Ptosis

10 days before the operation

Stop taking anticoagulant drugs. This after consultation and agreement from your general practitioner. If you are using Marcoumar, Marevan, Plavix or aspirin a substitute treatment will be suggested in agreement with your general practitioner. If the anticoagulants prescribed for a general pathology cannot be stopped, it is then possible that surgery cannot take place.

One day before the operation

Look for a cold compress (cool-pack or ice pack) at the pharmacist.

Pick up sunglasses or a protective hat.

Pick up a Dafalgan painkiller.

The day of the operation

You do not have to have an empty stomach. Take all your drugs as usual (except the anticoagulants).

Do not put on mascara, make-up, earrings or necklaces. Favour wearing comfortable clothes. Do not wear your contact lenses.

Take in recent photos (representative). A photo will be taken before and after the operation so you can judge the change for yourself.

Mention to the nurse and doctor if you are allergic to some drugs.

The operation will last about one and a half hours. In some patients this may last longer when the fatty fibres of the deep layer have to be removed. If a delay has built up with previous patients, you will need to take waiting time into account.

During the operation

Initially, a drawing will be made on your skin using a felt pen to know how much skin will have to be removed. The incision is made in the natural fold of the skin.

Then, the whole face will be disinfected with Isobetadine (if allergic: chlorhexidine) and sterile drapes will be placed around your face like a turban (no drape will block your nose or mouth, this will not prevent you from breathing).

During the operation, you will not be able to touch your face for sterility reasons.

Then, the doctor will give you subcutaneous injections (lidocaine 2 % with 1:100,000 adrenaline). These injections are comparable to dentist’s injections. The anaesthetic takes effect immediately and lasts about one hour.

During the operation, you will be lifted up a few times, as this enables the operation’s effect to be judged better.

As suture material, non absorbable sutures or medical glue are used (absorbable sutures cause a reaction that is harmful for the beauty of the scars).

At the end of the operation, an antibiotic ointment will be placed on your eyelids. Then, you will be given a cold compress, which you must leave on your eye for half an hour. When you return home, it is important to put on the cold compress every hour for 10 minutes. An alternative is to place a packet of frozen peas as this moulds easily onto your eyelids. This cooling is very important to reduce swelling, but only works during the first 24 hours after the operation.

If you are in pain, you can take a Dafalgan (this does not contain anticoagulant substances).

The day after the operation

Cool the eyelids with ice each hour (for 10 minutes). You are going to see the swelling will increase for up to 3 days after the operation, then it decreases.

The first week after the operation

During the first few weeks, the eye may be a little dry. This is why it is important you put ointment in the eyes (for example: Duratears). During the day you can also use a few drops of artificial tears solution. For about a week the skin may be blue in colour, swelling may last up to 3 weeks. Bruising must not worry you, this will slowly disappear.

As long as there are sutures present, the wound cannot come into contact with water and it is preferable not to wear make-up. No massaging eyelids for the first three weeks. Do not apply a dressing on the eyelids.

The sutures are removed 5 to 7 days after the operation. From now one, water can come into contact with the eyelids. Another check-up follows 4 weeks after the operation.

The first three months after the operation

Avoid sun on your skin as this may cause ugly scars. This can be avoided by using a factor 60 total sunscreen or wearing a hat. A pair of sunglasses does not give sufficient protection.

As with other operations, a series of complications and side effects may occur.

Under correction or over correction

As described in the above text, it may be that the eyelid’s state is still not perfect after the operation. This lasts several months before vision is stable and a decision is made to re-operate (if necessary).

Scars

Scars are not only the consequence of the operating technique, they are also the result of skin reaction relating to the operation. Some people naturally form ugly scars. To improve scar healing, it is recommended not to expose the scar to sun. Smoking also has a harmful effect on the wound healing.

Swelling of the eyelids and loss of skin sensitivity.

Eyelid correction leads to a temporary deterioration in the eyelids’ lymph ducts, which causes more swelling initially. During the operation certain nerve ends are cut and as a result hypersensitivity is possible in this skin area. The nerves recover within a few months.

Cysts

In the suture locations small yellow cysts may develop. In most cases these resorb after a few months.

Skin irritation caused by dryness

It may be that the swelling of the eyelids temporarily prevents the eyes from closing completely, which causes eye dryness. This problem can be treated by applying artificial tears solution.

A protruding eye caused by bleeding

In rare cases, post-operative bleeding may cause stressing of the tissues. This is an extremely serious complication which may even cause blindness. In this case, it is essential to contact your general practitioner immediately.