Patience is the toughest thing to have

Brent Moelleken, MD answers: Remaining eyebag and slight asymmetry after lower Blepharoplasty

I had a lower Blepharoplasty done 2 1/2 weeks ago where the incision was done on the outside corner of my lower lids. Before the surgery, I had a bigger eye bag under the left eye but my eyes were symmetrical. Now, 2 1/2 weeks later, I still have the bag under my left eye (some slight bruising still showing) and the left lower lid is slightly higher than the right (probably because of the skin that was excised). How can I tell if the left eye bag is still there or if it's just residual swelling?


Brent Moelleken, MD
12 months ago
By Brent Moelleken, MD - Beverly Hills Plastic Surgeon

Since your surgery was just performed, it is way to early to assess the long term results. Usually the 6 month timepoint is a good final result timepoint. Your doctor will likely have massage exercises for you to perform and may suggest injections, taping, etc. Once the final result has been achieved, hopefully you will be very satisfied with your result. If asymmetries are present, then the really tough decisions start.

Revisional lower eyelid surgery is one of the hardest of all areas in plastic surgery. Conventional lower eyelid surgeries involve removal of skin and fat from the lower eyelids. in some patients, this can cause characteristic patterns of hollowness or pulling down of the lower eyelids, often asymmetrically. The challenge for the revision is then to elevate the corners of the eyes, restore a healthy eye shape, and restore lost volume. All this and meet the patient's expectations!

This often involves a combination of midfacial advancement techniques (cheeklifts), LiveFill for volume restoration, canthal reconstruction, and scar revisions.

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A: Don't Bag on Your Surgeon Just Yet

Athleo Louis Cambre, MD
12 months ago
By Athleo Louis Cambre, MD - Los Angeles Plastic Surgeon

At just over two weeks after Blepharoplasty surgery, it is normal to have some asymmetry. This may affect both the skin and the fat of the lower eyelids, and may also affect the shape of the eye. There can be more swelling or bruising on one side versus the other, even if the identical procedure was performed, and identical amounts of fat were removed.

Four to six weeks after eyelid surgery, most of the early asymmetry caused by the above problems should be resolved. In the interim, follow the recommendations of your surgeon, keep your head elevated as much as possible, use cool compresses, use artificial tears and eye ointment as necessary, and be patient. Your final result isn't in the bag just yet!

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A: Too Early to Tell

Michael A. Persky, MD
12 months ago
By Michael A. Persky, MD - Los Angeles Facial Plastic Surgeon

Hi Sue,

You should consult with your surgeon who will likely tell you that it is still too early to judge your results. Give it another few weeks.

The reward of patience is patience. Good luck and I wish you a rapid and symmetric recovery.

Dr. P

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