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Miss Vickie Lee, MA FRCOphth
Consultant Ophthalmic & Oculoplastic Surgeon

Operation Diary

This page provides general information and advice regarding your surgery. For specific information refer to the procedure guides

01
Two weeks before surgery

If safe to do so, stop taking aspirin or other blood-thinning medications to minimize the risk of bleeding. Different medications often need different periods of stopping before surgery.  If you are unsure, consult your surgeon who can discuss this with your GP.

Avoid:

  1. Ibuprofen or other non-steroidal anti-inflammatory drugs (NSAIDs).
  2. Supplements such as garlic, ginkgo, ginger, vitamin E, fish oil, or omega-3, as they may increase bleeding risk.

It is generally recommended that these medications are stopped as in the eyelid or tear duct the surgical field is very small and often the desired correction is measured in millimetres (in lid surgery), so significant bruising and bleeding can have a significant impact on the surgical outcome.

Nicotine constricts blood vessels, reducing oxygen supply to the tissues, which is vital for healing and infection prevention. It is strongly recommended to stop smoking at least one month before surgery and avoid smoking for at least two weeks after your wounds have fully healed. 

If your procedure is under general anaesthesia or sedation , you may need blood tests and an ECG. If you are diabetic you will need to fast before your procedure  discuss  with Miss Lee /or the anaesthetist. You may need to not take the diabetic medication on the day of the surgery.

02
Day of surgery

  1. Wear comfortable clothing (a front-buttoning top and slip-on shoes).
  2. No jewellery, makeup, or contact lenses.
  3. Wash your face thoroughly before coming in.
  4. If you take regular medications most can be taken with a sip of water. • You will go through the consent process with Miss Lee and have an opportunity for any final questions. Pre-operative photographs may also be taken although usually this will have been taken beforehand.

Fasting Instructions (for sedation or general anaesthesia)

  1. Morning surgery: No food or drink after midnight. Clear Fluids (water only) until 2 hours before hospital admission 
  2. Afternoon surgery: Have an early, light breakfast; no food or drink after 7:30 AM.

Clear Fluids (water only) until 2 hours before hospital  admission 

During Surgery

Your consultant should go through the consent procedure and you will have your opportunity to ask your final questions and sign the consent form. Often pre-operative photographs may be taken if this has not already been taken at the prior consultation.

You will be taken to the operating theatre. If you are having the operation under local anaesthetic, the injection in the eyelid area is generally the most unpleasant part with stinging. Afterwards you may feel sensations of pressure but there should be no pain. If you experience significant discomfort please let your surgeon know so your local anaesthetic can be topped up.

If you are having your operation under a general anaesthetic or sedation, you will first be seen by your anaesthetist and when you arrive in the operating theatre he/ she will insert a needle into a vein in the back of your hand. After this you should not experience much discomfort from any further anaesthetic or surgery.

One or both eyes may be bandaged. These bandages stay on for about 6 hours or overnight in most cases and if you are having the surgery as a day case procedure you may remove the bandages the next morning at home. If you are having a bilateral procedure then one or both bandages are removed before you leave the hospital.

03
Day 1 after surgery

How to reduce swelling and bruising

  1. Once the eye pad is removed, start ice pack treatment immediately.
  2. Sit upright as much as possible and sleep with your head elevated on 2-3 pillows for the first few days.

Ice pack treatment

  1. Use a cold compress mask (available at pharmacies) or a bag of frozen peas in a sandwich bag.
  2. Apply the ice pack over clean gauze on the eyelids.
  3. Try 30 minutes every hour while awake.
  4. Continue ice therapy for three days after surgery.

If you opt to rent a HILOTHERM HomeCare device please make sure you ask for the Eye cuff, closed​. You can use the machine constantly in the first 3 days and less frequently on subsequent days.

Eyelid cleaning

First cleaning: When the eye pad is removed.

  1. Wash your hands before cleaning.
  2. Use sterile gauze and saline (Normasol® or homemade: 1 teaspoon salt in half a pint of boiled, cooled water).
  3. Soak gauze in saline and gently wipe across the eyelid. Avoid rubbing the eye.
  4. Clean twice daily for the first week, then once daily for the second week.

Additional Precautions

  1. Do not soak the wound in a bath or swimming pool for at least two weeks.
  2. You may shower and wash as usual, but avoid direct water pressure on the eyes.
  3. You may be given a cartella (clear plastic eye shield) to wear at night to stop you from rubbing the eye accidently when you are asleep.
  4. Do not wear contact lenses for at least two weeks but you can wear your glasses as normal.
  5. Your first clinic review will be in 1-2 weeks.

Using Eye Drops

  1. Wash hands before applying eye drops.
  2. After upper eyelid surgery: Pull down the lower lid and look up, then place a drop into the gap.
  3. After lower eyelid surgery: Pull up the upper lid and look down, then apply the drop to the eye.
  4. Avoid pressing on the lower lid.

04
Day 3 after surgery

Swelling and bruising usually peak at this stage—expect to look as if you’ve gone a few rounds in the boxing ring. Mild painkillers may be needed. Continue ice packs if they are soothing.

If you had to stop blood thinning medication, you may restart them now unless instructed otherwise.

05
Days 7-14 after surgery

  1. You will have a follow-up visit to remove sutures between 7-14 days post-surgery.
  2. Swelling should be subsiding, and bruising should start fading.
  3. 90% of bruising resolves in 90% of patients within 14-21 days.
  4. Once healed, makeup may be applied, and you can resume work, social activities, and mild exercise.

Sutures (stitches)

  1. Absorbable sutures may not need removal.
  2. Some absorbable stitches are still removed between 5-14 days if necessary.
  3. Non-absorbable sutures are typically removed between 10-14 days post-surgery.
  4. If a graft was taken (e.g., from the ear or scalp), sutures may remain for up to two weeks.

Important: If a stitch breaks, the wound opens, vision blurs, or there is bleeding, discharge, or severe pain, contact your surgeon immediately.

06
6 -8 weeks after surgery

By now, any lingering swelling or bruising should have resolved. Your consultant will assess your progress, and post-operative photographs may be taken.


At this stage, you should feel comfortable with your results and be able to return fully to all activities.