The lower eyelids take several months for full healing

William A. Portuese, 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?


William Portuese, MD
10 months ago
By William Portuese, MD - Seattle Facial Plastic Surgeon

The lower eyelids take several months for full healing to settle in so that some residual edema, swelling, and bruising can be in effect for several weeks after the surgery. The goal for lower eyelid surgery is to remove fat bags, which are composed of fatty tissue underneath the eyelids.

There are three fatty tissue bags in the lower lids and two in the upper lids. The bags are removed through an incision made inside the lower eyelid; this is referred to as transconjunctival approach.

If there is excess skin, which is typical of patients over 50 years of age, a small strip of “pinched” skin can be removed just below the lash line. This should be done symmetrically so that there is no asymmetry created.

Lower lid blepharoplasty needs to be performed conservatively. If too much fat is removed the lower lids will look too hollow, and if too much skin is removed, then a pulled-down, sad-eyed appearance will result (hound dog eyes).

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A: Need to give it more time

Samson Lee, MD
12 months ago
By Samson Lee, MD - Seattle Facial Plastic Surgeon

Unfortunately it is common to have swelling and mild asymmetry that early after surgery, particularly when a lower lid incision on the skin rather then on the inside of the eyelid has been performed. It is impossible to achieve complete symmetry in any plastic surgery procedure, but if you notice some mild asymmetry it probably will resolve. It will take several months before knowing the final result and any potential long term asymmetry that may result. Hopefully you will have an excellent result.

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A: Time will tell

Richard P. Rand, MD
12 months ago
By Richard P. Rand, MD - Seattle Plastic Surgeon

At only 2.5 weeks after surgery, there is still substantial swelling present so it won't be possible to know the answer to your question for another 3-4 months. Stay in close touch with your surgeon and be patient and give it some time. It's too soon to be worried.

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