Cosmetic Bilateral Upper Blepharoplasty, Cosmetic UNILATERAL Ptosis Repair, and Cosmetic Bilateral Lower Blepharoplasty FAQs
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Bilateral means surgery on both sides. Click to read about upper blepharoplasty and see photos.
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Unilateral means that the surgery will be on one side. Click to read about ptosis repair and see photos.
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Click to read about lower blepharoplasty and see photos.
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The surgery is performed at Blue Ridge Surgery Center. Review additional information about the facility.
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An adult will have to drive you to surgery, stay there, take you home, and stay with you for 24 hours after surgery. You and your guest will be at the surgery center for approximately 5 hours.
You cannot drive for 24 hours after anesthesia and you should not drive if your vision is blurry (more below).
Avoid surgery within 3 months of any major events (weddings, family reunions, etc.).
For the upper blepharoplasty, long acting sutures are used to help reform the eyelid crease. These sutures may take over a month to dissolve, but they are not visible. External sutures can take 1-2 weeks to dissolve. . Consider this a short term sacrifice for a long term gain. Expect bruising and swelling after surgery. Though the bruising and swelling will not be fully resolved after 14 days, many patients are socially presentable after 14 days (aside from having the aforementioned sutures in place at this time). Make up can be used on day 15.
For the ptosis repair, contact lenses are placed by Dr. Mettu at the time of surgery to help minimize irritation from sutures on the inside of the eyelid. These do not require maintenance, are comfortable, and are safe to leave in. Dr. Mettu will remove the contact lenses at the first post op visit.
After ptosis repair, vision may be very blurry initially due to bloody tears and blood clots on the inside of the eyelids. Blurry vision will steadily improve over the course of a few days and typically improves further once the contact lenses are removed.
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There will be an in-person pre-op (usually the day before surgery). There will also be a in-person post op about 7-10 days later to remove contact lenses placed in eye after ptosis surgery. Before booking your flights, be sure to touch base with us for guidance, but generally, the longer you can wait to fly, the better.
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Avoid strenuous activity until day 11 after surgery.
On day 11, you may resume exercise at 50% effort and slowly increase effort thereafter.
Avoid bending and lifting until day 11.
Do not rub, pull, or press on the eyelids.
Do not go swimming until day 21 after surgery.
Avoid water in the eyes.
Do not drink alcohol until day 11 after surgery as alcohol can thin your blood and increase the bleeding risk.
Do not wear make up until day 15 after surgery.
Do not wear contact lenses until day 15 after surgery.
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At the pre op appointment, we will send in the prescriptions for you. We will prescribe:
Antibiotic ointment to use on the sutures three times a day for ten days and then nightly until the sutures dissolve
Antibiotic eye drops to use three times a day for ten days
Oral antibiotics
Nausea medication for use if needed
You should also have the following over the counter medications available for use post operatively:
Artificial tears to use as needed for dryness/irritation
Tylenol for post operative pain (if this does not adequately reduce your pain to a tolerable level, please let us know)
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You will need to use ice packs after surgery.
They should be light weight so as not to put too much pressure on the surgical area and sutures.
Frozen ketchup packets in a clean ziplock bag work well.
You can also purchase reusable freezable gel packs if desired.
Product recommendations for eyelid cleansing can be found here.
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How Long Does Healing Take?
Recovery happens in stages and varies by patient, but most follow this general timeline:
1–2 Weeks:
Swelling and bruising are normal and peak in the first week. By about two weeks, most patients feel comfortable being out in public. Light facial makeup may be used after 14 days. Avoid eye makeup until at least 4 weeks after surgery.Around 1 Month:
Swelling continues to improve, bruising is typically resolved, and the eyelids look more natural and refreshed. Upper eyelid incisions continue to fade. Most patients resume full social and work activities.1–3 Months:
Ongoing refinement as subtle swelling and discoloration continue to improve and incisions soften.Around 3 Months:
Approximately 85% healed with stable, natural-looking results. This is often when before-and-after photos are taken.Up to 12 Months (Some Patients):
A small percentage of patients may have mild residual swelling or discoloration that takes longer to fully resolve.Bottom Line:
You’ll see noticeable improvement within weeks, with continued refinement over several months. Our team supports you throughout recovery and is available for any questions or concerns. -
We will schedule the first post op appointment typically 5-7 days after surgery at which time the contact lenses will be removed. Sutures will not be removed - they will be allowed to dissolve as noted above. There is one more post op appointment approximately 2-3 months after surgery. After that time, patients follow up as needed.
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After the initial consult, we see patients again prior to surgery (usually around 1-2 weeks) for a pre op visit. Before the pre op visit, you should review the following information again:
Review all of the information on this page in detail.
Review the pre op instructions.
Review the post op instructions.
Review the bilateral upper and lower blepharoplasty, and unilateral ptosis consent form (you will sign this in the office at the pre op visit).
You should also come to the pre op visit prepared with questions or send us any pressing questions in advance.
If there is any history of under eye filler that has not been dissolved, the under eye filler must be dissolved at least two weeks before surgery.
Please remove any false lashes or lash extensions prior to surgery day.
For patients who take GLP-1 medications for weight loss: medications must be stopped before scheduled procedure per anesthesia safety guidelines. For weekly injections, the medication must be held for at least 7 days prior to surgery. Please be sure to touch base with us for specific guidance.
Patients with GLP-1 for diabetes: Medical clearance will be required to hold medication. For weekly injections, the medication must be held for at least 7 days prior to surgery. Please be sure to touch base with us and your prescribing doctor for specific guidance.
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Here is a break down of the self pay costs for the bilateral upper blepharoplasty, unilateral ptosis repair, and bilateral lower blepharoplasty.
The self pay quote for surgery at Blue Ridge Surgery Center is $11,000. This includes the pre op visit, surgeon's fees, anesthesia fees, facility fees, and post op care.
The amount above will be paid in at least 3 transactions:
$500 non-refundable scheduling deposit is due within 48 hours of booking to reserve your surgery date. This deposit is applied toward your total balance.
$9,000 will then be due to Raleigh Eye and Face Plastic Surgery (surgeon’s and anesthesia fees) at least 30 calendar days prior to surgery.
$1,500 will be due to Blue Ridge Surgery Center for the facility fee*. We recommend calling Blue Ridge Surgery Center at 919-781-4311 at least a few days prior to the day of surgery to complete payment so we can help address any questions that could come up.
Cancellation & rescheduling: If surgery is cancelled or rescheduled within 30 days of the procedure, additional fees may apply. For full details, please review our Office Policies.
Important: If you receive any additional bills from the facility after surgery, please contact our office. -
Surgery times are finalized by the surgery center the day prior to surgery. You will be contacted by Blue Ridge Surgery Center with your arrival time. If you do not hear from them the day prior to surgery, between 2 pm and 4 pm the day prior to surgery, Call 919-781-4311 and press option 1 to get your arrival time.
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If you are an existing patient who has been seen in our office recently, were sent this information to review, and are interested in proceeding with surgery, text and let us know:
dates you CANNOT do with regard to the pre op visit, surgery date, and first post op visit
we will then text you proposed dates based upon our availability (Dr. Mettu operates on Wednesdays and Fridays)
If you have not been seen in our office and would like to be evaluated, you can schedule online.
If you are scheduled for surgery and are reviewing this information before your pre op appointment, see you soon!