Planning & Recovery
Everything you need to know to prepare for your procedure, from pre-operative steps to what to expect on the day of surgery and throughout your recovery.
Before your surgery
Once a surgical plan is agreed upon, the pathway to the procedure is organized and well-supported.
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Medical optimization
Lower blepharoplasty is a low physiologic stress procedure; routine pre-operative testing is not always required and depends on individual health status. Any specific requirements will be reviewed in advance. A detailed ocular history is obtained at or before consultation to identify any conditions relevant to surgical planning or anesthesia.
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Medications & supplements
Aspirin, ibuprofen, fish oil, vitamin E, and turmeric must be paused one week before surgery. Prescriptions will be sent to your pharmacy one week before your surgery date. All medications should be filled and on hand before surgery day.
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Ancillary considerations
Take care of routine monthly appointments, haircuts, dental cleanings, and similar tasks in the weeks before surgery. This is also a good time to coordinate any personal or professional obligations so your recovery period is low in stress and free of demands.
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Arranging support
A trusted adult must drive you home and stay the first night. Having someone available for the first few days is helpful, particularly for cold compress management and general comfort. After that, most patients are quite independent. Private nursing support is available and can be arranged through the practice if preferred.
What to expect when you arrive
Lower blepharoplasty with fat grafting is performed under general anesthesia in an accredited surgical facility. Nothing to eat after midnight; small sips of water only for approved medications. Wear comfortable, loose clothing and avoid makeup, lotions, and jewelry.
Arrival & preparation
Arrive approximately one hour before surgery for check-in, nursing assessment, IV placement, and anesthesia consultation. Anyone may drive you to the surgery center; however, a designated adult must be present to take you home, as the center cannot discharge you to a rideshare or taxi.
The procedure
The transconjunctival incision is made on the inner surface of the lower eyelid, providing direct access to the herniated fat without any external incision or visible scar. Fat is reduced or, when appropriate, transposed to fill the adjacent hollowing. Autologous fat harvested from the abdomen is then grafted to the tear trough and orbital cheek complex to restore volume and smooth the lid-to-cheek transition. When indicated, laser resurfacing or additional contouring procedures are performed in the same session.
Who is in the room
Throughout the entire procedure, the surgical team consists of a board-certified anesthesiologist dedicated solely to monitoring and managing your anesthesia and safety, a circulating nurse present at all times, and a scrub technician assisting directly with instruments. Before surgery begins, the anesthesiologist and nursing staff will each introduce themselves and speak with you personally, so you know exactly who is caring for you during your surgery.
Discharge
Most patients spend one to two hours in recovery before discharge the same day. That evening, Dr. Hashemi will personally reach out to check in. Patients are given a direct cell number and stay in close communication throughout the recovery period. Photos may be sent by text at any time, and stopping by the office during the first week is always welcome.
Engaged care, directly from the surgeon
Recovery is not a period of uncertainty. Patients have direct access to Dr. Hashemi throughout the healing process.
Evening of surgery
Dr. Hashemi personally reaches out the evening after surgery to check in, review how you are feeling, and address any questions before the first night.
Direct access throughout
All surgery patients have direct after-hours access to Dr. Hashemi. Photos may be sent by text at any time. Stopping by the office during the first week to have anything checked is always an option.
Follow-up visits
The first post-operative visit is at one week. All follow-up visits are conducted personally by Dr. Hashemi, ensuring continuity from first consultation through final result.
A lighter recovery than most expect
Lower blepharoplasty has a notably gentle recovery compared to other facial procedures. Most patients feel physically well within the first few days. The primary limitation is appearance, not function.
Swelling & bruising
Bruising and swelling are expected and typically peak around days three to five before gradually improving. Swelling is often most noticeable in the morning and improves through the day. By one week, most patients have yellowish discoloration and scattered bruising. By two weeks, the skin is mostly clear. By three weeks, most people look fully presentable and it is not obvious that surgery was done.
Cold therapy & positioning
Elevate the head on two to three pillows for the first two weeks. Apply a cool compress gently to the eyes and cheeks for 10 to 15 minutes every two to four hours while awake during the first three days. No direct ice on skin.
Eye care
Apply erythromycin antibiotic ointment to the eyelash line three times daily. Use Maxitrol antibiotic drops as directed. For dryness or irritation, use preservative-free artificial tears. Avoid rubbing or touching the eyes for at least two weeks. No makeup or creams near the eyes for at least two weeks.
Donor site care
The abdominal donor site will have small stitches where fat was harvested. Expect some bruising, firmness, and tenderness for one to two weeks. Apply antibiotic ointment twice daily. The area may feel firm or lumpy for several weeks as swelling resolves. Gentle massage may begin after two weeks if tenderness has subsided.
What you will be prescribed
All prescriptions will be sent to your pharmacy one week before surgery. Fill everything in advance so it is on hand when you arrive home.
- Tylenol: 650mg every 4 hours as needed (max 4,000mg/day). Most patients do well with Tylenol and Celebrex alone.
- Celebrex: once morning and evening. Do not combine with ibuprofen or aspirin.
- Oxycodone: available if needed for stronger pain. Do not drive or make legal decisions while taking it. Use Miralax or Colace to prevent constipation.
- Erythromycin ointment: applied to eyelash line 3 times daily for 10 days after surgery.
- Maxitrol drops: 2 drops in each eye 3 times daily for 10 days after surgery.
- Doxycycline: oral antibiotic, complete the full course as prescribed.
- Mupirocin ointment: applied to abdominal donor site twice daily for 2 weeks.
- Refresh Plus: preservative-free artificial tears for dryness or irritation, as needed.
- Any sudden change in vision
- Severe or increasing pain not controlled by medication
- Significant swelling on one side only
- Fever above 101.5°F
- Foul drainage or signs of infection
- Excessive bleeding from the donor site
- Shortness of breath or chest pain, call 911
Office: 650-313-2338
All surgery patients have direct after-hours access to Dr. Hashemi.
Returning to normal life
Lower lid blepharoplasty carries one of the lighter activity restriction timelines of any facial procedure. Most patients feel physically ready to return to their routines within days. The recovery is primarily about protecting the surgical result during early healing, not managing significant discomfort.
Days one through seven: Light walking is fine from day one. Avoid strenuous activity, bending, heavy lifting, swimming, and hot tubs. Do not drive until vision is clear and narcotic medications have been discontinued.
Week three: Light activity resumes. Keep heart rate generally below 110 bpm.
Week four: Full activity may resume if recovery is progressing well.
Lower eyelid stretch: Beginning after the first week visit, gently stretch the lower eyelids upward and outward two to three times daily for two weeks. Light stretching only, no circular or forceful massage.
No ibuprofen, Motrin, Advil, or aspirin while on Celebrex. After Celebrex is complete, ibuprofen may be used as needed.
The result reveals itself gradually
The visible recovery from lower blepharoplasty moves quickly relative to other facial procedures. The deeper healing, particularly the maturation of grafted fat and the final settling of contour, continues over several months.
Most patients feel physically well. Bruising and swelling present but improving.
Fully presentable. Surgery not obviously apparent. Light activity resumes.
Grafted fat settling. Contour refining. Most of the result is visible.
Final result. Grafted volume stable. Lid-cheek contour at its best.
Although most visible recovery occurs within a few weeks, healing continues to refine over four to six months. These are subtle, gradual changes that contribute to the final contour and are not noticeable day to day.
Your eyes. Your identity. Your result.
The lower eyelid is one of the first places fatigue and aging become visible in the face, and one of the most meaningful areas to address. Done well, the result is simply a more rested, more refreshed version of you.
For those considering lower blepharoplasty in Palo Alto or the Silicon Valley area, a consultation is the right first step.
Schedule a Consultation