoplasty if the skin folds are hanging over the eyelashes and directly obstructing central vision, but certain specific requirements must be met.

 

What are the risks of surgery?

As with any other surgery, eyelid surgery carries a small risk of infection and bleeding.  Some patients notice their eyes feel more dry after eyelid surgery.  This can be controlled with lubricating eyedrops and other treatments.  Because surgery is not an exact science and healing is not completely predictable, revision may be necessary, though it is unlikely.  Blindness has also been reported after blepharoplasty or ptosis repair, but is extremely rare.  The incidence of this complication has been calculated at 0.005% (5 thousandths of 1 percent;  Ophthal Plast Reconstr Surg. 2004 Nov; 20(6):426-32).  Note that a patient in Georgia is three times more likely to die from a car accident during a given year than lose sight in one eye from eyelid surgery (Georgia motor vehicle death rate 0.015% in 2016). 

​

How long will it take to recover?

Expect to be very bruised and swollen after surgery.  Different people heal at different rates, but about 70% of the swelling and bruising is gone after one week.  About 90% of the swelling and bruising is gone after two weeks.  After two weeks, it is often difficult to tell that a patient has had eyelid surgery.

 

When will I be able to return to work?

People undergoing only upper eyelid surgery generally feel comfortable returning to work after 1 to 1½ weeks.  People undergoing lower lid surgery alone or four lid surgery often take 1½ to 2 weeks to return to work, although many return sooner.

 

When will I be able to resume normal activities?

You will need to avoid strenuous activity for at least one week after surgery, but normal household activities such as reading, watching TV, and computer work are all acceptable.  Patients are recommended to not drive for one week.  Gentle exercise may resume one week after surgery and full exercise two weeks after.

 

Will I be asleep for the surgery?

No.  Sedatives will be given to help you relax, and anesthetic will be injected in your eyelids to eliminate pain, but you will not be unconscious.  In an ambulatory surgery center, sedation will be given by vein and will be so powerful that you will neither feel the numbing injections nor remember the surgery.  If surgery is performed in our office, only mild oral sedation will be given.

 

Will the surgery be painful?

The numbing injections are moderately painful, but will eliminate pain afterwards.  Some additional injections may be necessary during the procedure to maintain numbness, but these are even less painful than the first injections.  If surgery is performed in an ambulatory surgery center, heavy sedation will block the pain of the injections.

 

How much pain will I have after surgery?

Surprisingly little.  The vast majority of patients need no more than acetaminophen (Tylenol), and most do not even need that.

 

Will I have visible scars?

No.  The incisions for upper eyelid surgery are hidden in the eyelid crease and are essentially invisible after healing.

 

When will I need to be seen again?

You will be seen seven or eight days after surgery, then three to four months later.

 

Will the stitches need to be removed?

Most likely not.  In most cases, dissolving stitches are used and need not be removed.  In certain people who have a history of reaction to sutures, nylon sutures will be used and will require removal about 1 week after surgery.