Oculofacial Aesthetic Surgery — Justin Karlin, MD
For patients

Your surgery, day by day.

A guided walk through aesthetic eyelid surgery — from a month before to a year after, and everything in between.

The short version

A good result is built twice: once in the operating room, and once in the weeks around it. This guide walks the whole timeline — what to stop and when, what to have ready, what surgery day is like, what is normal in the days after, and exactly when to call us. It is general education, not a prescription: the written instructions you receive from our office are tailored to you, and where they differ from this page, your written instructions win.

Justin Karlin, MD, MS ASOPRS-certified oculofacial surgeon · UCLA faculty — about the surgeon
The journey

Six stops. The page keeps time.

As you scroll, the counter in the corner tracks where you are — from thirty days out to a year on. Preparation is checkable; tick things off as you do them and this page will remember.

Preparation T − 30 → T − 2 The night before T − 1 Surgery day Day 0 The first 72 hours Days 1–3 Weeks one to three Days 4–21 Months one to twelve The long arc
T − 30 → T − 2 days

Preparation: the result before the result.

Healing is decided partly in advance — by oxygen, by circulation, by what is and isn’t in your bloodstream on the day. Five checkpoints, in order.

One month out T − 30

The biggest levers move slowly. Start them now.

Three weeks out T − 21

Two weeks out T − 14

From here, your bloodstream belongs to the surgery.

One week out T − 7

Two days out T − 2

T − 1 · the night before

Quiet night.

After 11 pm, nothing

  • No food or drink from 8 hours before surgery — including water, gum, and mints.
  • If you were prescribed a pre-surgery medication, take it before the cutoff as instructed.

Wash, then stop

  • Bathe or shower tonight. Arrive tomorrow with nothing on your skin — no lotion, products, or makeup.
  • Know that hair-washing waits three days after surgery — tonight’s counts.
  • Early to bed. Tomorrow is a rest day that happens to start in an operating room.
Day 0

Surgery day. Your only job is to arrive.

Everything is prepared. The list below is the whole of what’s asked of you today — after that, it’s ours.

The morning

  • Wear loose clothing that buttons or zips — nothing that pulls over your head. Slip-on shoes.
  • Bring sunglasses and a wide-brim hat for the ride home.
  • No contact lenses — glasses from today until you’re cleared.
  • No jewelry, no valuables, no makeup, no lotions.
  • Take routine medications only if we told you to. Brush your teeth, but don’t swallow the water.
  • Arrive at the surgery center at your instructed time.

In the room

  • Under local anesthesia: upper blepharoplasty, ptosis surgery, and facial lasers and peels. Stand-alone fat transfer is usually local as well.
  • Under general anesthesia: lower blepharoplasty with fat transfer, quad (upper and lower) blepharoplasty with fat transfer, and brow lifting. In leaner patients, stand-alone fat transfer is sometimes done under general so fat can be harvested from more than one site.
  • Whatever the plan, it is set with you at your preoperative visit — nothing about it is decided on the day.
  • The operation itself is the part of this page you can skip preparing for. That part is Dr. Karlin’s.

When you wake

  • The protective ointment used during surgery blurs vision — for hours, sometimes days. Expected.
  • Your lids will feel heavy and may be hard to open. Open them slowly, when you’re ready.
  • You will look swollen and bruised. This is what day zero is supposed to look like.
  • Only someone you know may take you home — not a taxi or rideshare. Compresses and rest begin tonight, with your ointment as prescribed.
Days 1–3

The first 72 hours: swelling’s big weekend.

Swelling peaks around day two or three, is always worse in the morning, and eases as you sit up and walk. Your work this weekend is gentle and repetitive: cool, rest, elevate.

All of this is normal

  • Blood-tinged tears or a little pink ooze from incisions, the first few days.
  • Mild incisional pain, headache, and broken sleep in week one.
  • Lids that stick together from ointment — separate gently with a warm cotton swab moistened with distilled water or sterile saline, never tap water.
  • Red eyes; numbness along the lash line. Both clear on their own over weeks.

The compress rhythm

  • Cool compresses 15–20 minutes of every waking hour, for the first 48–72 hours.
  • Gauze lightly dampened with cool distilled water or sterile saline — not tap water — or a soft gel mask. Cool, never frozen; ice never touches skin directly, and nothing presses hard on the eyes.
  • White tapes under the eyes (if placed) stay on and stay dry until we remove them.

Medications & eyes

  • Antibiotic: start the day after surgery, as directed on your sheet.
  • Ophthalmic ointment: start the night of surgery, morning and night — on external incision lines for upper-lid surgery, a thin ribbon along the eye for lower-lid surgery. It will blur vision; it’s meant to be there.
  • Lubricating drops for any dryness or scratchiness — as often as 5–15 times a day, applied without pulling the skin.

The rules of the weekend

  • Rest. No bending, lifting, or straining — each raises pressure in exactly the wrong place.
  • Sleep on your back, head elevated on 2–3 pillows.
  • Soft, easy food first; for queasiness, dry crackers and a fizzy drink. Severe nausea → call us; medication exists.
  • No tap water near the eyes — for the first week, anything that touches near the lids is moistened only with distilled water or sterile saline.
  • No alcohol, no tobacco, no blood thinners — still.
  • Active bleeding: gentle, steady pressure for five minutes. If it doesn’t stop, call.

Call us the moment you notice

Fever over 100°F · shaking chills · persistent nausea or vomiting · continuous drainage or bleeding · an incision pulling open · difficulty breathing · pain that worsens instead of eases.

(310) 777-8880

For an emergency, call 911 first.

Days 4–21

Weeks one to three: the fade.

Bruising yellows and lifts; swelling packs its bags slowly. Two curves are worth knowing in advance — one on your face, one in your head.

Week one logistics

  • Your first post-op visit is at day 6–8 — it’s mandatory, and sutures are addressed per your plan.
  • Bathe shoulders-down from day one; full showers and gentle face-washing from day 3 — no direct spray on the eyes, no perfumed products, and tap water stays away from the lids for the first full week: the eye area is cleaned only with distilled water or sterile saline.
  • Back to work when you feel ready, typically around one week — if the job is physical, high-heat, or screen-heavy, give it longer.
  • Don’t rub or touch the eyes; tears get dabbed at the cheek, not the lid.

Green lights — when criteria are met

  • Driving: at least 48 hours past anesthesia, off pain medication, vision clear and full — for most people that lands day 5–10.
  • Exercise: nothing that strains or raises heart rate for at least 3 weeks — Dr. Karlin clears the return.
  • Eye makeup: once cleared, usually 3–4 weeks; face makeup on healed skin from about 3 weeks.
  • Sun: hat and large sunglasses outdoors; sunscreen on healed incisions from about two weeks. Fresh scars that see sun turn dark and stay longer.
Months 1–12

Months: the quiet part of healing.

By three months the swelling has left the story; what remains is slow refinement — scars maturing from pink to pale, contours settling into place for a full year.

Still on the calendar

  • Contact lenses: back at about a month, once cleared.
  • Sauna and steam: after one month.
  • Retinoids and active skincare: after 4–6 weeks, on fully healed skin.
  • Tanning of any kind: six weeks minimum — and sunscreen on incision lines all year.
  • Follow-up visits at one, three, and six months — and beyond if your healing asks for it.

What settling looks like

  • One month: looks good, feels tight. Both are on schedule.
  • Three months: “healed” to every eye but a surgeon’s.
  • Twelve months: incisions at their final, faded state; the result fully at rest.
One year

Still you. Rested.

The measure of eyelid surgery done well is that nobody asks what you had done — they ask if you’ve been away. From here, your only assignments are sunscreen and check-ins.

(310) 777-8880

465 N. Roxbury Dr., Suite 1011, Beverly Hills · book a consultation · see consented results

Appendix

The reference shelf.

The detail that doesn’t belong in the story but belongs at your fingertips — plus Dr. Karlin on video, walking each phase.

Preparing for eyelid surgery — Dr. Karlin
Risks, benefits & alternatives — informed consent
Post-operative care & healing — Dr. Karlin
Medications & supplements to avoid — the A–Z list

Everything below thins blood or interferes with healing. If you take anything on this list, it is stopped 10–14 days before surgery — but prescription medicines are stopped only with the prescribing doctor’s involvement, and every medication you take must be specifically cleared with our office. For pain before and after surgery, plain Tylenol (acetaminophen) is the one green light.

  • 4-Way Cold Tabs
  • 4-Way w/ Codeine A.C.A.
  • 5-Aminosalicylic Acid
  • A-A Compound
  • Accutrim
  • Acetylsalicylic Acid
  • Actifed
  • Actron
  • Acular (ophthalmic)
  • Adapin
  • Advil products
  • Aleve
  • Alka-Seltzer products
  • Amigesic
  • Amitriptyline
  • Amoxapine
  • Anacin products
  • Anafranil
  • Anaprox products
  • Anexsia
  • Anexsia w/Codeine
  • Anisindione
  • Ansaid
  • Anturane
  • Argesic-SA
  • Arthra-G
  • Arthriten products
  • Arthritis Bufferin BC Tablets
  • Arthritis Foundation products
  • Arthritis Pain Formula
  • Arthritis Strength BC Powder
  • Arthropan
  • ASA
  • Asacol
  • Ascriptin products
  • Asendin
  • Aspergum
  • Aspirin-B products
  • Asprimox products
  • Aventyl
  • Axotal
  • Azdone
  • Azulfidine products
  • B-A-C
  • Backache Maximum Strength Relief
  • Bayer Products
  • BC Powder
  • Berberine
  • Bismatrol products
  • Buffered Aspirin
  • Bufferin products
  • Buffetts 11
  • Buffex
  • Butal/ASA/Caff
  • Butalbital Compound
  • Cama Arthritis Pain Reliever
  • Carisoprodol Compound
  • Cataflam
  • Cheracol
  • Children’s Advil
  • Choline Magnesium Trisalicylate
  • Choline Salicylate
  • ever every paient S tilheiiie
  • ‘dio, you may require one
  • ERY
  • ery and only Tylenol should be taken for
  • octor prior to surgery. It is absolutely
  • Clinoril
  • Clinoril C
  • Clomipramine
  • Contac
  • Cope
  • Coricidin
  • Coumadin
  • Dalteparin injection
  • Damason-P
  • Darvon Compound-65
  • Darvon/ASA
  • Dipentum
  • Daypro
  • Desipramine
  • DHEA
  • Diclofenac
  • Dicumerol
  • Dimetapp Sinus
  • Dipyridamole
  • Disalcid
  • Doan’s products
  • Dolobid
  • Doxepin
  • Doxycycline
  • Dristan
  • Dristan Sinus
  • Duragesic
  • Easprin
  • Ecotrin products
  • Elavil
  • Emagrin
  • Empirin products
  • Endep
  • Enoxaparin injection
  • Equagesic
  • Etodolac
  • Etrafon products
  • Excedrin products
  • Feldene
  • Fenoprofen
  • Fiorgen PF
  • Fiorinal products
  • Fish Oils
  • Flagyl
  • Flurbiprofen
  • Fragmin injection
  • Furadantin
  • Garlic supplement
  • Gelpirin
  • Genpril
  • Genprin
  • Gensan Goody's Extra Strength Headache Powders
  • Ginkgo Biloba supplement
  • Ginseng supplement
  • Halfprin products
  • Haltran
  • Heparin
  • Hydrocortisone
  • IBU
  • Ibuprin
  • Ibuprofen
  • Ibuprohm
  • Imipramine
  • Indochron E-R
  • Indocin products
  • Indomethacin products
  • Isolly!
  • Isollyl Improved
  • tiatmine
  • Kaodene
  • Ketoprofen
  • Ketorolac
  • Lanorinal
  • Limbitrol products
  • Lodine
  • Lortab ASA
  • Lovenox injection
  • Ludiomil
  • Macrodantin
  • Magan
  • Magnaprin products
  • Magnesium Salicylate
  • Magsal
  • Maprotiline
  • Marnal
  • Marthritic
  • Meclofenamate
  • Meclomen
  • Mefenamic Acid
  • Mellaril
  • ee
  • Menadol
  • Meprobamate
  • Mesalamine
  • Methocarbamol
  • Micrainin
  • Midol products
  • Miradon
  • Mobidin
  • Mobigesic
  • Momentum
  • Mono-Gesic
  • Motrin products
  • Nabumetone
  • Nalfon products
  • Naprelan
  • Naprosyn products
  • Naprox X
  • Naproxen
  • Night-Time Effervescent Cold
  • Norgesic products
  • Norpramin
  • Nortriptyline Pamelor
  • Norwich products
  • Nuprin
  • Ocufen (ophthalmic)
  • Olsalazine
  • Opasal
  • Orphengesic products
  • Orudis products
  • Oruvail
  • Oxaprozin
  • Oxycodone
  • P-A-C
  • Pabalate products
  • Pain Reliever Tabs
  • Pan-PAC
  • Panasal
  • Pentasa
  • Pentoxifylline
  • Pepto-Bismol
  • Percodan products
  • Persantine
  • Pertofrane
  • Phenaphen/Codeine #3
  • Phenylpropanolamine
  • Pink Bismuth
  • Piroxicam
  • Ponstel
  • Prednisone
  • Profenal
  • Propoxyphene Compound products
  • Protamine
  • Protriptyline
  • Pyrroxate
  • Relafen
  • Rhinocaps
  • Robaxisal
  • Rowasa
  • Roxeprin
  • Ru-T'uss
  • Salatin
  • Saleto products
  • Salflex
  • Salicylate
  • Salicylate products
  • Salsalate
  • Salsitab
  • Scot-Tussin Original 5-Action
  • Sine-Aid products
  • Sine-off
  • Sinequan
  • Sinex
  • Sinutab
  • Sodium
  • Sodol Compound
  • Sofarin
  • Soltice
  • Soma Compound
  • Sparine
  • St. John’s Wort
  • St. Joseph Aspirin
  • Stelazine
  • Sulfasalazine
  • Sulfinpyrazone
  • Sulforaphane
  • Sulindac
  • Supac
  • Suprax
  • Suprofen
  • Surmontil
  • Synalgos-DC
  • Talwin
  • Tenuate
  • Tenuate Dospan
  • Thorazine
  • Ticlid
  • Ticlopidine
  • Tofranil
  • Tolectin products
  • Tolmetin
  • Toradol
  • Trental
  • Triaminicin
  • Triavil
  • Tricosal
  • Trilisate
  • Trimipramine
  • Tussanil DH
  • Tussirex products
  • Ursinus
  • Ursinus-Inlay
  • Vanquish
  • Vibramycin
  • Vitamin E
  • Vivactil
  • Voltaren
  • Warfarin
  • Wesprin
  • Willow Bark products
  • Zorpril
The eating plan — before & after

Building up (the month before): protein at every meal — fish, eggs, poultry, beef, tofu, yogurt, nuts, quinoa, beans — it’s the raw material of collagen and immune strength. Colorful fruit and vegetables for vitamins A and C, selenium, and manganese: kale, spinach, citrus, green peppers, mushrooms, cabbage, berries, pineapple. Water: 64 ounces a day minimum; 80–100 is better.

Cutting back: from a month out, ease off salt, sugar, and refined carbohydrates (white flour, white rice) — they inflame. From two weeks out, eliminate alcohol, multivitamins, herbal supplements, and omega-3 capsules; one cup of caffeine a day is fine; vitamin C, vitamin D, and zinc may continue as advised.

After surgery: soft, easy-to-digest food for the first 72 hours — applesauce, broth, scrambled eggs, yogurt. Then lean into anti-inflammatory fats (avocado, olive oil, almond butter) and berries and cherries, with protein and water throughout. Hold the line on salt, sugar, alcohol, and refined carbs for a month; caffeine and supplements return after the first week.

If your surgery includes fat transfer

The donor site (where fat is harvested) has its own small recovery: dissolvable stitches, kept clean; loose clothing over the area while it heals; and bruising, swelling, and tenderness there that are entirely expected. Everything else on this page applies unchanged.

If your plan includes CO₂ laser resurfacing

Before: skin irritants stop a week out; no Accutane within a year; pre-treat with the prescribed skin serum twice daily for the week before; arrive with clean, bare skin. Prone to cold sores? Tell us — preventive medication is given. Prepare cool compresses (frozen peas in small zip bags work) and, for full-face treatment, a vinegar-soak solution: 3 tablespoons white vinegar in 1 quart distilled water. No contact lenses on the day (bring glasses); bring the big hat; arrange a driver if your eyelids are treated or you’ll take comfort medication.

After: the loudest discomfort is the first 30–60 minutes; heat, throbbing, and swelling follow the same morning-heavy rhythm as surgery. Head elevated; cool compresses over a thin cloth 15–20 minutes hourly; for large areas, vinegar soaks three times a day until peeling begins. Gentle cleansing from the next day — and no picking, peeling, scrubbing, or exfoliating; that is how scars happen. A healing balm (as recommended) twice daily until the skin closes; daily SPF from day 5, and sun-shielding of lasered skin for a full month. Light exercise from day 5–7, full effort at 10 days. Avoid dust, dirt, and hairspray near treated skin; makeup returns once the surface has healed; actives after two weeks of fully healed skin; no tanning for six weeks.

This guide is general patient education for procedures performed by Justin Karlin, MD and is not a substitute for medical advice. Your written pre- and post-operative instructions are personalized and take precedence over anything here. Medication changes happen only with the prescribing physician involved. If you believe you are experiencing an emergency, call 911. Office: (310) 777-8880.