It is very common to see lumps around or near the eyelids. The vast majority of these lumps are benign (non cancerous) skin changes which either cause blurring of the vision, do not look nice, or cause irritation of the eye or pull and disturb the position of the eyelids.
If there is doubt as to the type of lump that is present, then it is advisable to remove it and send if off for histological analysis by a pathologist. The pathologist will then be able to report back on the exact diagnosis of the lump.
Skin lumps are often removed under local anaesthetic. The skin is first cleaned and then the area around the lump is made numb by injecting local anaesthetic. Depending on the position of the lump, it may be possible to keep the eyes closed while the lump is removed. If, however, the lump is very close to the edge of the eyelid, then it is usually necessary to keep the eyes open while the lump is being removed. Some people find this a little unnerving and request some sedation to relax them. An anaesthetist gives the sedation just before the operation starts.
To avoid unnecessary bruising after surgery, it is important to consider stopping any medications which might increase this possibility. Many people take a regular small dose of aspirin to thin the blood. This can be stopped for a week before surgery. However, other medications which thin the blood, such as warfarin and clopidogrel may need to be continued. Mr McLean will discuss this with you before your operation. Some supplements can also increase the risk of bruising and so you should avoid taking ginkgo, vitamin E, and garlic for two weeks before a lump is removed.
On the day of surgery please don’t use facial cleansers or make up on the face. If you are going to have sedation you need to have nothing to eat or drink for six hours before the operation. You will be given instructions about this before you come in to the hospital.
To reduce the amount of bruising after the operation, an eye pad is usually placed over the eye and eyelids to apply gentle pressure. The pad is usually left in place for an hour, but in some cases the pad needs to remain in place for longer. You will be given instructions about this on the day of the operation. Due to the possibility of an eye pad being in place when you leave the hospital, you should not drive yourself home after the procedure. In cases where there is very little bruising, an eye pad may not be necessary.
Usually there is not a great deal of discomfort after this type of surgery but if there is any discomfort, take regular analgesics at home. Paracetamol or medications containing codeine give good pain relief and unlike aspirin (or similar medications such as nurofen and ibuprofen) they don’t increase the likelihood of bruising.
At the end of the operation, the skin may need no covering or stitches if the lump that was removed was small. With bigger lumps, the skin may be closed with stitches or steri-strips (butterfly stitches) or a combination of the two. Occasionally, special glue can be used to close a cut in the skin. The skin stitches are usually the dissolving type but if they are slow to disappear then they can be removed at the follow up appointment. Steri-strips or glue will both naturally peel off after a few days.
It is important to keep the area that has had surgery dry for the first week after the operation, especially if stitches have been used. You will also be given some antibiotic cream to dab on the treated area, usually four times a day for one week.
If you are experiencing more discomfort than you were expecting or if there is any bleeding from the operation site or signs of increasing redness and discharge then you should call the office for advice.