The Seattle

Plastic Surgery Center

William A. Portuese, M.D.

How Painful Is Upper Eyelid Surgery?

Oculoplastic surgery, which involves surgical procedures on the eyelids, is a specialized area of ophthalmology. Upper eyelid surgery can be used to correct sagging skin, improve vision, and reduce wrinkles. This article will provide an overview of upper eyelid surgery and discuss the associated pain levels.

Upper eyelid surgery includes several types of procedures that can help to improve the appearance and function of the upper eyelids. In some cases, excess skin may be removed to create a more youthful look or reconstructive procedures may be performed to restore function. Depending on the type of procedure being done, local or general anesthesia may be used.

In terms of post-operative discomfort and pain levels associated with upper lid surgery, there is considerable variation depending on the technique used and patient tolerance level. It is important for individuals considering this procedure to understand what they might expect in terms of post-operative pain so they can plan accordingly. This article will explore these issues in detail and provide information about how painful upper eyelid surgery can be.

Definition Of Upper Eyelid Surgery

Upper eyelid surgery, also known as blepharoplasty, is an oculoplastic surgical procedure to improve the appearance of the upper eyelids. It can be performed on both the upper and lower eyelids in order to correct excess skin, puffiness, and wrinkles. The goal of the surgery is to create a more refreshed and youthful look.

During upper eyelid surgery, an incision is made in either the crease of the eye or along the lashes. The excess skin and tissue are then removed and repositioned to create a smoother contour. Depending on the patient’s needs, fat deposits may also be redistributed or removed. In some cases, excess fatty tissue can cause bulging above or below the eye which can be addressed with blepharoplasty.

The procedure typically takes about two hours and can be done under local anesthesia with sedation or general anesthesia. After surgery, patients may experience swelling, bruising, tenderness and some discomfort which should subside after a few days. Most people return to normal activities within one week of their surgery.

Reasons For Undergoing Upper Eyelid Surgery

Upper eyelid surgery, or blepharoplasty, is a common procedure that can help achieve a more youthful, rejuvenated appearance. The procedure can also treat functional concerns due to excess upper eyelid skin and fat. Common reasons for undergoing upper eyelid surgery include impaired vision due to sagging upper eyelids, tired or aged eyes due to excess upper eyelid tissue, and cosmetic concerns such as the desire to create smoother contours along the natural lines of the upper eyelids.

The primary goal of this procedure is to reduce the amount of excess skin and fatty tissue in the upper lids. This will result in improved visibility and a more rested, youthful appearance. Depending on the patient’s unique needs and goals, additional procedures such as browlift may be included as part of treatment plan. During consultation with an oculoplastic surgeon, patients can discuss their particular concerns in order to determine if they are candidates for this type of surgery.

Upper eyelid surgery is typically performed under local anesthesia combined with oral sedation or light intravenous sedation in an outpatient setting. Generally speaking, most patients experience minimal discomfort during and after the procedure with mild swelling, bruising and minor pain being reported by many patients following their procedure. Recovery times vary depending on individual factors such as age and health history; however many patients return to normal activities in 1-2 weeks postoperatively.

In summary, upper eyelid surgery offers substantial benefits for individuals who wish to improve their vision or achieve a more refreshed appearance around the eyes. By consulting with an experienced oculoplastic surgeon prior to undergoing this type of surgery, potential candidates can ensure that they receive safe and effective treatment tailored specifically for them.

Preparation For Procedure

Preparation for upper eyelid surgery is an important step in the process. Before the procedure, the oculoplastic surgeon will perform a physical examination and review of the patient’s medical history. The patient should inform their doctor about any medications they are taking, as well as any allergies or existing health conditions. The patient should also let their doctor know if they have had any previous facial surgeries.

The oculoplastic surgeon will advise the patient about what to do before and after surgery to reduce risks and get optimal results from the procedure. This includes instructions on preoperative skin care, such as avoiding sun exposure and using sunscreen when necessary. In addition, patients may need to stop taking certain medications prior to surgery, such as blood thinners or aspirin.

The patient should also arrange for someone to drive them home after the procedure and stay with them overnight if necessary. It is important that all pre-operative instructions are followed carefully in order to ensure a successful outcome of the surgery and minimal discomfort during recovery.

The Procedure Itself

Upper eyelid surgery is a minimally invasive procedure. It involves incisions made along the crease of the upper eyelid to remove excess skin, fat, and muscle. The procedure typically takes approximately one hour to complete and does not require general anesthesia. During the surgery, local anesthetic is injected into the area to minimize any discomfort that may occur during the procedure.

The surgeon will make small, precise incisions along the natural crease of the upper eyelid. Through these incisions, excess skin, fat, and muscle can be removed or adjusted as necessary to achieve desired results. Sutures are then used to close any remaining gaps in the tissue and maintain a clean appearance.

After surgery is completed and all sutures are in place, a cold compress or ointment may be applied to reduce swelling and relieve any discomfort associated with the procedure. Recovery time is typically short; patients can usually expect to return to regular activities within 2-3 days after surgery. In addition, most of the swelling should subside within 7-10 days after surgery.

Patients who have undergone upper eyelid surgery can expect improved vision due to reduced drooping of the eyelids and improved overall facial aesthetics due to increased symmetry in their eyes.

Recovery Process

Immediately after the procedure, the patient may experience some degree of swelling and bruising around the eyes. The patient may also experience a mild amount of discomfort or sensitivity to light. Cold compresses or over-the-counter pain medications can be used to help manage these symptoms. In most cases, patients are able to return home within one day of surgery.

The recovery process is typically quite short and uncomplicated. After approximately one week, the majority of postoperative swelling will have subsided and any mild discomfort should have dissipated. However, it is important for patients to follow their doctor’s instructions for wound care in order to reduce any risk of infection or irritation during the healing period. It usually takes anywhere from two to four weeks for incisions to heal completely, which is when final results become visible.

In addition, patients must remember to protect their eyes from sunlight and other strong sources of light during the recovery period with sunglasses or another form of protection. Wearing protective eyewear will help speed up the healing process while preventing further irritation or damage as well as reducing any chances of complications occurring during recovery.

Possible Side Effects

Upper eyelid surgery may lead to several possible side effects. These include, but are not limited to, temporary swelling, bruising, redness, irritation or discomfort. Swelling and bruising typically resolve in a few days; however, it can take up to several weeks for them to completely subside. Redness and irritation of the skin around the eyes should also dissipate within a few days. It is important that patients follow their doctor’s instructions carefully in order to facilitate healing and minimize any side effects.

In some cases, there may be dry eye symptoms following the procedure due to the disruption of tear-producing glands in the eyelids. Additionally, patients may experience double vision if the eyelids are too tight or if the incision was made too close to the orbital rim. If these issues occur, then additional surgery may be required for treatment.

Patients should contact their surgeon immediately if any of these symptoms persist after recovery or if they experience any new symptoms such as infection or excessive bleeding of the operated area. With proper care and attention during healing time, most patients will have no long-term complications from upper eyelid surgery.

Pain Management Techniques

Upper eyelid surgery is generally associated with minimal discomfort. Pain management techniques are employed to ensure a comfortable postoperative experience. In order to mitigate the pain and reduce the chance of complications, a combination of pharmacological agents and other interventions may be employed.

Analgesics such as acetaminophen, ibuprofen, or codeine may be prescribed following upper eyelid surgery in order to alleviate any postoperative pain. Non-steroidal anti-inflammatory drugs (NSAIDs) can also provide relief from muscular cramping or spasms that can accompany eyelid surgery. Additionally, systemic administration of local anesthetics has been utilized with favorable outcomes, providing both analgesic and sedative effects without causing dizziness or nausea. Transcutaneous electrical nerve stimulation (TENS) has also been used to control pain, as it stimulates nerve fibers in the skin and underlying tissues.

To supplement pharmacological treatments for pain management after upper eyelid surgery, cold compresses may be applied to reduce swelling and bruising at the operative site. Ice packs can also help minimize discomfort during recovery from the procedure. Furthermore, wearing sunglasses can help protect eyes from light sensitivity caused by irritation of nerves due to surgical trauma in the area. Adequate hydration is also necessary for optimal postoperative healing and recovery; therefore, drinking plenty of fluids should be encouraged throughout this period.

In conclusion, a variety of methods may be employed to manage postoperative discomfort following upper eyelid surgery including analgesics, local anesthetics for systemic administration, TENS therapy and cold compresses or ice packs in addition to adequate hydration and wearing sunglasses when outdoors.

Follow-Up Care

Post-operative follow-up is an essential part of upper eyelid surgery. The patient should be seen as soon as possible within the first week of the operation, and then again at three to four weeks and six months after the procedure. At these visits, the patient will be examined for any signs of infection or other complications, such as eye lid malposition. To ensure proper healing and scarring, patients may need to apply ointment or antibiotic drops to the incision sites or wear a protective shield over their eyes while sleeping.

In addition to post-operative checkups, it is important to discuss with the patient any activity restrictions that may be needed during recovery. These may include avoiding strenuous activities, contact sports, and swimming in chlorinated pools. Patients should also avoid rubbing or touching their eyes too much during recovery. It is also important to protect the eyes from sun exposure by wearing sunglasses when outdoors.

The patient should be informed about expected levels of pain and discomfort associated with upper eyelid surgery, which typically peaks within two days after surgery but usually resolves within two weeks after surgery. Most patients experience only mild discomfort during the recovery period; however some cases may require prescription medications for more significant pain relief.

Alternatives To Surgery

Non-surgical treatments are available for patients seeking to reduce the appearance of upper eyelid wrinkles. These treatments include injectable fillers such as hyaluronic acid and neurotoxins like Botox, which can smooth out upper eye wrinkles. Patients should be aware that these treatments may only provide temporary results, however, and that regular maintenance is required in order to maintain their effects. In addition, non-surgical treatments do not address any underlying structural changes in the eyes, such as hooding or sagging of the upper lid.

Surgical options for improving the appearance of upper eyelid wrinkles may be considered for those who wish to achieve a longer lasting result. Blepharoplasty is a surgical procedure that removes excess skin from the upper eyelids in order to reduce wrinkles and create a smoother appearance. It can also correct functional problems associated with hooded or sagging eyelids by restoring a youthful contour to the eyes. The procedure typically requires general anesthesia and recovery time can range from 1-2 weeks. Results are usually long lasting with minimal complications or risks associated with surgery.

Lifestyle modifications may also be useful in reducing the appearance of fine lines around the eyes. Proper hydration, sunscreen protection and avoidance of smoking are all important factors in preserving skin health and elasticity around the eyes. Additionally, gentle cleansing products should be used on delicate eye area skin to reduce irritation and inflammation caused by allergens or irritants present in harsh cleansers and scrubs. Following these simple steps can help minimize fine lines around the eyes without needing invasive procedures or topical treatments.

Long-Term Effects

The long-term effects of upper eyelid surgery are generally positive. Patients typically experience reduced skin laxity, improved visual field areas, and better overall aesthetics. In addition, the procedure is often associated with a reduction in symptoms related to age-related ptosis (droopy eyelids). However, it is important to note that this surgery is not without its risks. Possible side effects include temporary swelling, bruising, and numbness; in rare cases, there may be permanent nerve damage or scarring. The patient should also be aware that postoperative vision changes can occur if the procedure is performed too aggressively.

For most patients, however, the benefits of upper eyelid surgery far outweigh any risks or potential complications. With proper care and follow-up visits for evaluation and monitoring of results, this procedure can provide lasting aesthetic improvements with minimal discomfort and recovery time. It is also important to note that the results of this surgical procedure are likely to be seen within a few weeks after the operation has been completed.


Upper eyelid surgery is an effective and safe procedure to improve appearance of the eyes and provide relief from vision issues. The procedure can be done under local anesthesia with minimal discomfort and a short recovery period. Pain management techniques such as cold compresses, oral pain medication, and topical ointments can help reduce any postoperative discomfort. It is important to follow-up with a physician to ensure that all healing is progressing as expected. Alternatives to surgery are available for those who are not comfortable undergoing the procedure or are unable to due to medical reasons.

Overall, upper eyelid surgery is a safe and effective way to improve the appearance of the eyes and relieve any vision issues caused by drooping or sagging eyelids. Careful preparation, understanding of the procedure itself, appropriate pain management techniques, and follow-up care will ensure a successful outcome for the patient. Patients should consult with an oculoplastic surgeon prior to making any decisions regarding upper eyelid surgery in order to understand all benefits, risks and alternatives associated with it.

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Plastic Surgery Center


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