Preparing for Eyelid Surgery
Decisions to Make Before You Schedule
Your surgeon will help you decide whether your eyelid surgery is functional or cosmetic. Functional blepharoplasty corrects excess upper eyelid skin that blocks your vision and may qualify for insurance coverage. Cosmetic blepharoplasty improves appearance and is paid out of pocket. The distinction affects how your visit is documented and how you pay, so settle this point early.
Eyelid surgery sits millimeters from your eye, so the person holding the instruments matters. Look for a board-certified ophthalmologist with fellowship training through the American Society of Ophthalmic Plastic and Reconstructive Surgery (ASOPRS). Ask how many blepharoplasties the surgeon performs each year and request to see before-and-after photos of patients with similar anatomy.
Before booking surgery, write down what you want to change and what you hope to feel afterward. Bring this list to your consultation. Your surgeon will tell you which goals are achievable and which are not. Eyelid surgery can lift heavy upper lids and reduce under-eye bags, but it does not erase fine wrinkles, lift the brow on its own, or remove dark pigmentation.
Plan the date around two weeks of social downtime so you can heal without pressure. Avoid scheduling around major events, travel, or work deadlines. Many patients pick winter months when sunglasses look natural and outdoor sun exposure is lower. Your surgeon may also factor in seasonal allergies, since pollen and itching during recovery can irritate fresh incisions.
Medications and Supplements to Stop Before Surgery
According to the AAO (2024), patients should avoid anticoagulants such as aspirin, ibuprofen, naproxen, and prescription blood thinners for 7 to 10 days before eyelid surgery to reduce bleeding risk. Never stop a prescribed blood thinner without first speaking to the doctor who prescribed it. Your surgeon and your prescribing doctor will coordinate any changes so your other health conditions stay safe.
Many over-the-counter supplements thin the blood even though they are not labeled as blood thinners. Stop these the same week you stop other anticoagulants, unless your surgeon tells you otherwise.
- Vitamin E and high-dose omega-3 or fish oil
- Garlic, ginger, ginkgo biloba, and ginseng
- Turmeric and curcumin in supplement doses
- St. John's wort and high-dose vitamin C
- Any herbal blend marketed for circulation or anti-inflammation
Tell your surgeon about every prescription you take, including for diabetes, blood pressure, mood, hormones, or autoimmune disease. Some medicines change how you bleed or heal and need timing adjustments around surgery. Bring an updated list to every pre-op visit, including doses and how long you have been on each drug. Your anesthesia team uses this list to plan a safe sedation.
If you use prescription eye drops for glaucoma, dry eye, or allergies, do not stop them on your own. Some drops should continue right up to the morning of surgery, while others pause for a day or two. Your surgeon will give you a clear schedule for each drop. The same applies to any artificial tears or lubricants you use every day.
Health Steps That Improve Healing
Smoking narrows blood vessels and delays wound healing. The AAO (2024) recommends stopping all tobacco and nicotine products before eyelid surgery to optimize healing. Vaping carries the same nicotine effect on blood flow, so include it in your stop list. The longer you abstain before and after surgery, the better your incisions close. If you need help quitting, ask your surgeon or primary care doctor about nicotine cessation programs and medications that are safe to use around surgery.
Alcohol thins the blood, dries the eye surface, and slows liver clearance of anesthesia. Cut back at least one to two weeks before surgery and continue avoiding it for the first week of recovery. Heavy drinkers should tell the surgical team in advance because alcohol withdrawal during recovery can complicate healing and pain control.
Your body builds new tissue from the food you eat, so the weeks before surgery are not the time for extreme dieting. Focus on lean protein, leafy greens, fruit, and whole grains. Drink enough water that your urine looks pale yellow. Reduce salty processed foods that promote fluid retention and worsen post-op swelling. If you take a multivitamin, ask your surgeon whether to continue it through the surgical week.
Tell your surgeon about dry eye, glaucoma, prior LASIK, thyroid disease, diabetes, or high blood pressure. Each of these can change your surgical plan or your healing path. The AAO (2024) recommends a complete preoperative eye exam, including visual acuity and ocular surface health, before any blepharoplasty. Patients whose diabetes or hypertension is not well controlled should bring those numbers into a stable range before scheduling.
Logistics for Surgery Day and the Days After
You cannot drive yourself home after eyelid surgery, even if you only had local anesthesia. According to Cleveland Clinic (2024), patients receiving sedation need a designated driver and a trusted adult companion for the first 24 hours. Choose someone who can stay with you, help with eye drops, and notice changes in pain or vision. Tell them in advance which symptoms should trigger a phone call to the surgeon.
Get supplies in place before surgery so you are not running errands while bruised. Most items are inexpensive and stay useful for the full recovery.
- Two or three soft pillows or a wedge pillow for elevation
- Cold packs that you can wrap in a clean cloth
- Preservative-free artificial tears recommended by your surgeon
- A pair of dark wraparound sunglasses
- Easy meals that need no chopping or hot stove time
Wash your face and hair the morning of surgery with mild soap and shampoo. Skip moisturizer, makeup, eye makeup remover, perfume, and contact lenses. If you wear lashes or extensions, remove them before the procedure. Wear loose clothing that buttons or zips in front so you do not have to pull anything over your healing eyelids when you change at home.
Most office workers take about one week away from the desk, while jobs that involve heavy lifting or outdoor work need two weeks or more. Tell your employer the date in advance and arrange to work from home if possible during the second week. If video calls are part of your job, expect bruising to show even with makeup until day 10 or so.
What Happens at the Pre-Operative Visit
Your surgeon will measure your eyelids, check how well you see, and evaluate your tear film. The AAO (2024) requires a complete preoperative eye exam, including assessment of visual acuity and ocular surface health, before blepharoplasty. Expect drops that blur your vision for a short time, a slit lamp evaluation, and a check for dry eye. Tell the team about any symptoms you have not mentioned yet, even small ones.
The AAO (2024) requires preoperative photographs of the eyelids for planning and documentation. Expect close-up photos from several angles with your eyes open and closed. For functional blepharoplasty, the photographs also support insurance approval. Removing makeup and skipping moisturizer the morning of the photo session keeps the images accurate.
If your surgery is functional, you will have a visual field test that maps how much your upper eyelid blocks your sight. According to AAO (2024), this test documents the superior field defect and is required for insurance coverage. The test is painless and takes about 10 minutes per eye. You watch a screen and click a button each time you see a small flash of light.
Your surgeon will walk you through the risks, benefits, and alternatives before you sign the consent form. The AAO (2024) requires this discussion to be detailed and documented. Ask any question you have, no matter how small. Bring a notepad or your companion so you can review the information at home. If a risk worries you, ask the surgeon how often it occurs in their practice and how it would be managed.
Common Questions Patients Ask Before Eyelid Surgery
If you plan to lose more than 10 to 15 pounds, do that before surgery. Significant weight loss after blepharoplasty can change how your eyelids look because facial fat shrinks and skin can loosen again. Reaching a stable weight at least three months before surgery gives the most predictable result.
Hair coloring is fine until the day before surgery. Avoid bleach near the eyes during the recovery period because the fumes irritate healing tissue. Most surgeons pause Botox and other facial injectables for at least two weeks before surgery so the surgical team can read your natural eyelid position. Ask your surgeon for an exact restart date.
Yes, list anything you drink, swallow, or apply that has plant extracts in it. Many teas contain ginger, ginseng, ginkgo, or green tea concentrate that affect bleeding. Bring the box or bottle to your pre-op visit if you are unsure. The same goes for marijuana products, CBD oils, and unregulated weight-loss supplements.
If you are receiving IV sedation, you will fast from food and most fluids starting at midnight before surgery. Most centers allow sips of water with critical morning medications up to two hours before arrival, but follow the exact instructions from your anesthesia team. Patients having local anesthesia only may have a light meal, depending on the surgical center's rules.
Call the office the moment you notice symptoms. Active conjunctivitis, a stye, a chest cold, fever, or a flare of cold sores around the eye means rescheduling by one to two weeks. Operating through an active infection raises the risk of poor healing and post-op infection. Rescheduling is far better than pushing through.
Bring printed records of any recent eye exams, visual field tests, and a current medication list. If you have had previous eye surgery, bring those operative reports as well. Your surgeon needs this information to plan a safe procedure, and gathering records ahead of time prevents last-minute delays.
Getting Help With Your Eyelid Surgery Plan
Your eye care team is ready to walk you through every step before surgery, from medication adjustments to scheduling and consent. Call the office with any question that comes up between visits, and call right away if your health changes before the surgery date.