Is cooling effective before upper lid blepharoplasty?

To determine the efficacy of eyelid cooling before upper lid blepharoplasty in terms of pain, edema, erythema, and hematoma and report the results for the first time in the literature.

Forty-two patients who were scheduled to undergo upper lid blepharoplasty were enrolled in this study. One eyelid (right eye) was chosen to be cooled, and the other eyelid was left uncooled before the surgery. Pain scores were reported by the patients using a Visual Analog Scale (0 to 10), and photographs were obtained by the same ophthalmologist 1hour, 1 day, and 1 week after surgery. The ecchymosis and edema of the eyelids were evaluated and classified according to these photographs using respective graded scales.

Compared with the uncooled lids, less edema was observed on postoperative day 1 in the eyelids treated by cooling (P<0.01). The degree of eyelid ecchymosis did not differ between the two groups (P>0.05). Pain in the cooled eyelids was significantly less 1hour and 1 day after surgery (P<0.01), but did not differ 1 week after surgery.

We recommend the use of cooling before, not after, blepharoplasty, as it reduces pain and edema and eliminates patient compliance.