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Brent Moelleken, MD answers: Can't open eyes 25 days after Blepharoplasty

My eyes are still puffy and swollen 25 days after upper Blepharoplasty procedure. I'm also having problems opening my eyes, and the scars hurt and feel tight. Is this temporary? What can be done about it?


Brent Moelleken, MD
12 months ago

As all of the other panelists have mentioned, this is not the usual recovery from an upper blepharoplasty.  Only a small subset of patients have this degree of swelling this far post blepharoplasty.

Your doctor will likely examine what ointments you are putting on your eyelid, whether these are causing swelling, whether or not you have an infection, reaction to sutures, or the development of thickening of the scars (hypertrophic scarring), as well as an examination of the eyelid lifting muscle, although this is always difficult when the eyelid is acutely swollen.  Occasionally some patients think that putting certtain creams or neosporin on their eyelids can prevent infection, and this actually causes a dermatitis that then results in swelling of the very delicate upper eyelid skin.  Occasionally use of the laser for cutting on the upper eyelids, rather than promoting faster healing, leaves a burn injury that can prolong healing.

You should come away from the appointment with the feeling that your problems are being addressed and a potential explanation and treatment for your swelling.

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A: Beware the Levator Tear

Athleo Louis Cambre, MD
12 months ago

After Upper Blepharoplasty, it is not unusual to have some swelling in the first few days. Normally this is worse in the morning, after you have been lying down sleeping, and improves throughout the day. Occasionally the eyelashes are stuck together by dried blood or dried eye ointment, which can be corrected by placing a warm moist towel over the eyes.

If you are unable to open your eyes more than three weeks after surgery, and after you have been upright for several hours, there may be another problem such as an accidental cut or tear of the muscle that elevates your upper eyelid, or an infection that is causing prolonged puffiness in the eyelids. In order to diagnose this, you need to see your doctor.

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