What to Avoid Before Blepharoplasty
Medications That Increase Bleeding
Aspirin, ibuprofen, and naproxen all thin the blood and raise the risk of bruising and bleeding during and after surgery. Stop these at least seven to ten days before surgery unless your doctor specifically tells you otherwise. Acetaminophen is safe to use for pain or fever during this window.
Warfarin, clopidogrel, apixaban, rivaroxaban, and similar blood thinners require an individualized plan coordinated with the doctor who prescribed them. Do not stop these on your own. Your surgeon and prescribing doctor will decide together when to pause and when to restart, balancing surgery bleeding risk against the underlying medical reason for the medication.
Some hormone medications increase the risk of blood clots, which complicates surgery and recovery. Discuss with both your surgeon and prescribing doctor before stopping anything. Routine birth control is usually continued, but combined hormonal therapy in older patients may be paused.
Some antidepressants and mood-stabilizing medications can affect bleeding or interact with anesthesia. Do not stop psychiatric medications without your prescribing doctor's input, since abrupt discontinuation can cause withdrawal effects. Tell your surgeon and anesthesia provider about every medication you take.
Supplements and Herbal Products
Several common supplements have anticoagulant effects and should be stopped about seven to fourteen days before surgery: fish oil and omega-3 supplements, vitamin E, ginkgo biloba, garlic supplements (cooking with garlic is fine), and ginseng. These are sold over the counter, but they are not without effect.
Turmeric or curcumin in supplement form, high-dose green tea extract, ginger supplements, dong quai, and St. John's wort can also affect bleeding or anesthesia. When in doubt, share your full supplement list with your surgeon and ask which to pause.
Standard multivitamins are usually fine to continue. Vitamin C and B vitamins do not affect bleeding. The exception is high-dose vitamin E, which is included in many multivitamins above the threshold for surgery; check the dose and ask your surgeon.
Patients often forget to mention supplements because they are not prescription medications. Surgeons cannot plan safely around what they do not know. Bring every bottle to the pre-op visit, including teas and powders, so the team can review them.
Lifestyle Factors
Nicotine constricts small blood vessels and impairs wound healing. Most surgeons require cessation at least two to four weeks before and after surgery. This includes nicotine in any form: cigarettes, vapes, gum, patches, and chewing tobacco. Smokers heal more slowly, develop more visible scars, and have higher complication rates.
Alcohol thins the blood and interacts with anesthesia. Avoid alcohol for at least three days before surgery and during the first week of recovery while you are taking pain medication. Heavy drinkers should disclose intake honestly to the anesthesia team, since this affects medication dosing.
Marijuana, cocaine, and other recreational substances all affect anesthesia, bleeding, or wound healing. Disclose use honestly during the pre-op evaluation. Anesthesia providers do not report use to authorities, and dishonesty here can lead to serious complications.
Avoid significant sun exposure to your eyelids in the weeks before surgery. Sunburn or recent tanning can affect skin healing and pigmentation around the incision. Wear sunglasses and a wide-brimmed hat when outside.
Skincare and Beauty Treatments
Tretinoin, retinol, and other vitamin A derivatives thin the outer layer of skin and can impair wound healing. Stop topical retinoids at least one to two weeks before surgery and do not restart until your surgeon clears it.
Avoid chemical peels, microdermabrasion, laser resurfacing, and intense pulsed light treatments for at least two to four weeks before blepharoplasty. These treatments leave skin more fragile and prone to complications during surgery.
Remove eyelash extensions before surgery so the surgeon can see your natural lid margin clearly. Recent eyelid tattooing or permanent makeup should be done at least three months before surgery. Do not get new tattoos in the four weeks before your procedure.
Hair dye is not a problem for surgery itself, but plan to color your hair before surgery rather than after. You will need to keep water and chemicals away from the incision area for the first one to two weeks of recovery.
The Day Before and Day of Surgery
If you are having any sedation or general anesthesia, you must fast for at least six to eight hours before surgery per the surgical team's specific instructions. Nothing to eat or drink during that window means nothing at all: no water, no coffee, no chewing gum. Eating or drinking risks aspiration during anesthesia.
You cannot drive yourself home after sedation or general anesthesia. A responsible adult must drive you home and stay with you for the first 24 hours. Arrange this before surgery day; do not assume someone will be available.
Wear loose, comfortable clothing that buttons or zips in the front so you do not have to pull anything over your head after surgery. Avoid contact lenses, eye makeup, jewelry, and perfume on the day of surgery.
Get a good night's sleep before surgery if possible. Arrange your home for recovery: cold compresses ready, prescriptions filled, easy meals on hand, and a recovery spot with pillows for head elevation. Reducing day-of stress helps both your blood pressure and your peace of mind.
Things Patients Often Miss
Do not stop daily aspirin without checking with your prescribing doctor first. Some patients on aspirin for heart or stroke prevention should continue it through surgery, accepting slightly higher bleeding risk. Others can pause it briefly. The decision is medical, not cosmetic.
Some pre-workout supplements contain stimulants, herbal blends, or ingredients that affect bleeding. Bring the label to your pre-op visit. Plain whey or plant protein is usually fine, but proprietary blends should be reviewed.
CBD can interact with anesthesia and is not well studied in the surgical context. Most surgeons recommend stopping CBD products at least one to two weeks before surgery. Tell your surgical team about all CBD use, even topical creams.
No. Even small amounts of liquid violate fasting rules and can be a reason to delay or cancel surgery. If you are a heavy coffee drinker, expect a caffeine headache the morning of surgery; you can have coffee once cleared after the procedure.
A simple head cold may not require rescheduling, but tell your surgeon's office. Active fever, cough, or chest infection usually requires postponing surgery to allow safe anesthesia. Better to delay by a week than risk anesthesia complications.
Salt itself is fine in moderation, but high-sodium days before surgery can worsen swelling. Skip processed foods, deli meats, and salty snacks for the few days before your procedure. Stay well hydrated, and your post-op swelling may be less pronounced.
Confirm Your Pre-Op Plan With Your Surgeon
Your surgeon's office will provide a written pre-op packet listing exactly what to stop and when. Read it twice and ask about anything that does not match what you found here. Specific instructions from your surgeon override any general guideline.