24 hours

I had a million questions about eye surgery.  All of my life I dealt with puffy eyes.  I inherited puffy eyes under the eye from my mother and puffy eyes over the eyes from my dad. I was a perfect candidate for blepharoplasty surgery.  I tried every cosmetic product available from cheap to expensive to get rid of puffy eyes. Even the Oz products did not help. Although some would minimize the problem for a few hours, the problem was never eliminated.  The problem of my puffy eyes, both top and bottom, was that I was born with a glob of extra muscle on the top and a glob of extra muscle on the bottom. As I aged, the muscles started to relax and the puffy eye effect intensified.  The only way you can get rid of extra muscle around the eye is to have it removed. The swelling of the eyes may make the puffyness larger and products may make take out the inflamation, but there is a hard fact about puffy eyes:  They do no go away without the blepharoplasty surgery, not matter what you do.  That is due to the mass of muscles around the eye that you are born with!  That leads everyone to the list of reasons for having blepharoplasty surgery to reduce the puffy eyes.

I thought about the blepharoplasty surgery for years.  I went through the entire list of reasons why I should NOT do it:

     1.  It might be painful  to have blepharoplasty surgery to reduce puffy eyes. (It was not
          one bit painful. I didn't even need tylenol)
     2.  Insurance does not participate in paying for the blepharoplasty surgery even if the
          puffy eyes are creating a visual impairment. It is hard to justify getting rid of puffy eyes
          when it cost $2,000 for each eye.
     3.  It was "vain" of me to want to improve my looks by having blepharoplasty surgery to
          remove the puffy eye look.
     4.  The amount of money it would cost for blepharoplasty surgery tthe puffy eye look
          could be put to better use---
          I could think of many "needy" causes to contribute to or I could spend the
          money helping some of my own married children with school loans or
          getting into a house. 
      4. It seemed so selfish to spend that amount of money of elective blepharoplasty
          surgery.  Reducing the puffy eye look seemed like a surgery designed just to make
          me "look" better. I am sixty years old and very happily married.  Why am I worried
          about my "looks"?

As I aged, in addition to the puffy eyes on bottom, I eyelids started to show huge signs of the puffy eye syndrome as well.  I started to do a little research and found that the weight of the puffy eyes on the top was actually quite tiring for the eye to hold in the "open" position. I also learned that some people could not pass the driver's test because their peripheral vision was being impaired by the extra skin that blocked a portion of their vision due to the puffy eye syndrome. This gave me a different perspective about having the surgery done. It was more than cosmetic. It affected my well-being.  It was then that I started to look into blepharoplasty surgery to reduce the puffy eyes.

Because I had so many questions about my surgery, I decided, once I had to blepharoplasty surgery to remove the puffy eye look, to do a blog of my experience to help others who are considering the same surgery.

I am not a doctor and I have no monetary reason for sharing my experience of blepharoplasty surgery other than to help others with tips on whether to make the decision to do the blepharoplasty surgery or not.  If you decide to do the blepharoplasty surgery to remove your own puffy eye problem, this blog will help you to know how to better prepare. I have also included pictures of the healing process from the blepharoplasty surgery and the daily reduction of the puffy eyes so that you know what to expect along the way.

GETTING READY

You will need to purchase 6 items prior to the blepharoplasty surgery.
     1.  A new bottle of hydrogen peroxide (used in half-strength to clean off blood in the
          stitches). The blepharoplasty surgery is close to the eyes. You need to keep it
          clean and germ free.
     2.  A large container of Q-tips (you will use many of these every day, several times a
          day). The Q-Tips are used to apply the hydrogen peroxide to the stitches created
          by the blepharoplasty surgery.  Being able to treat each part of the puffy eye during
          the healing process is important. 
     3.  A tube of "bacitraycin plus."  This is available over the counter, near the neoposporin
          and anti-bacterial ointments. This ointment will be used to keep the stitches from the
          helps with keeping the stitches from leaving a scar along the puffy eye incision, so it is
          important NOT to choose a substitute for the "bacitraycin plus ointment".  It is
          important to note that this ointment should only be used for a maximum of 10 days
          after the blepharoplasty surgery. If you use it longer, it begins to compromise the skin.
    4.  You should buy many rolls of Plenty of paper towels. You can use these to cover the
          ice wraps after the blepharoplasty surgery. You will need something to buffer the
          ice cubes you are putting on the puffy eyes and the paper towels are disposable and
          cheap. This gives them an advantage over washcloths because you will use so many
          after the blespharoplasty surgery while you are trying to reduce the puffy eyes. You   
          can just toss paper towels in the garbage after each use.
    4. You will also need two days worth of clear liquids after you have the blepharoplasty
         surgery. While you are icing your puffy eyes, you can't really eat for a couple of
         days. I chose unsalted chicken and beef broth because I didn't want to gain added
         weight or feel thirsty. I also found an unsalted vegetarian broth that I liked as well.
  

    6.  Following the blepharoplasty surgery, you will need to apply some sort of ice packs,
         to promote the healing and to reduce the puffy eyes that are created from the surgery.
         You will apply ice packs, only, for two days at intervals of one-half hour on and
         half-hour off. This helps with a different cause of puffy eyes. After two days of icing,
         you will add heat every other time. The process of icing and heating makes the  eyes
         remain puffy for a few days, but you will immediately see that, even with the swelling,
         your eyes will be less puffy than they were before the blepharoplasty surgery. There
         are a couple of options that are better than the drippy ice packs. One is to purchase a
         N.A.P. kit from Brookstone. I have given you a picture below. Two N.A.P. kits make t
         it even more convenient to apply ice packs or heat packs to the puffy eyes after the
         blepharoplasty surgery.  Having N.A.P. kits will allow you to have one in the freezer
         you are using the other one to apply cold to the puffy eyes. Each N.A.P. kit is under
         $25.
         
         The N.A.P.  kit is made up of a terry cover and a gel-pack inside. The gel pack can be
         taken out and frozen to make the "ice" affect. As you can see from my picture below,
         that I actually separated the gel in the pack prior to freezing it so that I could
         maximize the coolness on the puffy eyes and make it more bendable over the nose.

         I did not use the terry covering while I was icing the puffy eyes. The blepharoplasty
         surgery drains a little and I found using paper towels to be more sanitary.  I could just
         toss them after I had used them to ice the puffy eyes and I didn't have to worry about
         laundry.
        
          When I started to ice the puffy eyes, I found it was better to wrap  the gel pack from
          the N.A.P. kit  right in a paper towel. This tossable way of dealing with the liquid that
          was secreating from the stitches created from the blepharoplasty surgery was easy. I
          tried the terry  covering at first. It absorbed too much of the cold from the ice pack.
          The cost of the N.A.P. was under $25 and it eimilated the "wet" of ice packs while
          I was dealing with the swelling and puffy eyes right after the blepharoplasty surgery.

    7.  After blepharoplasty surgery, the doctor's office also provided five  little plastic water
         pouches that were about 1 inch by 2 inches long.  These turned out out to be the best
         thing to put on specific areas where the puffy eyes were still swollen.  I am so glad I
         did not toss them when I came home from the blepharoplasty surgery. Instead, I put
         them in the freezer as soon as I arrived home.  I found I could freeze and refreeze
         these over and over to use on the puffy eyes following the blepharoplasty surgery.
          I would have loved the option of buying a full box of about a dozen or so of these to
         use following the blepharoplasty surgery. The combination of the N.A.P. gel and the
         individual ice packs made it possible to target every part of the puffy eyes and reduce
         points that were more bruised. Since they are not a "cube shape", as they thaw, they
         conform to the section of the eyes that are puffy.  Having them contained in plastic
         keeps them from dripping.  These are a winner!  Someone should be marketing them!

8. You will need a driver to take you from the blepharoplasty surgery and someone to stay with you for the first 24 hours following the blepharoplasty surgery.  Although the blepharoplasty surgery seems minor, at first you will need a little help. My husband drove me, and my son, who is working toward becoming a doctor and still living at home, helped me with cleaning the stitches left from the blepharoplasty surgery. They also got me the things to keep my puffy eyes iced, since that is pretty much constant if you do it one eye at a time.
9.  I also found it very helpful to have my eyebrows shaped and plucked prior to the blepharoplasty surgery so there was no extra hair around the area to deal with.  I found out later that this was a really smart decision. You can wax your eyebrows or do the string-thing or pluck each hair out one by one.  I had the string thing done. There was a cart at the mall and it cost me $10 and about 10 minutes. There was some swelling for two days around the area, so if you do the string thing, do it a week in advance.


ABOUT THE SURGERY

Lower eyelid blepharoplasty is performed to reduce puffiness and wrinkles in the lower eyelids. In my case, there was a hereditary factor.  In the case of my family genes--the puffy eye trait was abundant and present from my mid-thirties. This produced an aesthetically unpleasing fullness to the lower eyelids. Fatty tissue is normally present in the space behind the eye and probably evolved to help cushion the eye in minor impacts. The barrier which keeps fat behind the eye can weaken, allowing fat to come forward into the lower eyelids. I can only refer to it as puffy eyes!

To eliminate this condition permanently, there are two options. Lower eyelid blepharoplasty may be performed through an incision under the eyelashes or an incision on the inside of the eyelid. Excess fat can be removed to reduce the puffy eye effect from either type of incision. However, if the blepharoplasty surgery is performed through an external incision, excess skin can also be removed, reducing lower eyelid wrinkles.

When the fattiness was removed, if I had chosen the incision on the inside of the eyelid, they would not have been able to remove the excess skin that would be left after removing the fatty portions, so my surgery was done by making an incisison just under the eyelash.

I will share a day by day account of my experience of blepharoplasty surgery and my own reduction of puffy eyes!

In addition to the over-the counter products, my doctor prescribed a pain-killer which I did not need. The blepharoplasty procedure is totally painless even though it looks like it in not. I mentioned to him that I probably did not need to pain killer but he said that some people do not use the pain killers for pain, they just like the feeling of being able to escape the unpleasantry of the blepharoplasty surgery. Honestly, from my perspective and from the perspective of other patients I had talked to, who had the surgery as well, no pain medication is necessary. 

In addition to the pain killer, my doctor prescribed an antibiotic as a precautionary procedure and an anti-inflamatory pill to help reduce swelling in the first three days.

WHEN YOU FIRST GET HOME FROM THE BLEPHAROPLASTY SURGERY.....

You should take the anti-inflamatory pill, the antibiotic, clean the stitches with the hydrogen peroxide and put on the ointment and then start the ice packs. Don't plan to go anywhere for the first two days.


AFTER THE  BLEPHAROPLASTY SURGERY

The first day after the blepharoplasty surgery, your eyes will be puffy and bruised. Although the eyes appear to be very painful, they are not. I did not even take tylenol after the blepharoplasty surgery. For everyone, the level of bruising is different.  Things that will help are: Don't take fish oil, vitamins, or aspirin for at least 2 weeks prior to blepharoplasty surgery.  They cause more bleeding, therefore more bruising.  I did not take any of these products prior to surgery for three weeks, but bruising occurs automatically as part of the procedure. Although the brusing looks bad, but it is painless.

The most annoying part of the blepharoplasty surgery is that the stitch line is held with weith pieces of surgical tape. If you look closely, you will see little black hair-like lines under the tape that is on the side of my nose and eyes. These are itchy. Also because the tear ducts are swollen, they tend to be itchy to itchy, too. Other than those two factors, blepharoplasty surgery is a cake walk.  You just have to deal with the icing of the puffy eyes and not do too much.  Because you don't feel "bad" is is easy to over-do.  You must decide before you do the blepharoplasty surgery that you will pamper yourself for at least a week.

The pictures above and below provide a closer looks at the stitches and the tape that is used to hold the stitch line in place after the bleparoplasty surgery. The stitiches will be removed by pulling on the thread that is being held under the tape. This will be done six days after the blepharoplasty surgery if everything heals properly in that time. If not, don't panic. You want the blepharoplasty surgery to be successful, so be patient with the process.

You will need to plan to stay awake as long as possible on the day of the blepharoplasty surgery so that you can keep the ice packs going on the puffy eyes. I set midnight as my limit because sleep is also good for healing.  You will also need to plan to sleep sitting as near upright as possible. This can be done in a recliner, a mechanical bed (if you are lucky enough to have one) or with several pillows to prop you up.

Not even a full 24 hours later, but after a night's sleep--which I can't claim to have been good---

The swelling and bruising from the blepharoplasty surgery are about the same as the first day. I have noticed a tiny headache today, otherwise no other pain.  The biggest annoyance is trying to not bend down for a couple of days. Have you ever thought of how many times you bend over in a day?  My surgeon daughter said that it is very important to not bend over because it puts pressure on the stitches from the blepharoplasty surgery. Too much pressure can actually rupture them.

The second day after the blepharoplasty surgery has been filled with putting ice packs on the puffy eyes, one half hour on followed by one half hour off.  Lucky for me, I could just listen to the Olympics while they were on. 

There are two options to icing the puffy eyes following the blepharoplasty surgery. You can do constant icing by covering only one eye at a time, or you can ice both at once. I did both methods depending on what else I wanted to do.   Icing one puffy eye at a time allows you to watch TV all day.

In the doctor's instructions, it said that it was good to walk, not just sit, and by evening, it was a good idea not to ice for a couple of hours after 24 hours had elapsed since the surgery.  My husband and I walked around the park and a normal walking pace. We normally walk around it twice (2.9 miles) but this evening, we only walked around it once.  I noticed that the walking was overall very comforting.