What happens in the first 48 hours, when the stitches come out, when the bruising fades, and which signs mean you should call straight away.
The most common question before eyelid surgery is not “How much will it hurt?” but “When will I look normal?” The answer depends on what we mean by normal: popping out to the shops, going back to work and being photographed at a wedding are three different timelines.
Below is a realistic picture of recovery. The timings are approximate: everyone heals at their own pace, and recovery from lower blepharoplasty is slower than from upper.
Day 0 — the day of surgery
If the operation was performed under local anaesthesia, you go home the same day. Your vision may be slightly blurred by the eye ointment — this is caused by its greasy film, not by the operation.
The most important thing on this day is the position of your head. Sleep on two pillows or propped up in a semi-sitting position. Gravity does half the work of reducing the swelling.
- Cold compresses for 10–15 minutes every hour while you are awake
- No bending over, no heavy lifting, no hot baths
- Take pain relief before the pain starts, not once it already hurts
Days 1–3 — peak swelling
This is when most people get a fright. The eyelids are swollen and bruised, sometimes with bruising in the white of the eye as well. It looks worse than it did on the day of the operation.
This is the normal course. Swelling peaks at around 48–72 hours and then goes down every day. If anyone told you that you would look good by day three, they were not telling you the truth.
Days 4–7 — the stitches
The stitches in the upper eyelid are usually removed between day five and day seven. This takes a few minutes and is not painful — it feels like a slight tug.
By now the bruises are changing colour, from purple to yellowish green. This is a good sign, even though it is the least attractive stage to look at.
You can read and use screens, but your eyes will tire more quickly. Use artificial tears if your eyes feel dry.
Week 2 — back out in public
Most patients with office jobs return to work between day seven and day ten. If your work is public-facing or on camera, allow two weeks.
Eyelid make-up can be worn once the incision has fully closed — usually a few days after the stitches are removed, and only once you have been told it is fine to do so. Concealer on a healing wound is a bad idea.
Contact lenses — usually after about two weeks.
Weeks 3–6 — exercise and everyday life
Gentle walking from the first few days. Cardio, weightlifting and anything that raises the pressure in your head are postponed until after the third or fourth week.
Swimming in a pool or the sea — once healing is complete and you have been given the go-ahead. Salt water or chlorinated water on a fresh wound is an unnecessary risk.
Sunglasses are not vanity; they are part of the treatment. Ultraviolet light can permanently darken an immature scar.
Months 1–6 — the scar
The scar in the natural crease of the upper eyelid stays pink for about two to three months, then fades. When the incision is correctly placed, it is practically invisible with the eyes open.
The subtle swelling around the incision settles slowly, and it is normal for the eyelid to feel slightly stiff for months.
The final appearance can be judged at around six months, and the scar's final appearance after up to a year.
When to call straight away
Recovery is predictable, and most of the things that worry people are normal. There are, however, a few exceptions where you should not wait until your next check-up.
- Severe pain that is getting worse, especially on one side
- Deteriorating vision or double vision
- Rapidly increasing swelling of one eye in the first few hours
- A temperature above 38 °C
- Discharge of pus or spreading redness
- Being unable to close your eye fully
What speeds recovery up and what slows it down
Helpful: a high pillow, cold compresses for the first two days, sticking to the activity restrictions, and sun protection.
Unhelpful: smoking — it narrows the small blood vessels exactly where the skin heals with most difficulty; aspirin and anti-inflammatory painkillers taken without checking with your surgeon first; strenuous activity too early; saunas.
Have a question about this topic?
Consultations take place at Solica Medical Centre and Grupchevi Plus Medical Centre in Varna. Book online or send an enquiry — you will receive a reply within 24 hours.