Blepharoplasty Recovery: A Week-by-Week Guide to Eyelid Surgery Aftercare

What to expect immediately after blepharoplasty

Blepharoplasty — upper, lower, or combined — is almost always performed as a day case, meaning you go home on the day of surgery. The procedure is typically performed under general anaesthetic, so you will need a responsible adult to drive you home and stay with you on the first night.

Immediately after surgery your eyelids will be swollen, puffy, and may feel tight. This is completely normal and expected. Your vision may be temporarily blurred from eye drops or lubricating ointment placed in the eye during surgery, and from the swelling pressing gently on the eyelid margin.

You will leave hospital with: a prescription for antibiotic eye drops (to prevent infection), lubricating drops or ointment (to keep the eye surface comfortable), and instructions on how to care for your wounds. A follow-up appointment is typically scheduled for 5–7 days later for wound check and, if external sutures were used, suture removal.

Days 1–3: immediate post-operative period

Swelling and bruising reach their peak during the first 72 hours. This is the period most patients find most uncomfortable, though pain is generally mild — paracetamol (1g, four times daily) is usually sufficient. Ibuprofen and aspirin should be avoided for at least two weeks as they increase bleeding risk.

Cool compresses applied for 10–15 minutes every hour while awake help significantly reduce swelling. Use a clean cloth dampened with cold water rather than ice directly on the skin. Sleep with your head elevated on two or three pillows — this reduces fluid accumulation in the eyelid tissues.

Avoid bending over, straining, or lifting anything heavy. These activities raise blood pressure in the facial vessels and increase bruising.

Your eyes may feel gritty, dry, and slightly uncomfortable. This is partly from the surgery itself (the corneal surface is exposed for longer than normal while lids are healing) and partly from reduced blink reflex. Use lubricating drops frequently — at least every hour while awake in the first few days — and lubricating ointment at night.

You should not drive, operate machinery, or make important decisions on the day of or the day after general anaesthetic.

Days 4–7: early recovery

Bruising begins to yellow and spread downward onto the upper cheeks — this is a normal part of the resolution process, not a sign of new bleeding. Swelling starts to reduce noticeably, particularly in the mornings.

Most patients who have had upper blepharoplasty alone feel comfortable returning to sedentary (desk) work by days 5–7. The suture removal appointment at day 5–7 is an important milestone — once sutures are removed, the eyelids feel more comfortable and look tidier.

You may find your eyes are more sensitive to light than usual. Sunglasses are helpful outdoors. Do not wear contact lenses until your surgeon advises — typically around 2–3 weeks post-operatively.

You can shower normally, being careful not to get soap or shampoo in the eyes. Pat (rather than rub) the wound area dry. Eye makeup should be avoided until at least 10–14 days post-operatively, or until the wounds are fully healed — your surgeon will advise at the suture removal appointment.

Weeks 2–4: continuing improvement

By week two the most significant bruising has typically resolved. Residual swelling — particularly in the morning — continues, and the eyelids may look and feel 'full' until this dissipates fully. This is normal and not a cause for concern.

Lower eyelid recovery consistently takes longer than upper eyelid recovery. The lower lid anatomy is more complex and more prone to sustained oedema (fluid retention). Patients who have had combined upper and lower blepharoplasty should anticipate the lower lids taking the longer timeline to settle.

You can return to light exercise — walking — from around 10–14 days. Avoid any exercise that raises facial blood pressure significantly (running, cycling, resistance training, yoga inversions) until at least three to four weeks.

Avoid swimming and submerging the face until at least three weeks, and contact sport for a full month.

Residual swelling is typically worse in the morning and improves through the day as gravity assists fluid drainage. Elevating the head overnight remains helpful throughout this phase.

Months 1–3: scar maturation and final result

At 4–6 weeks the majority of swelling has resolved and the result is becoming visible. The upper eyelid crease — where the incision was made — may appear slightly pink, thickened or irregular during this phase. This is scar maturation and is normal.

At 3 months the result is fully established. The scar in the eyelid crease is typically a fine, pale, barely visible line that sits within the natural skin fold. Most people find it impossible to detect at a normal conversational distance.

A small number of patients notice residual asymmetry at three months that warrants a minor adjustment. This should always be discussed with your surgeon at the three-month review appointment rather than seeking intervention earlier, as the final result cannot be assessed until healing is complete.

Sun protection of the scar is important throughout the healing period — UV exposure stimulates melanocyte activity in healing skin and can cause hyperpigmentation. A broad-spectrum SPF 30+ should be applied to the eyelid area daily from week two onwards.

Signs that require urgent review

Most blepharoplasty recovery proceeds smoothly, but all patients must know the warning signs that require urgent contact with the surgical team:

Sudden increase in pain and swelling in one eye after the first 48 hours — particularly with any reduction in vision — may indicate a retrobulbar haemorrhage (bleeding behind the eye). This is rare but is an ophthalmic emergency requiring immediate review. You are given the emergency contact number for Spire Elland Hospital at discharge.

Significant fever (temperature above 38°C) with increasing redness and warmth around the wound — may indicate wound infection. A course of oral antibiotics is usually effective when started promptly.

Persistent inability to close the eyelid fully (lagophthalmos) beyond 4–6 weeks — more than a few millimetres of closure gap that persists warrants review. Aggressive lubrication is essential in the meantime to protect the cornea.

Any change in vision, new floaters, or flashes of light — contact the surgical team immediately.

All Mr Mohyudin's patients receive a direct contact number for the Spire Elland clinical team for any post-operative concerns.

Tips for fastest blepharoplasty recovery

Based on oculoplastic surgical practice, these measures have the greatest impact on recovery speed and quality of result:

Stop smoking at least four weeks before and four weeks after surgery. Smoking dramatically impairs wound healing and increases the risk of infection and poor scarring.

Stop blood-thinning supplements two weeks before: fish oil, vitamin E, ginkgo, ginseng, and aspirin (unless medically essential) all increase bruising.

Stay well hydrated and maintain a balanced diet rich in protein and vitamin C during recovery — these support tissue healing.

Use lubricating eye drops frequently and consistently. Dry eye after blepharoplasty is the most common cause of post-operative discomfort and delayed healing.

Be patient with the scar. The eyelid scar at three months looks very different — and much better — than at three weeks. Judging the result before three months is premature.