What to Avoid Before Blepharoplasty
Medications That Increase Bleeding
Certain medications interfere with how your blood clots, raising the risk of bruising, excess bleeding, and complications during and after surgery. Identifying and managing these before your procedure is one of the most important steps in your preparation.
Aspirin, ibuprofen, and naproxen all reduce the ability of your blood to clot normally. You should stop these at least seven to ten days before surgery unless your prescribing doctor advises otherwise. Acetaminophen does not affect clotting and is safe to use for pain or fever during this window.
Medications like warfarin, clopidogrel, apixaban, and rivaroxaban require a carefully coordinated plan between your Oculoplastic Surgeon and the doctor who prescribed them. Do not stop these on your own. Together, your care team will determine the safest timing for pausing and restarting, balancing your surgical risk against the underlying reason the medication was prescribed.
Some hormone-based medications increase the risk of blood clots, which can complicate surgery and recovery. Routine birth control is often continued, but combined hormonal therapy in certain patients may need to be paused. Always discuss this with both your surgeon and your prescribing physician before making any change.
Some antidepressants and mood-stabilizing medications can affect bleeding or interact with anesthesia. Never stop psychiatric medications abruptly without guidance from your prescribing doctor, as doing so can cause serious withdrawal effects. Make sure your surgeon and anesthesia provider have a complete list of every medication you take.
Supplements and Herbal Products
Many patients are surprised to learn that common over-the-counter supplements can significantly affect bleeding and anesthesia. Because these products are not prescription medications, they are easy to overlook, but they are not without effect.
Several widely used supplements have blood-thinning properties and should be stopped approximately seven to fourteen days before surgery. These include fish oil and omega-3 capsules, vitamin E, ginkgo biloba, garlic supplements, and ginseng. Cooking with garlic in food is generally fine, but concentrated garlic supplements are not.
Turmeric or curcumin in capsule form, high-dose green tea extract, ginger supplements, dong quai, and St. John's wort can all affect bleeding or interact with anesthesia. When in doubt, bring your full supplement list to your pre-operative appointment and ask which items to pause.
Standard multivitamins are usually fine to continue. Vitamin C and B vitamins do not affect clotting. The one exception to watch for is high-dose vitamin E, which appears in some multivitamins at levels that may be relevant before surgery. Check the label and confirm with your surgeon.
Patients frequently forget to mention supplements because they do not think of them as medications. Your surgical team cannot safely plan around information they do not have. Bring every bottle, powder, or tea to your pre-op visit so the full picture can be reviewed.
Lifestyle Factors
Your daily habits in the weeks before surgery have a direct impact on how your body heals. A few key changes can meaningfully reduce your risk of complications and help you recover more comfortably.
Nicotine narrows small blood vessels and slows wound healing, increasing the risk of poor scarring and complications. Most surgeons require patients to stop nicotine at least two to four weeks before and after surgery. This applies to all forms of nicotine, including cigarettes, vapes, patches, gum, and chewing tobacco.
Alcohol thins the blood and interacts with anesthesia medications. Avoid drinking alcohol for at least three days before surgery and through the first week of recovery, especially while taking any prescribed pain medication. Patients who drink heavily should disclose this honestly to the anesthesia team, since it affects how medications are dosed.
Marijuana, cocaine, and other recreational substances can affect anesthesia, bleeding, and healing in ways that put patients at risk. Your anesthesia provider needs accurate information to keep you safe. Disclosures made during a pre-operative evaluation are used for your medical care, not reported to outside authorities.
Significant sun exposure to the eyelid area in the weeks before surgery can affect skin quality and pigmentation around incisions. Wear sunglasses and a wide-brimmed hat when outdoors. Avoid tanning beds entirely in the pre-operative period.
Skincare and Beauty Treatments
Several common skincare products and cosmetic treatments can affect the condition of your eyelid skin before surgery. Knowing what to pause and when gives your skin the best starting point for healing.
Tretinoin, retinol, and other vitamin A-based products thin the outer skin layer and can impair how surgical incisions heal. Stop all topical retinoids at least one to two weeks before surgery. Do not restart them until your surgeon specifically clears you to do so.
Chemical peels, microdermabrasion, laser resurfacing, and intense pulsed light treatments leave the skin more fragile and reactive. Avoid these treatments for at least two to four weeks before blepharoplasty, as they can increase your risk of complications during and after the procedure.
Eyelash extensions must be removed before surgery so your surgeon can see your natural eyelid margin clearly. If you have permanent eyelid makeup or an eyelid tattoo, it should be completed at least three months before surgery. Do not get new tattoos in the four weeks leading up to your procedure.
Hair dye does not directly affect surgery, but you will need to keep water and chemicals away from the incision area for the first one to two weeks of recovery. Plan to color your hair in the days before your procedure rather than waiting until after.
The Day Before and the Day of Surgery
The final 24 hours before your procedure require specific preparation. Following these instructions carefully helps ensure your surgery proceeds on schedule and without avoidable risk.
If your procedure involves sedation or general anesthesia, you must fast for at least six to eight hours beforehand, following your surgical team's exact instructions. This means nothing at all, including water, coffee, or gum. Eating or drinking in the fasting window raises the risk of aspiration, a serious complication in which stomach contents enter the airway during anesthesia.
You cannot drive yourself home after sedation or general anesthesia, and a responsible adult must stay with you for the first 24 hours after the procedure. Make this arrangement well in advance. Do not leave it to the day of surgery to figure out.
Choose loose, comfortable clothing that buttons or zips at the front so you do not need to pull anything over your head after surgery. On the day of your procedure, do not wear contact lenses, eye makeup, jewelry, or perfume.
A little preparation at home goes a long way. Before surgery day, fill any prescribed medications, prepare easy meals, have cold compresses ready, and set up a comfortable resting area with pillows to keep your head elevated. Reducing day-of stress supports both your blood pressure and your overall sense of calm going into the procedure.
Common Questions Patients Often Have
A few specific situations come up often in pre-operative conversations. The answers below address some of the most common points of confusion when preparing for eyelid surgery.
Do not stop daily aspirin without first checking with the doctor who prescribed it. Some patients taking aspirin for heart or stroke prevention should continue it through surgery, accepting a slightly higher chance of bruising. Others may be able to pause it briefly. This is a medical decision that must be made by your care team, not a cosmetic one.
Plain whey or plant-based protein is generally not a problem. However, many pre-workout products contain stimulants, herbal blends, or proprietary ingredients that may affect bleeding or interact with anesthesia. Bring the label to your pre-operative appointment so it can be reviewed specifically.
CBD can interact with anesthesia and has not been well studied in surgical settings. Most surgeons recommend stopping all CBD products, including topical creams, at least one to two weeks before surgery. Tell your surgical team about any CBD use so they can advise you accordingly.
No. Even a small amount of liquid violates your fasting instructions and may result in your surgery being delayed or cancelled. If you are a regular coffee drinker, expect a caffeine headache that morning. You may have coffee once your surgical team clears you after the procedure.
A mild head cold does not always require rescheduling, but you should contact your surgeon's office right away so they can assess your symptoms. Active fever, a productive cough, or a chest infection usually means surgery needs to be postponed. Proceeding with those symptoms raises the risk of anesthesia complications in ways that are not worth taking.
Spicy food is not a concern, but high sodium intake in the days before surgery can worsen post-operative swelling. Avoid heavily processed foods, deli meats, and salty snacks for a few days beforehand. Staying well hydrated during this time may help reduce the severity of swelling during your recovery.
Frequently Asked Questions
These questions address practical decisions and situations that often arise as patients finalize their preparation for blepharoplasty.
This is not uncommon, and the safest step is to let both doctors speak directly with each other. Do not make independent decisions about stopping or continuing a medication based on conflicting advice. Your Oculoplastic Surgeon and your prescribing physician are both working in your best interest, and a brief conversation between them usually resolves the question quickly.
Most surgeons recommend stopping fish oil and other omega-3 supplements around seven to fourteen days before the procedure. Because individual supplement doses vary, bring the bottle to your pre-operative appointment so your care team can confirm the right timing for your specific situation.
Recent Botox injections in or around the eyelids can affect the muscle activity your surgeon relies on when assessing and planning the procedure. Let your surgical team know about any recent injections, ideally before your pre-operative appointment. Timing between treatments and surgery matters and should be discussed in advance.
Yes. Staying well hydrated, eating balanced meals, getting enough sleep, and managing any underlying health conditions as directed by your primary care physician all support a safer surgery and smoother recovery. Your pre-operative visit is also the right time to ask any remaining questions so you feel fully prepared and confident going in.
Contact your surgeon's office as soon as you remember, even if it is close to your surgery date. It is always better to disclose something late than not at all. Your team would rather have the information and reassure you that it is not an issue than proceed without knowing something that could affect your safety.
Plan Your Pre-Operative Care With Our Team
At Rhode Island Eye Institute, our Oculoplastic Surgeon brings decades of specialized experience to every eyelid procedure, including a thorough pre-operative process designed to keep you safe and well prepared. We are proud to serve patients across Rhode Island and southeastern Massachusetts with fellowship-trained expertise and personalized care. If you have questions about your preparation or are ready to schedule a consultation, we welcome the opportunity to guide you through every step.