Bulge Under Left Eye After Blepharoplasty

I had transconjunctival Blepharoplasty 14 weeks ago. Right eye has healed, but left eye heals slow. There's a slight bulge directly beneath where the bag used to be (can't be fat, way too far from lid). If you were to place the tip of your thumb on a piece of paper, trace it with a pencil, that's the shape of it, with the rounded edge facing downwards. Is this residual swelling? Is it normal to have swelling in that region? Why do eyes heal at different rates? (Hard to see in photo, very apparent in person)

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12 Doctor Answers | Asked by DDC38 in Chicago, IL

Doctor Answers (12)
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Prolonged swelling in a facial fat pocket

To address your last comments: There are several fat compartments in the face. A transconjunctival blepharoplasty will only address the three lower lid fat pockets. You have some swelling of the other pockets. Lymphatic massage helps a lot.

Gravity allows Blepharoplasty swelling to "pool" on cheek bone

Swelling, edema, after eyelid surgery is not uncommon. Each side can heal independently of one another; just like the right arm is different in strength to the left. If you sleep on this side it is more likely that the swelling will remain longer. After eyelid surgery, we get swelling that gravity pulls down to this lower eyelid/ cheek junction. It should improve over time. Speak to your doctor about using gentle massage techniques and warm compresses to help hasten the swelling. If this... more

Healing after surgery

First off to answer your last question first, the reason the eyes heal at different rates is because the anatomy is not exactly the same on both sides. Just like an eyeglass prescription can be different in two eyes because they are different, the eyelids can heal differently because they are anatomically a little different. Also if you sleep on one side, that may create more edema on one side as opposed to another in the healing process. I would give this 6 months to a 1 year but this... more

It is best to be patient for swelling to resolve

Healing rates after blepharoplasty can vary. Swelling can settle under the lower lid and sometimes take weeks to resolve - sometimes even months. It is hard to tell for sure without examining you. The best advice to follow up closely with your surgeon. Good luck.

Boy, I think I would give this a whole lot of time to resolve.

Dear DDC38 The thing you are pointing to is well outside where the eyelid fat lives. And yet, in the photograph it appears to be in continuity with a ridge extending from the medial portion of the lower eyelid where the lower eyelid fat does live. This is where a personal consultation is invaluable because in person we would know exactly what you are pointing to. However, assuming that what you are pointing to is the fullness outside of the orbital rim, this is a little relaxation in... more

Kenneth D. Steinsapir, MD

8 reviews

Los Angeles Oculoplastic Surgeon

Hard to tell without exam

This may indeed be resdual swelling, or cheek fat pad left behind/displaced. Have your doctor examine it to see if this will heal on its own, or perhaps a steroid injection may help. Massage? sek

Give your Blepharoplasty some time

I would give it another three months before considering any additional treatments. It certainly could be some residual swelling especially since it is below the operative site. If it hasn't corrected itself after three more months, then go back to your surgeon and discuss options. Malar swelling can be corrected with a variety of techniques, including fillers to camoflage the bump.

See your surgeon

It is mere speculation to determine what is happening without examining you or knowing what transpired at surgery. You might ask if fat wassimply removed or if the surgeon tried to reposition the fat over the lower orbital rim. Any acute swelling from the surgery should be gone by 14 weeks although it is standard for bilateral procedures to heal at slightly "different rates." It is possible it might be a seroma, or collection of fluid, or fat, if it was repostioned. more

Robin T.W. Yuan, MD

4 reviews

Beverly Hills Plastic Surgeon

Bulge After Blepharoplasty

Bulges after blepharoplasty can be disconcerting to the patient. Early on after blepharoplasty, it is not uncommon to see some asymmetry of the lower eye / cheek complex. Persistence of lower lid swelling under the eye can be from the following causes: Malar edema Festoon persistence Lower lid fat Medical condition (especially thyroid or allergy) Discussion with a well qualified surgeon can identify the solution to the persistent... more

Bulge under eye after blepharoplasty may be a festoon or malar bag

I agree that asymetrical healing is common after blepharoplasty but at 14 weeks your eyelid looks well healed. In some cases, particularly after puffy eyes or eye bags have been removed, a swelling on the upper cheek becomes apparent that was not noticed before the eye bag was removed. If this is the case and you do have a festoon or malar bag, the swellking will not go down. Festoons are usually present on both sides although they can be more noticeable on one side. They are very difficult... more

Asymmetrical healing of eyelids is typical

There is always asymmetrical healing with respect to eyelids. One eyelid always heals faster than the other. The bulge that you are describing is difficult to see and can be related to malar edema in the high cheek area. Make sure that any allergies are under good control so as not to create more swelling and edema in the lower lids.

3.5 months is way out for significant swelling

The area of concern that you are describing is the lid/cheek junction. This protrusion can only really be caused by one thing-lower lid fat. The fat of the lower lid is divided into three distinct compartment, medial, middle and lateral. When doing a transconjunctival bleph it is imperative that all three compartments be opened and the appropriate amount of fat removed. You have an interesting postoperative appearance. You still have tear trough depressions and you have excess fat over... more