Blepharoplasty recovery timeline: eyelid surgery healing week by week

Blepharoplasty is surgery to remove excess skin or fat from the eyelids. Recovery is short compared with many operations, but the visible signs of healing are slow. The NHS describes puffy, numb eyelids that can be difficult to close, irritated and watery eyes that may last a few weeks, bruising and scars that should eventually fade to almost invisible.

Timings quoted by NHS trusts vary a little, partly because techniques differ and partly because some leaflets give cautious figures. The table brings together the figures from the NHS website and two NHS aftercare leaflets.

The NHS says you may be advised to prop your head up with pillows for a couple of days when resting, to reduce swelling, to gently clean your eyelids using prescribed ointment or eyedrops, and to apply a cold pack, such as a packet of frozen peas wrapped in a tea towel. Sunglasses help protect your eyes from sun and wind, and paracetamol or other prescribed painkillers can relieve pain.

The Royal Berkshire leaflet adds that you will probably have an eye pad for the first night, that bruising and swelling are likely, and that you should take paracetamol rather than aspirin, because aspirin may cause severe bleeding. It suggests keeping the area dry for approximately 48 hours and then, if you need to clean it, using cooled boiled water and cosmetic pads. The NHS Lothian leaflet similarly advises gentle cleaning with cooled boiled water and cotton wool when the pad comes off, with ointment or drops used as instructed.

The NHS notes that the surgeon will need to know about any medicines you take to reduce the risk of blood clots, such as aspirin, warfarin or apixaban, before surgery.

It is common to have temporarily puffy, numb eyelids that are difficult to close, and irritated, sensitive or watery eyes, which the NHS says may last a few weeks. Bruises and redness may take several weeks to fade. The NHS says these are expected effects, though it also lists occasional problems such as blurred or double vision, eyes looking uneven and reduced or increased sensation in the eyelids.

The NHS describes the incision for upper eyelid surgery as made along the natural crease of the eyelid, so that the scar is usually hidden in the fold. For the lower eyelid, it can be made just below the lashes or on the inside of the eyelid. These differences affect how visible early bruising and scars are, and the surgeon can advise on what to expect for the procedure you are having.

The NHS says most people take about 2 weeks off work, and that you will not be able to drive for a number of days after the operation. Strenuous activity and swimming are to be avoided for a few days according to the NHS, whereas the Royal Berkshire leaflet is more cautious: avoid strenuous exercise and heavy lifting for two weeks and swimming for one month. The difference is a reminder to follow the instructions given by your own surgeon.

The NHS advises avoiding smoking, as smoke can irritate your eyes, and avoiding wearing contact lenses or rubbing your eyes during recovery.

• Driving: not for a number of days after the operation (the NHS); ask your surgeon when it is safe.

• Work: about 2 weeks for most people, depending on the job (the NHS).

• Exercise: avoid strenuous activity for a few days (the NHS) to two weeks (Royal Berkshire).

• Swimming: a few days (the NHS) to one month (Royal Berkshire).

• Contact lenses and eye rubbing: avoid (the NHS).

The Royal Berkshire leaflet says you will be given a follow-up appointment in clinic for a check-up, and that any stitches are usually removed 5 to 14 days after the operation. If you had suture strips, the NHS says they are usually removed up to 1 week later.

The NHS adds that occasionally people find the desired effect was not achieved and feel they need another operation, and that you should take up any concerns about the results with the surgeon who treated you.

The NHS says to contact the clinic where the operation was done as soon as possible if you have severe pain or any unexpected symptoms, and that you can also call NHS 111. The Royal Berkshire leaflet says that if you have severe pain, bleeding or a discharge from the wound you should attend Eye Casualty as soon as possible, and that for minor eye problems you can seek advice from your GP, optician or pharmacist.

The NHS lists rarer serious problems, including bleeding into the eye socket and visual impairment. These are why sudden changes in vision, a rapidly swelling eyelid or severe pain should not be left to settle on their own.