Having surgery?

 

This section is designed to address common questions. It is general advice, and your individual instructions may vary.

Any other questions can be answered by Dr Ullrich during your consultation. 

Before Surgery

 

Dr Ullrich and the surgical team are here to take care of you! It is our outmost priority to make your surgery as comfortable as possible. 

 It is normal to feel nervous about having an operation, but please discuss with Dr Ullrich and the anaesthetist if you are feeling very anxious.

 Leave plenty of time for travelling on the day of your surgery to avoid undue stress for yourself. You will need someone to pick you up after the surgery and take you home.

Wear comfortable clothes and shoes that easily slip on and off. Please do not wear any make up on the day of surgery. If you are having a general anaesthetic, please remove all nail polish. Wear your glasses, not contact lenses, on the day of surgery.

You will receive information about fasting prior to your surgery. If you have been booked for sedation or general anaesthesia and you have not fasted, it may be dangerous to proceed with the operation and your surgery may be cancelled.

 Please discuss the use of any blood thinners with Dr Ullrich before your surgery. Do not stop your blood thinners unless discussed with Dr Ullrich / your GP / your cardiologist. 

Common types of blood thinning medications are listed below:

  •  Warfarin

  • Coumadin

  • Apixaban

  • Rivaroxaban

  • Aspirin

  • Clopidogrel / Plavix

 Some medications may thin the blood but are often used for other reasons:

  • Ginko bilba / ginger / garlic

  • Some anti-depressant medications

  • Fish oil / Krill oil

  • Arnica

  • Evening Primrose

If you are taking any of these, please discuss them with Dr Ullrich.

After surgery

Pain relief

If you had local anaesthetic as part of your surgery, it will often last for up to 8 hours. 

Dr Ullrich recommends that you take paracetamol (unless you have been told not to take paracetamol) when you get home after your surgery and again before going to sleep.

You may want to take regular paracetamol for 1-2 days after the surgery if you have discomfort, but this is not required.

The correct adult dose is 1-2 tablets (that is 500mg – 1g) Paracetamol up to 4 times per day. DO NOT exceed a dose of 8 tablets in 24 hours. 

Dr Ullrich will advise people that cannot take paracetamol and children / their families about pain relief. 

Swelling and Bruising

You will develop some swelling and bruising. How much swelling you have is variable, but it is normal to have significant amounts of swelling even after straight forward surgery. The swelling often travels down the face with gravity, and you may find that your lower cheek or jaw line feels swollen after a few days. 

Do not worry about this, it will be much better within a week.

The swelling will have improved significantly after the first week, but it can take up to 4 weeks to subside completely. 

 Try and sleep with your head slightly elevated for 2-3 days after the surgery. Use 2 pillows for example, rather than just 1. 

You can limit swelling and bruising by applying cold packs for 2-3 days after the surgery.

  • Use a gel pack that is suitable for the freezer, or place ice cubes into a zip lock bag

  • Use a moistened clean tissue / gauze / thin clean towel to wrap your cold pack

  • Apply the cold pack for 10-15 minutes up to 3 or 4 times per day.

  •  If the cold packs feels too cold, please remove it and re-apply it a short while later. Be guided by your comfort level to avoid giving yourself frost bite.

It is normal to have blood stained tears for up to 10 days after your surgery.

Dressings / Sutures / Stitches

Leave any dressings in place unless instructed otherwise by Dr Ullrich.

Your stitches may be dissolvable or may need removal.

You may have steristrips around the operated eye. Leave these dry and intact and they will start to fall off within a few days. If you have steristrips on your upper eyelid(s), leave them for 6 days, then remove them. Underneath, you will see one long blue suture (thread or stitch), that you need to pull out.

Don’t worry if you cannot see it – it has probably fallen out by itself. If you are not sure, do not worry. Any remaining sutures can be removed by Dr Ullrich or the nurse during your follow-up appointment. 

If you had ptosis surgery, you may see a small depression or dip in your upper eyelid – don’t worry about this, it will disappear in a few weeks. 

Some of the deeper stitches may take several weeks to resolve, and this can cause itchiness.

Eye Ointment

Dr Ullrich may ask you to apply an ointment with or without antibiotic to the operated eye. Please wash and dry your hands before touching your eyes. Look up and apply a small strip of ointment onto the eye itself or in the corner of the eye. Close your eyes for a minute to allow the ointment to spread. You may ask a family member to assist you with this. 

Your vision will be blurry whilst the ointment is in your eye – this is normal and nothing to be concerned about. Please use the ointment for as long as prescribed but you may shift the time of ointment application during to daytime, to avoid for example having to use the ointment just before driving / reading your favourite book. 

Exercise

Avoid heavy lifting and dirty/dusty activities for one week to reduce the chance of bleeding and infection. 

Ask Dr Ullrich about return to exercise. Generally, no swimming or hot tub use for 2-4 weeks (depending on the surgery) and intense exercise should be avoided for 1 week. You may return to gentle activities such as walking or stretching as soon as you feel able to. 

Glasses / Contact Lenses

You can wear your glasses over the dressing or once it has come off as per normal. If you wear contact lenses, you can start wearing these after 2 weeks. Be mindful to avoid pulling on your eyelids. If you had ptosis surgery, you should ideally avoid contact lens wear for 3-4 weeks. 

Bathing / Showering

You may shower the day following the surgery. Avoid submerging your face and getting your dressings wet. 

If you wish to wash your hair, please lean your head back and rinse without getting water onto your face. Avoid getting water/soap/shampoo in your eyes. 

If you had surgery on your scalp or a brow lift, avoid washing your hair for 5 days. You may then gently wash using a mild shampoo. Be mindful that you may have stitches or staples hidden in your hair, and be extremely careful when combing/brushing your hair.

Driving

Do not drive or operate machinery within 24 hours of having sedation or general anaesthesia. You may drive when you can see clearly / wear your prescription and open both eyes. 

Scar Management

Initially a scar is visible around your eyes. This scar may look red and feel lumpy or itchy for some time. The scar will fade with time – you can expect significant improvement over the first 3 months. However, the scar will fade for up to 12 months after the surgery. 

Dr Ullrich recommends scar massage twice per day for 3 months. Dr Ullrich will advise you when to start with scar massage and she will demonstrate to you how to perform it properly. You may use any moisturiser to massage the scar, but a thick and unscented formulation is preferred. Examples of suitable options are simple white paraffin, oils formulated for scar massage or any lotion/cream for dry skin. You may choose to apply Manuka honey to your scar lines. 

If you are known to suffer from excessive scarring / keloid scarring, please discuss this with Dr Ullrich before your surgery.

Follow-up

Dr Ullrich will discuss follow-up appointments with you.