You must stop taking anticoagulants 10 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 sure 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 how much skin needs to be removed. (The incisions will be made in the natural creases of your skin.) Precision is extremely important at this stage in the procedure, and this is why a lot of time is spent on it.
Next, your whole 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, enabling you to 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 have at the dentist. The anaesthetic will start to work immediately and the effect 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 can cause a reaction leading 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 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 can use a packet of frozen peas because they will mould to your face easily. This cooling is very important as it helps to reduce the swelling, but it is only effective during the first 24 hours following the operation. If this causes pain, you can take some paracetamol (as this does not contain any anticoagulant substances).
Chill your eyelids using ice every hour for 10 minutes. You will notice that the swelling gets worse up until the third day after the operation and that 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 they 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