Swelling changes when we lay down

Adam David Lowenstein, MD answers: Upper eyelid still swelling a week after Blepharoplasty

I had one of my upper eye lids lifted just a little, to match my other eye lid. Now after one week, I'm still noticing that the swelling comes and goes after sleeping. I'm wondering if my doctor injected some kind of saline or some kind of filler because if I lay down, it becomes swollen all over again, just on that one side of my face. Half my face is swollen and the swelling seems to move around on that one side of my face only!


Adam David Lowenstein, MD
10 months ago

What you are experiencing is, in all likelihood, normal. Swelling that comes with reclining and goes away a while after you get up is usually not a dangerous situation, although it is always helpful to check in with your doctor to be sure.

Particularly in the head and face, when we lie down, we lose the effect that gravity provides in the upright position- gravity pulls any excess fluid down, which is why you might notice that your feet may swell during the day but be better in the morning.

The fluid that gravity causes to flow down to your trunk and to your legs gets re-distributed when you lay down, and all of your body parts, including your head, are at the same vertical level. Areas that have recently had surgery are more susceptible to swelling because the healing process may allow fluid to accumulate more in areas where the blood vessels and other drainage vessels are still regenerating.

This is the reason that we often ask patients to elevate the head of their bed at night- to keep the head and face at a higher level than the rest of the body, so gravity can help us with the swelling.

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A: See your doctor

Brent Moelleken, MD
12 months ago

While swelling after any surgery is of course normal, it would be best to see your doctor to make sure you have not developed an infection in the operated area.  It is a bit unusual to see significant swelling in the face a week after a simple blepharoplasty.

If there is no evidence of an infection, he may recommend warm or cool compresses and elevation of the head at nighttime.  You may also want to discuss with him your activity level (i.e. working out), which can worsen early postoperative swelling.

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