The questions that arrive after the surgery, not before it
Before under-eye fat repositioning, patients ask about technique and results. Afterward the questions become practical and they come daily: can I put my contacts back in, when can I wear eye makeup, is one coffee a problem, can I colour my hair, I sleep on my side — did I just ruin it? ST's surgeon has answered these in several question-and-answer videos. This column collects them in one place. Two things decide most of the timings. The first is where the incision is: a transconjunctival approach leaves a healing wound on the inside of the lid, an incisional approach leaves one on the skin just under the lashes, and each wound has things it should not meet too early. The second is bleeding risk, which is highest in the first days and is the reason behind most of the two-week rules. These are ST's standard instructions. If your own surgeon has told you something different, follow your surgeon — they know what was done inside your eyelid.
The short version: what, and from when
The table below is the quick reference; the sections after it explain the reasoning, because a rule you understand is easier to keep. Where a range is given, the earlier figure is the minimum and the later one is what ST is more comfortable with.
| Activity | From when | Why |
|---|---|---|
| Walking, light daily activity | The next day | Gentle movement helps swelling clear; bed rest does not |
| Moisturiser on the face, away from any wound | As soon as the tape is off | Antiseptic and theatre lights leave the skin dry |
| Face washing over the area | Transconjunctival: once the tape is removed. Incisional: the day after suture removal | Keeps a skin wound dry until it has sealed |
| Shower | Day 2 to 3 (day 3 with a waterproof dressing if fat was harvested) | Protects the incision and the donor site |
| Makeup on the rest of the face | Once the tape is off | Not near the wound |
| Eye makeup | About 2 weeks | Pigment and cleanser can enter a healing wound |
| Contact lenses | 2 weeks at the very earliest; 3 to 4 weeks preferred | The inner-lid incision needs to close before a lens rubs on it |
| Hair colour, lash perm | About 2 weeks | The issue is bending the head forward, and chemicals or heat near the lid |
| Sleeping on your side, massage, pressure on the area | 2 weeks minimum; 3 weeks to be safe | Pressure can restart bleeding |
| Caffeine | 2 weeks for most people; 4 if you are sensitive to it | Acts on blood vessels |
| Alcohol and nicotine | Avoid for 2 weeks before and ideally 4 weeks after | Alcohol dilates vessels and prolongs swelling; nicotine constricts them and slows healing |
| Strenuous exercise, sauna, swimming | 4 weeks | Raised pressure can reopen a sealed vessel; water and heat are wound risks |
| Important events and photographs | Transconjunctival: about 1 month. Incisional: about 2 months | Bruising has usually cleared by a month; incision redness takes longer |
| LASIK, LASEK, cataract surgery afterward | About 2 months | The lids must tolerate being held open |
The eyes themselves: contacts, makeup, vision
Contact lenses are the most frequent question, and for some people the most urgent — a few patients genuinely cannot function in glasses. The limiting factor is the conjunctiva. In a transconjunctival operation the incision is made through the inner surface of the lower lid with a laser or radiofrequency device, and that surface takes at least two weeks to close properly. A lens sits against it and moves with every blink. Two weeks is therefore the floor, not the target; ST usually asks for three to four. Wearing lenses earlier risks irritation, a foreign-body sensation, and infection. Eye makeup follows the same logic from the other direction: the concern is less the makeup than what removing it pushes toward the wound. Makeup on the rest of the face can resume as soon as the tape is off. For eyeshadow, liner, and mascara, ST advises about two weeks; with an incisional approach, never before the sutures are out. A lash perm combines chemicals and heat at the lid margin and waits two weeks as well. Blurred or hazy vision in the first week worries people more than it should. It has ordinary causes — swelling of the conjunctiva, a dry or mildly irritated corneal surface, ointment in the eye — and in most patients it settles within one to two weeks. Vision that worsens instead of improving, or that comes with severe pain, is not part of this pattern and needs a same-day call to the clinic. As for refractive or cataract surgery: ophthalmologists generally allow eyelid surgery about a month after their procedure, and ST asks for about two months before eye surgery that follows a repositioning, because the lids have to be held open during it.
Cold first, then warm — and how to sleep
For the first three days the small vessels in the operated area are still fragile, and the goal is to keep them closed. That is what cold does. ST's surgeon uses a plumbing comparison: cold compresses turn the tap off. Use a chilled — not frozen — pack, wrapped in gauze so it does not touch the skin directly, for no more than ten minutes at a time. The ten-minute limit matters because sensation under the eye is dulled after surgery, and skin that cannot feel cold properly can be injured by it. You can repeat as often as you like, with breaks. From about day four or five the goal reverses. Now the task is to drain the fluid that has collected, and warmth opens the drain: a warm compress, tested first on the inside of your wrist, again for no more than ten minutes. Sleep with your head raised on two pillows for the first week, since a head lower than the heart raises pressure in exactly the vessels you are trying to keep quiet. Side-sleepers can relax a little. Physical pressure on the area is safe from about three weeks, and the two weeks before that are the period of real caution — but ST's surgeon, a side-sleeper himself, points out that lying on a freshly operated eye is uncomfortable enough that the body corrects the position on its own. Waking on your side once is unlikely to have caused harm; check for new swelling or bruising. The same two-to-three-week rule applies to facial massage and to anything that presses on the lower lid.
Alcohol, nicotine, caffeine, and exercise
Alcohol and nicotine are restricted for opposite reasons, and both reasons are about blood vessels. Nicotine constricts them: less blood reaches the wound, and healing slows. Alcohol dilates them: more fluid leaks into the tissue, swelling and bruising last longer, and a vessel that had sealed can open. ST asks patients to avoid both for two weeks before surgery and, ideally, four weeks after it. Caffeine acts on vessels too, though less dramatically. Most patients can return to coffee at two weeks; those who know they react strongly to caffeine should wait the full four, and energy drinks count as a larger dose than coffee. Exercise divides into two categories. Walking and ordinary daily activity are encouraged from the day after surgery — patients who move gently clear their swelling faster than those who stay in bed. Anything that raises blood pressure or involves straining is different: running, weights, hot yoga, and for that matter a severe coughing fit or heavy lifting in the first two weeks. ST sets four weeks for strenuous exercise, saunas, and swimming pools. Hair colouring has nothing to do with the eyes as such; the actual rule is not to bend your head forward for two weeks. Colouring at home over a basin breaks that rule. At a salon where you lean back, two weeks is fine.
Special situations: nursing, glaucoma, itching, children, later treatments
Breastfeeding does not rule out the surgery. The operation itself has no bearing on nursing; the oral antibiotics afterward do. The usual course is about a week. For nursing mothers the drug and its duration are decided individually, and whether feeding needs to be paused depends on what is prescribed. Tell the clinic in advance so the prescription is planned around it. If you have raised eye pressure or glaucoma, tell the clinic in advance; ST will ask for your ophthalmologist's clearance before scheduling. Itching after surgery is usually an allergic reaction — to tape, to ointment, or simply seasonal — and not a complication of the operation. Check with the clinic before taking allergy medication so it can be matched against your prescriptions. Dryness is common while the lids are swollen and normally fades with the swelling; dryness that continues after the swelling has gone should be examined. Parents of small children ask what happens if a child's head hits the eye. Within the first two weeks, a knock followed by new bruising or swelling means a visit to the clinic. After two weeks the risk is lower, but new swelling, bruising, pain or a change in vision after a knock should still be checked. Dieting does not shrink repositioned or grafted fat in any meaningful way — weight loss draws mainly on the fat under the skin. Later skin treatments are compatible: lasers and skin-quality injections work at a level above the repositioned fat. Devices that deliver energy deeper can thin grafted fat lying near their target depth, so let the treating doctor know you have had grafting and leave the choice of device to them. Filler for the aegyo-sal, if you want it, is better judged at about three months, when the lower lid has settled into its final shape. All surgery carries risks, including bleeding, infection, asymmetry, scarring and lid malposition; results and recovery vary between individuals.