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Patient Resources


A rough estimate:

  1. Upper or lower eyelid surgery – 45 min to one hour for bilateral
  2. Upper and lower eyelid combined surgery – 1.5 to 2 hours
  3. Browlift – 45 min to one hour for bilateral
  4. Facelift – 3 – 4 hours
  5. Injections – 10 min to 30 min, depending on number of sites and whether using a filler or Botox

We do our best to ensure that your experience is as pain-free as possible.  All surgeries are performed under local sedation.  That means you will not be unconscious with a tube inserted into your throat.  Dr. Higa will also inject local anesthesia into the area being operated.  Following surgery, pain is controlled using ice packs and acetominophen.  Post-operative pain of the lids is minimal since surgery cuts through the sensory nerves leaving the skin numb for around 2 months.  By that time, the lids have long since healed.  Brow and facelift surgeries have mild discomfort which eases by one week, if not sooner.

Insurance companies will only cover the procedure if there is a “functional” impairment of activities of daily living (ADL), such as difficulty reading or driving.  Dr. Higa will evaluate you during consultation to determine if your case would be covered by insurance.  Also, keep in mind that insurance often covers 80% of the procedure.  You may be responsible for the remainder.

Insurance eyelid surgery covers “functional” impairment since a person is unable to perform necessary daily activities without having surgery.  On the other hand, cosmetic eyelid surgery is performed because a patient is unhappy with his/her appearance.  They are able to perform ADL without problem.  The surgery is performed in exactly the same way otherwise.  There are no “cutting corners” just because a surgery is paid by insurance.  The only difference here is who pays – the insurance company or the patient.

  • Good nutrition. Eat well during the weeks prior to your surgery. Crash dieting, over-eating or high alcohol intake can greatly affect your overall health and well-being. A healthy, balanced diet is essential. Also, talk to your doctor about what supplements, if any, you should start taking.
  • Stop smoking. Smoking can greatly impair your ability to heal. You must be nicotine and smoke-free for at least 4 weeks prior to surgery. You must also be free of any nicotine patch or nicotine-based products for a minimum of 4 weeks prior to surgery.
  • Stay healthy. Prior to your surgery strive to maintain the best health and hygiene. Let us know if you catch cold or illness.  Also let us know if you are prescribed medication since your last appointment with us.
  • Discontinue blood thinners and products containing aspirin.  These agents may cause bleeding during surgery which may prolong the procedure.  Your primary doctor will let you know when to stop the medications.  Generally, the rule is to discontinue them 10 days prior to surgery.  You may restart them a couple days following your procedure.

A few rules:

  1. No food or drink eight hours before your procedure.  You may take your high blood pressure medication on the morning of your surgery with a sip of water.  If you are diabetic, do not take your diabetes medication on the day of surgery.
  2. Come to the center wearing comfortable, loose fitting clothes.  You do not need to change into a gown for surgery.
  3.  Do not bring cash or wear jewelry on the day of your surgery.
  4. Make sure you arrange transportation to and from the surgery center.
  5. If you have any questions, please ask before your scheduled surgery date.
  • This is a frequently asked question!Washing hair – No hair washing on day of surgery.  Eg. Surgery Wed.  No hair washing until Thursday.  Showerhead should be from behind.
  • Washing body – Okay to shower / bathe on day of surgery as long as not wetting head.
  • Do not immerse your head in the bath, pool, or ocean until your incisions have healed.

The length of time it takes to recuperate after plastic surgery varies depending on the procedure performed and the person operated on. Most patients will require assistance for the first two days. Then most patients are able to care for themselves, but may still need assistance if they have small children to care for. The specific lengths of disability are outlined below by procedure. These are approximations, and do not include return to exercise.

  • Eyelid Surgery—Usually can get around independently by the second day. With the use of sunglasses, may feel comfortable going to the store by day 3-4, and with makeup could return to work by 5-7 days.
  • Facelift Surgery—Usually can get around independently by the second day. Usually do not feel comfortable going out in public for 5-7 days. Requires 10-14 days before returning to work if in the public eye.
  • Liposuction—Usually can get around independently by the second day, earlier if smaller number of areas treated. One can return to work and normal activities in 5-7 days.

Surgery Facts

After you have been scheduled for surgery, it is important that you:

  1. Obtain medical clearance from your primary medical doctor
  2. Hold any blood thinning medications, including aspirin, ibuprofen, and other pain relievers.  Acetominophen is okay to take.  You will also need to make sure your primary physician will allow you to hold any prescribed blood thinning medications
  3. Do not eat or drink at least 8 hours before your surgery is scheduled.
  4. It is okay to take prescription medications on the morning of surgery with a SIP of water.
  5. If you are diabetic, do not take insulin or oral diabetes medications on the day of surgery
  6. If you have any questions, please call us.


  • Wear loose, comfortable clothes.  Avoid make-up and do not wear jewelry.
  • You should check in at the surgery center at least an hour before your procedure.  Do not bring any money, wallet, or purse.  Have your designated driver hold on to these items while you are still in the waiting room.
  • You will be brought back to the preoperative area where a nurse will ask you health-related questions and check to make sure your health documents are current.  He/she will also confirm with you the surgery you will be having.  Do not be worried that we don’t know what surgery you will be having.  We will ask the same questions over and over.
  • An I.V. line will be inserted into your hand or arm.
  • The anesthesiologist will introduce himself and will ask some anesthesia-related questions
  • I will come in and mark the area I will be operating on.
  • Please use the toilet before we go into the operating room.  There’s nothing more uncomfortable than a full bladder!
  • We will wheel you into the operating room.  You will hear heavy metal music.  This is all normal.
  • The anesthesiologist will hook you up to the blood pressure and heart monitor machine.  A breathing hose will be placed over your ears and rest up against your nostrils.
  • The nurse will confirm your name, date of birth, allergies, and the procedure you are having done.
  • I will inject the numbing solution into your skin where we will operate.  There is discomfort but should be receiving anesthesia by this time.
  • The nurse will prep your skin with a skin antiseptic solution before placing loose drapes around your face.  You should have no problem breathing.
  • We will begin the surgery.  You will hear different voices but all should be well.  Don’t worry – you will not say anything you will regret saying later!
  • We may sit you up during the surgery to check the lid height.
  • When we are finished, we will remove the drapes, clean your skin then wheel you back out to the recovery area.
  • We will apply some eye ointment and ice packs to your lids/brow.  You may look at yourself – the swelling will be minimal at this time.
  • Juice and water is available if you would like
  • You may use the toilet.  We will assist you.
  • Once you are awake and stable, the nurse will take you to the area where your ride will pick you up (about 20-30 min after you return from the operating room).  We will call your ride to let them know when you will be ready.


  • Following your surgery, you will be groggy from the anesthesia.  Do not operate any machinery or even go outside “for a walk”.  Rest is the most important activity you should be performing.
  • You may shower, but do not wash your hair or get your eyes wet
  • Sleep in an elevated position
  • Begin to apply ice pack every hour for 15 minutes while you are awake
  • Wash your hands, apply a 1/4 inch strip of ointment on your fingertip, and wipe gently across the suture line to apply ointment
  • You should only have mild pain, if at all.  If you have severe pain, please contact us immediately

Day 1 (morning after surgery)

  • Continue ice pack every hour for 15 minutes while you are awake
  • Continue ointment 4x/day
  • Okay to wash hair
  • You may have some small bleeding.  Most of the blood will be on the inner corners of your lids
  • You should only have mild pain, if at all.
  • Follow up with Dr. Higa today (or tomorrow as scheduled previously)

Day 2 and 3

  • Continue ice pack and ointment

Day 4

  • Continue ointment 4x/day
  • Put ice pack under warm water until melted.  Put pack into microwave for 1 minute on high.  Wrap in towel and place on lids four (4) times a day.

One week

  • Follow up with Dr. Higa for suture removal
  • After sutures removed, begin using ointment before bedtime until tube finished.  Do not refill unless otherwise instructed
  • You may continue warm pack until bruising on lids is gone

One month

  • Most swelling will have resolved though final appearance may not be set for up to 6 months

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