Pre & Post Operative Instructions
The following are some suggestions to help make your surgery with Dr. Goldstein a more pleasant experience.
  1. Do not use any aspirin, ibuprofen, or herbal products for about 1 week prior to surgery (Please see list). If you have another medical condition that requires you to take aspirin or ibuprofen and it would be dangerous to stop these medicines, then by all means continue to take them. Just be sure to mention this to your surgeon prior to the day of surgery.
  2. Do not take any Vitamin E for 2 weeks prior to surgery. Vitamin E also increases bleeding time and can increase the amount of bruising following surgery. Since most multi-vitamins contain Vitamin E, you should avoid these for 2 weeks prior to surgery.
  3. Vitamin C taken prior to surgery and following surgery is reportedly helpful in wound healing. You may want to consider taking 1000 milligrams of Vitamin C once a day starting a few days prior to the surgery and continuing for 1 week following surgery.
  4. On the night before surgery or the day of surgery, clean your face with a mild cleanser.
  6. Avoid tanning for 2 weeks prior to surgery (including tanning booths) and ask Dr. Goldstein as to when you may resume tanning. Remember that excessive sun exposure on a new scar can lead to permanent darkening of the scar.
  7. Do not use any exfoliating scrubs, hydroxy acid products or Retin-A™ for 5 days prior to any cosmetic surgery.
  8. DO NOT EAT OR DRINK after midnight the night before any operations. Medications can be taken with sips of water the morning of surgery if necessary.
  9. Never hesitate to ask your doctor or his staff any questions you have before or after surgery.
Your Medications and Surgery

Surgery is obviously an invasive procedure and thus bleeding and bruising are to be expected. Most eyelid and facial surgery has only slight bruising that will last 1-2 weeks. However certain prescription and many over the counter medications can thin the blood increasing your risk for both bleeding during or after surgery as well as post operative bruising. Thus it is imperative to discuss all your medications and supplements with your surgeon prior to any surgical procedure.

Medications and dietary supplements that increase your risk of bleeding and bruising can be broken down into four major categories:

  1. Aspirin containing products
  2. NSAIDS (non steroidal anti-inflammatory drugs like Advil, Motrin or Alleve)
  3. Blood thinners/anti-clotting medications
  4. Herbal / dietary supplements

These various medications may be used to treat pain, arthritis, inflammatory conditions, or as part of a cold remedy. Blood thinners are used in patients with heart disease and other conditions that increase risk for clotting. Herbs and vitamins are used to promote better health.

The bottom line is, it is important to know ALL your medications. If you are taking any of these products, we usually like to stop them 2 weeks before surgery, if medically possible. Other medications for things like diabetes or high blood pressure should not be stopped. Please discuss these issues, and your medications, with your personal physician and with Dr Goldstein.

Healing from Surgery

Recovering from surgery takes time and patience. During the days following surgery several things can be done help the healing process and keep you comfortable.

Bruising & Swelling: Surgical procedures, no matter how delicately performed, will induce varying amounts of bruising and swelling. This is a normal part of eye and facial surgery. Thankfully, most swelling and bruising is at its worst in the first 1-3 days and will resolve after 1-3 weeks. Here are some helpful hints to improve and aid you in recovery as it takes a few months to fully heal.

Cold Compresses: These are very helpful, especially around the eyes. Cold compresses should be applied as much as possible for the first 2-3 days after surgery. This can be done in several ways. A wash cloth may be soaked in a bowl of ice water, rung out, and applied to the surgical areas every 20 minutes while awake. A second option is to apply a zip lock plastic baggie filled with frozen veggies. This stays colder longer, is less messy and nicely contours to your eyes. If this is too cold, wrap the baggie in a small, thin towel.

Homeopathic / Vitamin supplements: A variety of remedies are available to help minimize bruising as well as speed up healing. Arnica is probably the most utilized agent but a complete list is provided to choose from. These can be started with in a few days before surgery and typically continued for about a week afterwards. Of note, these are optional as there is no proven science that they actually help in low doses.

  1. Arnica Montana – this homeopathic remedy is well known for its ability to minimize post operative bruising and swelling. To use this product, place 3 or 4 pellets under your tongue the night before surgery. Continue taking the pellets 4 times daily for 5 days. Arnica can be purchased at most health food stores and generally it is best to follow the directions not he bottle.
  2. Bromelain – Another homeopathic remedy found in Pineapple may be useful to minimize bruising and swelling. Take 1000mg daily for 5 days after surgery.
  3. Vitamin A – improves wound healing. Take 25,000 IU daily for 5 days.
  4. Vitamin C – important part of natural wound healing process. Take 1000mg daily for 7 days.
  5. Vitamin E cream – this topical treatment can be applied to old incisions starting 2 weeks after surgery for 2-3 months.
Post-operative Instructions for wound care, exercise and follow-up:

Do not rub the incision site for 10 days. Do not swim for 10 days. You may shower the day after surgery, but do not rub the incision site. Otherwise keep incisions clean and dry. No eye makeup for 1-2 weeks near incisions. You may use cover up over bruising on the cheeks if needed starting after surgery.

Do not lift objects heavier than 20 pounds for 7 days. No strenuous exercise for 1-2 weeks.

There are may be small adhesive strips on your incision site. You may apply ointment directly on top of these strips. If they become loose, you may gently peel them off, otherwise, leave them on the incision. Leave any bandage on until seen by the doctor, unless instructed otherwise. Do not forcefully blow your nose for 5 days if surgery on the nose or sinuses were completed.

Make sure to follow up for your post operative care as instructed. This is usually done within one week of surgery.

Long Term Healing

As noted, most of the bruising and swelling fade during the first few weeks after surgery. However full healing takes months. Wounds tend to tighten up for 4-8 weeks after surgery but will then relax over 4-8 months. It is common for lids to feel stiff or tight, to see some redness or firmness to an incision/scar, but this will fade. Some patient have mild numbness near their eyelashes and this too improves & fades over several months. Time and Patience are your two best physicians after surgery.