You must stop taking anticoagulants 14 days before the operation. However, before stopping, you must consult your doctor and check that he or she agrees that it is safe to do so. If you are taking MARCOUMAR you will be offered a plan so that you can take an alternative drug as a replacement. Your doctor will be consulted about this to make ensure that he or she agrees. If anticoagulant treatment prescribed for a general illness cannot be stopped, it is possible that the eyelid surgery will not be able to go ahead.
First, the doctor will draw on your skin with a felt-tip pen so that he or she knows where to make the incision.
Next, your entire face will be disinfected with Isobetadine and sterile tissues will be placed around your face like a turban. Your nose and mouth will still be free so that you can breathe normally.
During the operation you will not be able to touch your face. This is because it needs to be kept sterile.
The doctor will then give you subcutaneous (i.e., under the skin) injections (lidocaine 2% with adrenalin 1: 100,000). These injections are similar to the injections you are given at the dentist. The anaesthetic will start to work immediately and will last for about one hour.
During the operation you will have to sit up on a few occasions so that the doctor is able to judge the results more effectively.
Small non-absorbable sutures will be used, as absorbable sutures cause a reaction which can lead to unpleasant scarring. While the sutures are being put in place, it is possible that the anaesthetic will start to wear off. Consequently, you may feel some of the last sutures slightly. We prefer not to give you any more anaesthetic for these final sutures, as this would increase the risk of swelling and subcutaneous bleeding.
At the end of the operation, an antibiotic ointment will be applied to your eyelids. You will then get a cooling mask that you will have to leave on your eyes for half an hour. When you go home, it is important that you use the cooling mask every hour for 10 minutes. Alternatively, you may use a packet of frozen peas because they will mould to your face easily.
It is advisable to sleep with your head at a 45° angle because this helps to minimise swelling. You should carry on with the cooling the next morning: you need to use the cooling mask or an alternative for 10 minutes every hour. This cooling is extremely important as it helps to reduce the swelling, but it is only effective during the first 24 hours after the operation. If this causes pain, you can take some paracetamol (as this does not contain any anticoagulant substances).
The ice should never come into direct contact with your skin. Wrap it in something suitable such as a bath glove. The best technique is to push the ice against your lower eyelid and to apply pressure upwards. You will then be literally pushing the eyelid upwards.
Cool your eyelids every hour for 10 minutes using the ice. You will notice that the swelling gets worse up until the third day after the operation, and then it will then start to get better.
It is possible that your skin will be blue for about a week. The swelling can last for up to three weeks. Don't worry about any haematomas (blood clots under the skin), as these will gradually disappear.
While you still have the sutures, you must not get any water on your eyes. You are also advised not to wear any make-up. Do not massage your eyelids in any way during the first three weeks. Do not put any dressings on your eyelids.
The sutures will be removed 5 to 7 days after the operation. Once they have been removed, you may use water on your eyelids again. You will have another check-up 4 weeks after the operation.
Stay out of the sun as it can cause nasty scars. You can avoid it by using total sun block (factor 60) or by wearing a hat. Sunglasses will not offer you sufficient protection.
If you want more information, or would like to make an appointment:
Contact us or call 0032 (0)2 741 69 99