Blepharoplasty Recovery

Recovering from blepharoplasty is a predictable process, but the day-to-day experience can feel surprising if you don’t know what to expect. Bruising migrates. Eyes water for no reason. One side looks more swollen than the other. All of this is normal — and understanding the timeline ahead of time is the single best way to reduce anxiety and recover smoothly. This guide walks you through eyelid surgery recovery week by week, explains what is normal, and clearly identifies the few warning signs that warrant a call to Dr. Fountain.

Immediate Post-Op (Days 1–3)

The first 72 hours set the tone for your entire recovery. Swelling and bruising peak during this window, and the steps you take — or skip — have an outsized effect on how quickly you bounce back.

What to Expect

You will leave the surgery center with eyelids that feel tight, slightly numb, and mildly sore. Most patients describe the discomfort as a 2 or 3 out of 10 — closer to a sunburned sensation than sharp pain. Vision may be blurry from antibiotic ointment, and your eyes may water or feel gritty. Bruising typically appears within 12 to 24 hours, often spreading downward toward the cheeks because of gravity. By day 3, swelling usually reaches its maximum before slowly improving.

Essential First-Day Care

• Cold compresses: Apply chilled gauze or a soft gel pack to the eyelids for 15 to 20 minutes every hour while awake during the first 48 hours. This is the most effective swelling-reduction tool you have.
• Head elevation: Sleep with your head propped on two or three pillows, or in a recliner, for at least the first week. Keeping your head above your heart prevents fluid pooling overnight.
• Lubricating drops: Preservative-free artificial tears every 1 to 2 hours during the day. Eyelid swelling temporarily impairs blinking, and the ocular surface dries out quickly.
• Ophthalmic ointment at night: A thin ribbon along the incisions and inside the lower lids prevents corneal exposure while sleeping.
• Avoid bending, lifting, and straining: Even small spikes in venous pressure can worsen bruising or trigger bleeding.

Pain Management

Most patients need nothing stronger than acetaminophen (Tylenol). Avoid aspirin, ibuprofen, naproxen, and other NSAIDs for at least the first week unless Dr. Fountain directs otherwise — these increase bleeding risk. If you were prescribed a short course of stronger pain medication, you likely won’t need more than a dose or two.

The First Week

The first week is when recovery feels most dramatic. Swelling shifts day to day, bruising changes color, and you may look worse on day 4 than you did on day 1 — this is expected. By the end of week one, most patients begin to recognize themselves in the mirror again.

Days 4 to 7

Bruising transitions from purple to greenish-yellow as hemoglobin breaks down. It often migrates downward into the cheeks, which can look alarming but is completely normal. Swelling begins to subside, particularly first thing in the morning improvement may be more obvious than evening. Incision lines look pink and slightly raised. You may notice small lumps along the suture line — these are knots and tissue reaction, not complications.

Suture Removal

For most upper blepharoplasty patients, skin sutures are removed between days 5 and 7. Lower lid sutures, when used externally, are typically removed in the same window. Transconjunctival lower lid incisions (hidden inside the lid) use dissolvable sutures and require no removal. Suture removal is quick and essentially painless — described by most patients as a light tugging sensation.

Normal vs. Worrying at One Week

Weeks 2–4: Returning to Normal

This is when most patients re-enter the world. By the end of week 2, the majority of visible bruising has resolved or can be easily covered with makeup. Swelling continues to improve, though subtle puffiness — particularly in the lower lids — can persist much longer.

Returning to Work

Most desk-job patients return to work between days 7 and 14. If you’re comfortable being seen with light residual bruising (or are skilled with concealer), one week is realistic. If appearance matters for your role — client-facing work, public speaking, video meetings — plan for two weeks. Physically demanding jobs that involve lifting, bending, or heat exposure require at least three weeks off.

Makeup Timeline

• Day 7–10: Mineral-based concealer and foundation may be used on intact, healed skin away from incision lines.
• Day 10–14: Eyeshadow and concealer over incisions, once sutures are out and the skin is sealed.
• Day 14–21: Mascara and eyeliner. Use fresh products to reduce infection risk — throw out anything from before surgery.

Exercise and Activity

Light walking is encouraged from day 1, but cardiovascular exercise, weight training, and yoga should wait until at least three to four weeks post-op. Anything that elevates your heart rate significantly, requires bending below the waist, or strains the Valsalva maneuver (heavy lifting, planks) can cause delayed swelling or bleeding.

Months 1–3: Final Results

The dramatic part of recovery is over by week 4, but final results take considerably longer to emerge. Patients are sometimes surprised that subtle changes continue for months — this is normal scar biology, not a problem.

Month 1

At one month, you look like yourself again. Friends and family who didn’t know about the surgery may simply comment that you look rested. Incision lines are still pink but settling. Some firmness or thickening along the scar is expected.

Months 2 to 3

Scars transition from pink to white as the tissue remodels. Residual swelling — especially in lower lid surgery — gradually resolves. The eyelid contour becomes more refined. Most patients consider themselves at about 90% of their final result by 3 months.

Final Result

True final results emerge between 6 and 12 months. In most patients scars fade to become inconspicuous, particularly when hidden in the natural upper lid crease, though healing varies by individual. If you had a brow lift or ptosis repair at the same time, allow the full 12 months before judging the outcome.

Week-by-Week Recovery Timeline

Activity Restrictions

The activity restrictions after blepharoplasty exist for two reasons: to prevent bleeding into the surgical pockets, and to keep incisions from being disturbed before they have tensile strength. Following these guidelines is the single most controllable factor in your recovery.

First Week — Strict

• No bending below waist level (tie shoes from a seated position; ask someone to retrieve dropped items)
• No lifting more than 5–10 pounds
• No exercise beyond gentle walking
• No alcohol — it dilates blood vessels and worsens swelling
• No smoking or nicotine products — nicotine constricts vessels and impairs wound healing
• No swimming, hot tubs, or saunas (heat and bacteria risk)
• No contact lenses for at least 2 weeks after lower lid surgery

Weeks 2 to 4 — Gradual Return

• Light cardio (stationary bike, elliptical at low resistance) can begin around week 2–3
• Resume contact lenses when comfortable (typically week 2–3)
• Avoid eye rubbing for at least 4 weeks
• Resume weight training and yoga at 4 weeks, once cleared by Dr. Fountain

Long-Term

Sun protection matters for months. UV exposure during the first 6–12 months can cause permanent hyperpigmentation of the scars. Sunglasses and mineral sunscreen are non-negotiable.

Warning Signs to Call Dr. Fountain

Most blepharoplasty recoveries are uneventful. However, a small number of issues do require prompt attention. Knowing the difference between expected discomfort and a true problem keeps you safe and gives you peace of mind.

Call Promptly

• Vision changes: Sudden blurring, double vision, or loss of vision in one eye
• Severe pain: Pain disproportionate to expectation, especially if one-sided
• Rapidly increasing swelling: Tense, hard swelling on one side
• Signs of infection: Expanding redness, yellow/green discharge, fever above 101°F
• Persistent bleeding: Active bleeding from incisions that won’t stop with light pressure
• Incomplete eye closure: Inability to fully close the eye after 2–3 weeks (mild lagophthalmos in the first week is normal)
• Lower lid pulling down or outward: Especially after lower lid surgery, an outward-rolling lower lid (ectropion) needs evaluation

Upper vs Lower Blepharoplasty Recovery

Although these procedures are often discussed together, they recover quite differently. Understanding which you’re having — or both — helps set accurate expectations.

Lower lid surgery, particularly when fat is repositioned or skin is excised externally, takes longer to look fully “finished.” Be patient — minor unevenness or fullness at 6 weeks usually resolves over the following 2 months.

Recovery After Combined Procedures

Many patients combine blepharoplasty with related procedures — a strategy that delivers a more harmonious result and consolidates downtime into a single recovery period.

Blepharoplasty + Brow Lift

Adding an endoscopic or direct brow lift extends recovery modestly. Expect:

• Forehead and scalp numbness or tingling for several weeks
• Slightly more swelling that travels into the upper face
• Social downtime extended to 10–14 days
• Avoid hair coloring or chemical treatments for 4 weeks

Blepharoplasty + Ptosis Repair

When ptosis repair is added, the upper lid height takes longer to settle — sometimes 6 to 8 weeks before final symmetry is clear. Asymmetry during early recovery is expected and almost always self-corrects as swelling resolves.

Blepharoplasty + Laser Resurfacing

Combining blepharoplasty with CO2 laser resurfacing of the lower lids or full face addresses both skin laxity and fine wrinkles in one recovery. The laser portion adds 7–10 days of redness and crusting. Total social downtime is typically 10–14 days, and sun protection becomes especially critical for 3–6 months.