What are the postoperative care instructions for ptosis surgery?

Postoperative care following upper eyelid ptosis repair is essential to optimize surgical outcomes, minimize complications, and support proper healing. Patients should keep the surgical site clean and dry for the first 24–48 hours; after that, gentle cleansing with sterile saline or mild soap and water may be performed, avoiding direct pressure or rubbing. Cold compresses applied intermittently (15 minutes on, 15 minutes off) during the first 48–72 hours help reduce swelling and ecchymosis. Patients must avoid strenuous activity, heavy lifting (>10 lbs), bending below the waist, and straining for at least 10–14 days to prevent elevated intraocular or venous pressure, which could compromise wound integrity or increase bleeding risk.

Topical antibiotic ointment (e.g., bacitracin or erythromycin) is typically prescribed for 5–7 days to prevent infection, and patients should apply it as directed—usually twice daily—using a clean fingertip or cotton-tipped applicator. Sutures are generally removed between postoperative days 5 and 7, depending on wound healing and surgeon preference. Patients should avoid wearing contact lenses for at least one week and refrain from applying eye makeup or using facial creams near the incision until fully epithelialized (typically 10–14 days).

Pain is usually mild and well-controlled with acetaminophen; NSAIDs (e.g., ibuprofen, naproxen) and aspirin should be avoided for at least 10 days unless specifically approved by the surgeon, due to their antiplatelet effects and potential to increase bruising or bleeding. Patients must monitor for warning signs—including sudden worsening of vision, severe or progressive pain, purulent discharge, increasing redness or warmth, or fever—and contact their surgeon immediately if any occur. Follow-up visits are typically scheduled at 1 week, 1 month, and 3 months postoperatively to assess symmetry, lid height, contour, and functional improvement.

It is important to note that full resolution of edema and final aesthetic and functional results may take 3–6 months. During this time, subtle asymmetries or mild lagophthalmos (incomplete eyelid closure) may persist temporarily but often improve spontaneously. Adherence to all postoperative instructions significantly enhances recovery and long-term satisfaction.