Blepharoplasty Aftercare: Looking After Your Eyes in the First Two Weeks

The two pieces of aftercare that make the biggest difference in the first days after eyelid surgery are cool compresses and keeping your head raised, because both act on the swelling that peaks at 2 to 3 days and settles over 1 to 2 weeks. Everything else, the drops, the ointment, the careful washing, the list of things not to do, is about protecting a fine incision and a dry eye surface while they heal¹.

I went home from a day-case operation with a printed sheet and no real idea how any of it would feel in practice. This is the practical version of that sheet, written by a patient who has done it, with the caveat that runs through the whole article: your surgeon’s instructions are written for your lids and mine were not. If you want the calendar rather than the care, the week-by-week recovery covers what each stage looks like, and the eyelid surgery pillar covers the operation itself.

Cool compresses and keeping your head up

Cool compresses and keeping the head raised are the standard first-days measures, and they matter most through the stretch when the swelling and bruising are peaking at 2 to 3 days. Gravity is not a small factor here: fluid pools in lid tissue that is lying flat, which is why faces are always at their puffiest first thing in the morning².

The practical version is duller than it sounds. Compresses are gentle and cool rather than freezing, rested lightly on closed lids rather than pressed, and used in short spells rather than continuously. I slept propped on a stack of pillows for about a week and found it less unpleasant than I had feared, mostly because I was too tired to care. What I did learn is that the day three peak is genuinely alarming to look at even when nothing is wrong, so it helps to know it is coming. The first time I saw my eyes after surgery is my honest account of that particular mirror.

Drops, ointment and the dry weeks

Lubricating drops through the day and a thicker ointment at night are the usual mainstays, because the healing lids are too tight and swollen to blink and close fully at first, and the tear film cannot spread properly. Dry, gritty or watery eyes are the commonest after-effect of blepharoplasty and are normally temporary³.

Two things surprised me. The first was how much of the routine was mine to keep up rather than something that happened on its own; the drops became a small hourly ritual in the first week and tapered from there. The second was the ointment blurring my vision at bedtime, which is expected and not a sign of anything going wrong, but is worth knowing before you try to read in bed and panic. The watering caught me out too, since a dry surface triggers a reflex flood of tears that spill rather than coat the eye evenly⁴. Dry eyes after blepharoplasty explains why the two go together and how long it tends to last.

What I will not do is tell you which product or how often. Those are the parts your surgeon prescribes for your eyes, particularly if the lids are not closing fully overnight, and following their regimen matters more than any general account.

Washing, showering and touching the incisions

The incisions are kept clean and dry at first, washed around rather than over, and left alone as much as possible, with the exact timing of when they may get wet coming from your surgeon. The upper-lid incision is a fine line hidden in the natural crease and it is not fragile forever, but the first week is not the time to test it⁵.

In practice this meant washing my face in sections and avoiding the lid area entirely at first, then tilting my head back at the basin for hair washing so nothing ran down into my eyes, which is a manoeuvre far easier to describe than to perform. Hot water on the face, steam, scrubbing and any face cloth over the lids all waited. So did makeup remover, which is really a licence to rub the exact tissue you want left alone. Stitches on the upper lid are usually taken out at 5 to 7 days, and the pull I had been dreading turned out to be a strange, brief tugging and nothing more¹.

Milia, tiny white cysts, can appear along a healing lid line and are common and treatable; picking at them is the one thing worth actively resisting. Blepharoplasty scars and the eyelid crease covers how the line settles over the months.

What to avoid, and for how long

Straining, bending and heavy lifting wait in the early days, eye makeup and contact lenses return at about 2 weeks, and strenuous exercise at about 2 to 3 weeks, built back up rather than resumed all at once. These are the ordinary timings quoted after blepharoplasty, and they exist because raised pressure and rubbing are the two things that most disturb a fresh lid².

Bending forward to pick something off the floor turns out to be an unexpectedly common act, and I noticed the pressure in my lids every time I forgot. Gentle walking was fine from early on and helped my mood more than anything else. The gym waited. Contact lenses waited longer than I wanted, because glasses over a swollen lid are annoying and lenses on a dry, healing eye are worse. Smoking is discouraged around any surgery, and alcohol is worth being sparing with early since it does the swelling no favours.

There is also a category of instruction that is genuinely individual: any medication or supplement paused around your surgery is paused and restarted on your surgeon’s schedule, not on advice found online, and that includes anything affecting bleeding.

Sun, sunglasses and the longer game

Sunglasses do two jobs after eyelid surgery: they shield dry, watery eyes from wind and light in the early weeks, and they keep the maturing scars out of strong sun while they fade over roughly 6 months. Fresh scars are more prone to darkening with sun exposure than settled ones².

I lived in sunglasses for a fortnight and would have done so on vanity grounds alone, but the comfort was the real reason. Wind is genuinely unpleasant on a dry post-operative eye. Beyond that, the long stretch of aftercare is mostly patience: the last swelling drains over weeks to a few months, the crease softens and drops, and the two sides catch each other up on their own schedules. Photographs a fortnight apart show it when the mirror will not. Whether any topical scar treatment is worth using on lid skin is a question for the surgeon who made the incision.

When aftercare stops and a phone call starts

Ordinary recovery is uncomfortable, uneven and slow, but it improves; anything sharply painful, visually alarming or getting worse is a call to your surgeon on the day rather than a thing to manage at home. The eye is not a place to be casual, and the difference between healing and a problem matters more here than after most surgery³.

Pain with pressure and a change in vision together can signal a bleed behind the eye, the rare but sight-threatening emergency that eyelid surgery carries, and it needs immediate treatment. A lower lid pulling down or showing white below the iris, spreading redness and heat that suggest infection, or dryness that is worsening rather than easing all belong at a follow-up appointment rather than in a search box. Blepharoplasty risks and complications sets those out in proportion, and knowing your surgeon’s out-of-hours arrangements before the operation is part of the aftercare, not an afterthought.