LaFace by Laura Phan MD
20398 Blauer Drive
Saratoga, CA 95070
Phone: (408) 502-5000
Monday–Friday: 9 a.m.–5 p.m.
You can get some of your questions answered before visiting our oculofacial plastic surgery practice and medical spa in Saratoga, California. Below, you’ll learn about preparing for surgery, what to expect during your recovery, and more.
Surgery – General
Where does Dr. Phan operate?
Most eyelid procedures, such as upper lid blepharoplasty, can be performed under local anesthesia (injection of numbing medicine into the skin) in our office.
We may perform some cases at the surgery center using sedation, which is given through an IV with an anesthesiologist present. Few surgeries are performed under general anesthesia.
Dr. Phan typically operates at the Los Gatos Surgery Center when sedation or general anesthesia is necessary. In rarer instances, surgery is performed at El Camino Hospital.
Are the surgeries outpatient?
Yes. Patients are typically observed in the recovery area for 30 to 60 minutes after undergoing sedation or general anesthesia and for less time after local anesthesia before going home.
How often does Dr. Phan perform these procedures?
Dr. Phan performs 4 to 5 surgeries each Thursday and Friday and other days with advanced arrangement.
Do I need to take any medicine before or after my surgery?
Once the surgery is decided and confirmed, prescriptions will be sent electronically to your pharmacy of choice. Prescriptions include an antibiotic/steroid ointment called Maxitrol (generic: Neomycin/Polymyxin/Dexamethasone) and possibly an antibiotic/steroid eyedrop called Tobradex (generic: Tobramycin/Dexamethasone). These are to be used on the day of surgery.
If the eye is patched, you may start topical antibiotics after patch removal. Most patients do not require more pain medicine than 2 tablets of extra-strength Tylenol every 4 to 6 hours. Infrequently, stronger pain medication with a narcotic, like Norco, may be prescribed. Dr. Phan asks that you pick up all prescriptions before surgery.
For in-office surgery, anti-anxiety medication, such as Xanax, Valium, or Halcion, can be prescribed and taken 30 to 45 minutes before the in-office surgery. For more sensitive procedures, Norco may be taken 15 minutes before in-office surgery. These are not necessary for surgery under sedation or general anesthesia.
Please be aware of the common adverse effects of anti-anxiety and pain medications. These medications can cause drowsiness, so you may not drive while under the influence of these substances.
Pain medication with narcotics can cause nausea, vomiting, and constipation. Please eat something before taking narcotic pain medication and take a stool softener if there is a history of constipation. Excessive use of these medications can cause dependency.
What kind of sutures does Dr. Phan use?
Dr. Phan uses super-fine nylon sutures, which are less likely to cause inflammation and, thus, skin scarring. Because they are super-fine, these sutures will break if they are pulled on.
They are kept clean with antibiotic ointment once daily at bedtime. The ointment is made for the eyes and is safe for use in and around the eyes; however, it will blur the vision as it liquefies and gets into the eyes.
Dr. Phan removes superficial sutures on the skin 7 to 10 days after surgery. There may be other sutures, depending on the type of surgery. These will be removed a few weeks after surgery.
Can I see before-and-after photos?
Yes. Please visit our gallery to see featured before and after transformations, or go to our Instagram or Facebook page.
Before Surgery
What should I avoid before surgery?
Dr. Phan asks that patients discontinue blood thinners, such as Aspirin and other NSAIDs (e.g., ibuprofen, Motrin, Advil, Aleve, etc.), fish oil, vitamin E, and ginseng, ginkgo, or garlic supplements 10 days prior to surgery.
Dr. Phan also asks patients to discontinue other anticoagulants, such as Plavix, Aggrenox, Xarelto, Eliquis, Pradaxa, and Coumadin, 5 days before surgery. Since these medications are usually prescribed to prevent life-threatening conditions, Dr. Phan asks that patients discuss discontinuing these medications with the prescribing physician before doing so.
If surgery is to be performed under sedation or general anesthesia, patients must refrain from eating, drinking, and even chewing gum 8 hours before surgery; otherwise, the surgery will be canceled.
The exception to this restriction is blood pressure medication. If the patient typically takes blood pressure medication in the morning, they should still take it with a small sip of water the morning of surgery.
Do I need medical clearance for surgery?
If surgery is to be performed under sedation or general anesthesia, Dr. Phan requires that you see your primary care physician for cardiorespiratory clearance within 1 month of surgery. If you have a cardiologist, you should see your cardiologist instead of your primary care physician. This clearance must be completed and provided to Dr. Phan no later than 1 week prior to surgery.
After Surgery
May I drive myself home after surgery?
No. You need a responsible adult driver to bring you in and take you home after surgery. You should not be driving the rest of the day after sedation or general anesthesia. It is also a good idea to have a driver even if you are having surgery under local anesthesia in the office.
If you live alone, you need to arrange for someone to stay with you the first night after sedation or general anesthesia.
Are there supplements I should take to help with recovery?
Most patients will bruise and swell for 1 to 2 weeks. Some patients with thicker skin will swell longer, typically for a month or more after surgery. Generally, swelling peaks first thing in the morning and improves once you are upright and moving around, which helps with the drainage of the swelling.
While many patients find that taking Arnica and Bromelain 3 to 5 days before and a week after surgery helps alleviate bruising and swelling, respectively, large-scale research studies demonstrate equivocal results. Therefore, the consensus is that these herbal supplements likely do not hurt and may help the recovery. Arnica is an herb, and Bromelain is an enzyme found in the core of pineapples. Both have anti-inflammatory properties. The typical dosage for Arnica is 200C daily; Bromelain dosage is 1000 mg twice daily.
Are there special supplies I need during my recovery?
For your convenience, the office has a surgical care kit for purchase prior to surgery. The Basic kit includes items that Dr. Phan frequently recommends for before and after surgery care, such as antiseptic lid scrub, gauze, gel mask, pain relief, and lubricating gel drop.
For more delicate skin, there is the Ultra Surgical Care Kit. In cases of Asian blepharoplasty or multiple procedures being done at the same time, Dr. Phan strongly recommends the use of a Lid Lift Goggle for the first 3 days after surgery instead of a cold compress. The goggle applies constant pressure to the blood vessels to keep them from bleeding and causing swelling. Please inquire with staff about the purchase of these items.
For patients who opt not to get the surgical care kit, the following are suggestions for cold and warm compresses. For cold compresses, many patients find frozen corn in snack-size Ziploc bags to be effective and comfortable while sitting snuggly over the eyelids. We recommend that clean, wet gauze or paper towels be placed underneath the Ziploc bags to absorb bloody discharge (a normal post-surgical occurrence) and discarded as necessary.
For warm compresses, many patients find tea bags soaked in hot water keep their warmth longer than washcloths. The tea bags should be placed in Ziploc bags to prevent liquid from dripping into the eyes. Beware that the tea bags are not too hot to cause burns.
Unless specified otherwise by Dr. Phan, you should apply a cold compress on the surgical area 20 minutes on and 20 minutes off while awake during the first 3 days of surgery. After applying a cold compress for the first 3 days of surgery, you may switch to a warm compress 4 times daily for 20 minutes each time.
During the first week of surgery, you should sleep on your back with your head elevated to 45 degrees. Icing constricts the blood vessels and stops bleeding and bruising, while a warm compress and head elevation assist in draining the blood cells and serum collection.
What activities should I restrict after surgery?
In terms of activities, Dr. Phan asks that patients avoid lifting more than 10 pounds, excessive bending or straining, and swimming for the first week after surgery. You may resume work 2 to 3 days after surgery as long as you are comfortable with the visible bruising and swelling and can observe the above restrictions.
When can I shower after surgery?
You may shower the day after surgery and get the surgical site wet. You should gently pat dry the incisions and not rub or pull on the incisions for 1 month. Most patients’ skin heals within a week, but the deeper tissues underneath the skin take at least 1 month, if not 3 to 4 months, to heal completely.
How can I reduce scarring from surgery?
Many patients inquire about scar revision creams. Dr. Phan does not feel strongly that they are necessary for routine eyelid surgery. The skin of the eyelid is the thinnest of the body, and the incision is typically placed in a crease or wrinkle. Therefore, incisions on the eyelids heal very well and hide nicely as well.
For patients who tend to form keloids or hypertrophic or hyper-pigmented scars, Dr. Phan recommends using a silicone-based gel, like BIOCORNEUM® or Silagen®, twice daily starting 2 weeks after surgery. These gels are thick and not formulated for ophthalmic use, so a tiny amount is sufficient for the eyelids to avoid contacting the eyes.
Silicone-based gels are beneficial for deep scars but not necessarily for thin scars; they may help after eyelid surgery and are not likely to hurt the incisions.
Scars form most actively 2 weeks to 2 months after surgery. The incisions may feel tightest during this time, but the tightness will subside after the first couple to a few months. In some cases where the scar feels thickened, Dr. Phan may have you massage the scars with silicone gel 4 times daily to relax them or even inject the scars with anti-inflammatory and anti-metabolic agents to help thin them.
When can I apply makeup, sunscreen, or other skincare products?
Dr. Phan strongly recommends avoiding the sun on the incision line to prevent hyperpigmentation. You should wear sunglasses, hats, and sunscreen with SPF 30+ that is safe for use around the eyes. You may start wearing sunscreen 2 weeks after surgery, at the same time that you can begin wearing makeup.
Dr. Phan advises you to refrain from rubbing or pulling on the incisions for the first month after surgery. Therefore, makeup should be applied and removed gently around the incisions.
Will there be bandages after my surgery?
Generally, there will be no bandage or patching. In some cases, wherein one eye is worked on, Dr. Phan may apply a pressure patch on the eye. The patch may be removed either after 24 or 72 hours. In rare instances, Dr. Phan may apply a Steri-Strip tape over a small area of the incision after suture removal if that area appears to need more support for healing.
Is it normal for my eyes to be dry, blurry, or teary after eyelid surgery?
Yes. When the eyelids are swollen, they may not blink fluidly or close completely. Therefore, the eyes can become dry from increased exposure to air. Significant dryness, in turn, can interfere with the cornea’s ability to focus, causing intermittent blurry vision. Tearing occurs as a compensatory mechanism for dry eyes.
Dr. Phan recommends using lubricants immediately after surgery to prevent the onset of dry eye symptoms, which can make the recovery process less comfortable. Dr. Phan recommends starting with preservative-free artificial tears 4 times daily or using Celluvisc or Blink gel from 4 times daily to every 1 to 2 hours for moderate to severe dryness. For more severe dryness, Dr. Phan recommends adding a petroleum-based ointment, like Retaine PM or Systane Nighttime, in the eyes at bedtime.
Dry eyes are typically temporary for the first couple of weeks to a few weeks after surgery. However, in patients who have underlying dry eye syndrome that may or may not have been previously diagnosed, the dryness or increased dryness may become a new baseline, requiring frequent use of eye lubricants. Symptoms of dry eyes include feelings of dryness, burning, grittiness, sandiness, or sharp pain; redness; blurriness; or increased tearing, crustiness, or mucus.
How often do I need to return for follow-ups after surgery?
Dr. Phan will need to see patients at least 7 to 10 days after surgery and roughly 4 to 6 weeks after surgery. Dr. Phan asks that you not travel until after the first follow-up after surgery.
What health and safety protocols are in place?
To limit the risks of COVID-19 spreading in our community while meeting our patients’ needs and resuming in-office evaluation, our office implements several precautions.
We know these measures can be a nuisance, but we also know they help our first responders and the community at large. We are confident that, with such measures, we will continue to keep you safer as well. We thank you for your understanding and cooperation and wish everyone health and safety.
- When making or confirming appointments over the phone, we will ask whether you have a cough, fever, and shortness of breath or have been in contact with someone with those symptoms. If the answer is affirmative to any of the above, we will reschedule you for 2 weeks after you are asymptomatic and refer you to the PCP.
- If you need to bring a companion, only one may come to the office. All others will have to wait in the car to allow for a 6-foot distancing.
- Because of the limited available appointments to allow for 6-foot distancing, the office will enforce our $100 no-show or late cancellation fee. Late cancellation includes canceling or rescheduling less than 2 business days before the appointment. All appointments must be confirmed electronically or by phone 2 business days before the appointment. If not confirmed, the office will cancel the appointment.
- The New Patient Packet must be completed as thoroughly as possible and returned to the office, along with copies of insurance cards, 1 week prior to the appointment. The New Patient Packet can be found on our website or OnPatient and returned to the office via email, fax, or OnPatient. OnPatient is a secure portal for patients’ electronic medical records and rapid messaging with the doctor and staff. We strongly encourage you to use OnPatient to reduce surface contact and efficiency. If you are unable to complete the packet prior to the appointment, the new patient registration may be done electronically on a tablet.
- On the day of the appointment, once you arrive in the parking lot, you may check in by logging into OnPatient with your smartphone. If you cannot access this, please call the office to check in. Changes in insurance, address, phone number, PCP, pharmacy, etc., may be done via OnPatient or over the phone at this point. If you have Apple Pay or a credit card with a chip, the staff will collect the out-of-pocket cost when you come up. Otherwise, staff will do it over the phone with a credit card number. We will limit handling cash.
- We ask that you wait in your car until the staff calls you to come up.
- If it is necessary for you to wait in the waiting room, we ask you to keep 6 feet of distance by standing or sitting at the designated X’s.
- We will check your temperature upon arrival with a no-touch thermometer scanner. If the reading is 100 degrees or above, we will have to cancel the appointment and refer you to your PCP.
- We ask that you use hand sanitizer upon entering and leaving the office. Sanitizers are available in every room and the hallway.
- We will refrain from handshaking.
- We will keep the front and hallway doors open to avoid handling doorknobs.
- We will disinfect surfaces and objects, such as door handles, the front desk area, pens, clipboards, exam and other patient chairs, and all exam equipment after each patient.
- We will avoid touching our eyes, nose, or mouth and ask you to do the same.
- We will wear and discard gloves and wash our hands between patients.
- We will wear masks and ask you and your companion to cover your faces at all times unless instructed otherwise.
- We will cough or sneeze into a disposable tissue and discard it. We will wash or sanitize our hands afterward and ask you to do the same.
- We will eliminate all samples, reading materials, and tablets in the waiting area.
You can review our other office policies for more information. If you are interested in discussing treatment options with Dr. Phan, please request a consultation or call LaFace by Laura Phan MD at (408) 502-5000.