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Lower Eyelid Drooping and Tired Look After Blepharoplasty

I had an upper and lower blepharoplasty almost 3 weeks ago by an eyelid specialist cosmetic surgeon. I'm 41 and always had beautiful big eyes. However, the upper lids were starting to sag a bit and the lower lids were prematurely losing elasticity. I decided to go with the surgery, and now I'm totally discouraged and unhappy as I see myself looking tired. The left eye drooped a bit too, my doctor is saying that it's due to the swelling that is pulling the skin down.

I had added fillers added in the past to the lower eyelids to give me a fuller face and accentuate my eyes. Now that the fillers are gone, my face looks hollow under the eyes, and the skin also looks that it's pulled upward. Please help me, I'm desperate. Is this a passing phase or am I stuck with these results? Will these eventually improve over time?

Asked 36 months ago by desperate in New York, USA
Sort 16 expert answers by:
+2

Be patient

It is not uncommon to not have a perfect result immediately.  There likely is swelling that is causing the problem.  If fat was removed this may be adding to the change of the lower lids.  See your surgeon often to get reassurance but don't look for further action for months.
Christopher L. Hess, MD
Fairfax Plastic Surgeon
+2

Wait till swelling is gone

Please wait till swelling is gone. Discuss your concerns with your doctor and if you have lost your confidence get a second consultation from a board certified plastic surgeon.
Kamran Khoobehi, MD
New Orleans Plastic Surgeon
+2

It will probably improve as you heal further

It is difficult to say without seeing you in person. Sometimes, swelling takes a little longer to resolve and hopefully it will improve for you shortly. Discuss this with your doctor again. You might benefit from a lyphatic massage by a specially trained aesthetician. You might need a filler injection in the future as well, but I would wait till the swelling is gone.
Stella Desyatnikova, MD
Seattle Facial Plastic Surgeon
+2

No way to know

While there are many horror stories of excessive removal of tissues from the lower eyelids, the majority of patients who have your complaints are the result of swelling to the lower lids. It will take up to 6 months for the swelling to resolve. So, relax and follow the advice of your doctor.
Robert M. Freund, MD
New York Plastic Surgeon
+2

It is probably the swelling

Desperate, Without seeing a picture or examining you, it is hard to tell for sure. However, just three weeks after surgery there is still a considerable about of swelling, so you should not get too discouraged. Hang in there.
David Shafer, MD
New York Plastic Surgeon
+2

Give it more time

It is a little difficult to answer your questions without a photograph but there are several generalizations that can be made at this point: 1. You are still very early in the post operative period and swelling is a likely possibility. 2. You mention some drooping of the lower eyelid, this could be a condition known as an ectropion. There are several causes for an ectropion including early swelling. 3. You mention some hollowness of the lower eyelid area but you did not mention whether or... more
Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
+2

Three weeks is too early to tell final Blepharoplasty results

3 weeks is too soon after surgery to know what the final result will be. It is tough to look in the mirror and not be happy, but this is the time that you need to honker down and be patient. It will take months before you see the final result. If your lower lids are drooping, ask the doctor if supporting them with steri-strips will help. Even if you are not happy with the result, something can usually be done to "touch up" and get you happy. Don't get discouraged yet. more
Scott E. Kasden, MD
Dallas Plastic Surgeon
+2

It can take 6 to 12 weeks to see final blepharoplasty results

Desperate, Please relax and don't be so worried. You are only 3 weeks out from your blepharoplasty and the swelling is surely pulling the lids down. You will definitely improve over the next 4-5 weeks. This is a passing phase. If after your recovery you still see the hollowness beneath the lower eyelid and cheek area there are other things you can do. I do not use fillers on the eyelid. The eyelid skin is so thin that discoloration and lumps are common. Open fat grafting can improve the... more
Brooke R. Seckel, MD
Boston Plastic Surgeon
+1

Post-Operative Blepharoplasty Concerns

This is a very real possibility, so I always advise patients to give things a full 8 weeks before starting to make assessments as to its success. The other possibility is that you had an underlying preexisting lid ptosis or droop that was not adequately identified pre-operatively, and now you are seeing it very clearly due to the removal of what was overlying excess skin. Likely what you have also described is filler such as Perlane to the tear troughs, which can really create a nice... more
Jeffrey S. Epstein, MD
Miami Facial Plastic Surgeon
+1

Three weeks after surgery is a short time

This is a very short time after eyelid surgery as far as your body is concerned.  I would give it a full 3-6 months before any judegements can be made. The healing process can take up to one year and to be honest as far as your body is concerned three weeks is a very very short time after surgery. You need to give it some time.
Chris Thiagarajah, MD
Washington DC Oculoplastic Surgeon
+1

Could take 3 months for swelling to subside

Even though it has only been three weeks after your blepharoplasty, it takes time for the swelling to subside. A low-salt diet will help reduce some of the swelling in the eyelids and prednisone pills also help if your physician is willing to prescribe them. Drooping in the eyelids can be normal in the first few weeks after the surgery if there are some lazy eye muscles. As long as the muscles have not been violated during surgery, this will resolve to its pre-surgery state. It may take... more
William Portuese, MD
Seattle Facial Plastic Surgeon
+1

Traditional lower blepharoplasty will create hollowness

Aging many times involves a volume loss. For the lower eyelids, this means that you lose volume in the cheek and under eye area. This reveals your lower eyelid fat and also exposes your muscle that surrounds your eye. With the more exposed orbital rim under your eye, you have many reasons for bags under the eyes. The fat protruding creates a shadow under your lower eyelid. The exposed muscle creates a darker appearance to the lower eyelid. The exposed orbital rim creates a visible rim... more
Philip Young, MD
Bellevue Facial Plastic Surgeon
+1

Blepharoplasty swelling may take several weeks

It takes several weeks for swelling to resolve following a blepharoplasty. In the mean time, I would recommend gently massaging the lower eyelid to prevent a scar contracture from forming. Once your swelling has resolved, reevaluate the results with you surgeon. At that time, if you are still not satisfied, you can formulate an appropriate game plan with your surgeon. At this time, I would recommend patience. Good luck
David A. Robinson, MD
Munster Plastic Surgeon
+1

Don't be discouraged

Hello, Usually, it can take 4-6 weeks for the lower lid to regain its tension after lower lid blepharoplasty. During that time you should be massaging the lower lid consistently which helps scar contracture from forming. For hollowness around the eye, fat transfer can have a long lasting and natural result, sometimes after only two sessions. Continue to discuss your concerns with your surgeon so you will both be on the same page. Good luck. Dr. Miller
Andrew Miller, MD
Edison Facial Plastic Surgeon
+1

Patience and Lid Stretching

If the lower lid appears pulled down slight lid stretching can help the position until it is healed.  Be patient and positive and work with your surgeon.
Richard Gentile, MD
Cleveland Facial Plastic Surgeon
+1

Blepharoplasty results can be evaluated after 6 months

Three weeks is a very short time. Please wait until you get the final result. The upper and lower lids are very delicate structures and they will be affected by the swelling as well as by scar formation. Your board certified plastic surgeon will be able to help you during this process. At the 6 months mark, a real evaluation could be done. You will not be stuck with any result, different things could be done to address all the issues in the future.
Hisham Seify, MD, PhD
Los Angeles Plastic Surgeon
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