Before surgery: what to prepare
Stop aspirin, ibuprofen, naproxen, fish oil, vitamin E, ginseng, and ginkgo for 7–10 days. No alcohol for 48 hours. Arrive with a clean face: no makeup, no contacts, no false lashes, no extensions. Bring photos of yourself from a few years ago if available, the surgeon uses them to assess how much your ptosis has progressed over time. If you wear hard contact lenses, mention this in consultation; long-term hard contact use is a recognized contributor to acquired aponeurotic ptosis and the surgical plan may differ.
The day of surgery
Ptosis correction is performed under local anaesthesia with mild sedation, runs 60–90 minutes total for bilateral correction, longer for complex unilateral or asymmetric cases, and discharges same-day. The technique used (Müller muscle resection for mild cases, levator advancement or resection for moderate, frontalis sling for severe) is determined by your levator function measurement at consultation. You leave with sutures along the upper lid crease and a slightly over-lifted appearance, which is intentional because the muscle will relax somewhat as it heals.
Days 1–3: peak swelling
Swelling and bruising peak day 2–3. The eye may not close completely while sleeping during the first week, this is normal and expected because the lid has been intentionally tightened. Use the artificial tears and lubricating ointment the clinic provides, especially at night. Cold compresses (10 on, 10 off) for the first 48 hours. Head elevation on two pillows. No bending, no lifting, no salty food. Pink oozing in the first 24 hours is normal.
Week 1: stitches out, bruising fades
Sutures come out around day 5–7. The eye looks more open than your pre-op baseline but still swollen, and the lift may look uneven if one side was more ptotic than the other (almost always the case). Mild lagophthalmos, inability to fully close the lid, can persist into week 2 and is managed with night-time lubricant. Bruising is concealable with makeup once sutures are out.
Weeks 2–4: back to public
Office work and public-facing situations from the end of week 2. The eye now closes properly for most patients by week 2–3. The lift looks slightly excessive, this is intentional and resolves. Asymmetry between the two eyes can look more obvious during weeks 2–4 as one side resolves faster than the other; this typically equalizes by month 2–3. No eye rubbing for at least 6 weeks. Contact lenses around week 2–3 depending on lid tenderness.
Months 2–3: swelling resolves
The intentional over-lift relaxes into the target height between months 1 and 3. If the lid settled too low (under-correction), it will be obvious by month 3 and the surgeon can begin discussing options. If the eye is still not closing fully at night past month 2, flag it, persistent lagophthalmos can dry the cornea and needs management.
Months 6–12: the final result
Final lid position is set by month 6 for most patients. The frontalis sling technique used for severe cases continues to settle slightly longer, up to month 9. Revision rates for ptosis correction are higher than for cosmetic DES because muscle behaviour is harder to predict than skin behaviour; under-correction is the most common reason for revision and is assessed at month 6 minimum. Scar maturation along the crease continues through month 12.
Red flags: when to call the clinic
Call the clinic the same day for: sudden severe swelling distorting the eye, persistent inability to close the lid past day 5 with grittiness, burning, or sharp pain (corneal damage can occur within 48 hours of exposure, do not wait until day 7), vision changes that don't clear within an hour, pus or yellow discharge, fever over 38.5°C, or a lid that suddenly drops well below the surgical position (suture dehiscence). Go to an emergency room for sudden severe eye pain with vision loss in the first 48 hours. A lid that closes incompletely while sleeping in the first 5 days, mild asymmetry, and intermittent tearing are not red flags.