Healing during the immediate post-operative period has been summarized elsewhere. Expect to wake up the day after surgery, study yourself in the mirror, and then seriously question why you ever considered doing such a thing to yourself.

Swelling can be marked. Fortunately, improvement is rapid. Once you are upright, gravity will drain some of the swelling into your cheeks. The act of blinking helps to "pump" away some of this initial inflammatory swelling.

The difference between eyelid bruising and most other bruises you have ever experienced is that the eyelids don't require much blood to become discolored. A few drops of blood mixed in with tissue fluid can tint the thin skin of the eyelid region.

The routine use of oral corticosteroids is probably of little value, while the risks of taking such medications are very real.

The intense red of the first few days will give way to a purple and finally a yellow discoloration that appears just prior to full disappearance. Often times, the last area to clear is at the top of the cheek.

If a transconjunctival approach was used on the lower eyelids, the clear conjunctiva lining the sclera of the eye may be lifted up like a blister.

If itching becomes a nuisance, switch back to cold compresses.

Numbness of the lashes on the upper eyelid is a universal temporary nuisance. Sensation will start to return at around one month and usually be back to normal in about two months.

While most bruising is gone in about two weeks, about 10% of the swelling will persist much longer. You will notice that your eyelids continue to "thin out" for four to six months after surgery.

Once the bruising and most of the swelling are gone, it is only natural to concentrate on their scars. All scars go through phases as they heal. At first the scars will appear red and slightly thickened; in some patients, the thickening may increase at around four weeks after surgery. Small cysts may be noticed but almost always disappear without special treatment. Any "lumps and bumps" that do not disappear can always be removed, but it is wise to give them a chance to go away on their own. Once a scar is well-healed, it will appear as a thin white line.

As with any healing wound, you will notice day-to-day improvement at first, then week-to-week improvement for a month, then month-to-month improvement for six to twelve months.

Many patients inquire about the effectiveness of applying Vitamin E to their scars to facilitate healing. While the scientific evidence for this is lacking, many patients know other patients who have experiences superb healing while applying Vitamin E. Applying Vitamin E to the skin doesn't hurt, as long as you wait about ten days for the wounds to close to prevent the oil from getting between the healing wound edges and interfering with initial closure. Some people may be allergic to Vitamin E applied topically, so it is wise to "skin test" your arm for a few days before placing it on your eyelids.

Just as the surface scars take time to soften, so do the "internal" scars. Until this process is well underway, the eyelids may feel a bit stiff and not "drape" freely. Time is usually curative.