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Chemosis After Blepharoplasty

I had upper and lower blepharoplasty, and I still have severe chemosis on one eye after 9 weeks. I am using tear drops and a lubricant, and I'm also taking antibiotics. Will this heal, and how long will it take? I'm very depressed.

Asked 35 months ago by Annouscka in UK

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chemosis

Chemosis after Blepharoplasty

Although it can happen with any surgery around the eyes (and to any plastic surgeon for this matter), chemosis develops most commonly if lower blepharoplasty has been part of the procedure. If only the upper lids have been operated, it is very rare. If additional procedures have been performed such as canthopexy, canthoplasty or midface lift, chemosis may be more common. Although after 9 weeks, understandably, most patients and surgeons lose their patience, chemosis will resolve. Many... more

Frank P. Fechner, MD

Worcester Facial Plastic Surgeon

An unfortunate complication

Chemosis after blepharoplasty is one of the complications we all look to prevent. This can occur because of a negative vector or is more common in women in their 40's and 50's because dry eyes tend to occur more in these ages due to hormone changes. You're doing everything right. And usually chemosis will resolve without surgery. As the other physicians have stated steroids may help. You might also consider seeing an Ophthalmologist for a second opinion or evaluation of the duct.... more

Christopher L. Hess, MD

Fairfax Plastic Surgeon

ASPS

Chemosis will resolve

Ann, Chemosis can be a very frustrating complication from blepharoplasty. The treatment includes natural tear drops, steroid eye drops and sometimes even a temporary stitching together of your eyelids (tarsorrhaphy). See your surgeon for treatment options and good luck.

Kenneth R. Francis, MD

Manhattan Plastic Surgeon

ASAPS ASPS

Would use steroid drops by this time

Chemosis, or inflammation of the conjunctiva, happens about 20% of the time, even to the best of surgeons. It is usually treated initially by the measures you have mentioned. When it persists, as yours has, use of steroid drops is the next treatment, unless you have some contraindication. If so, there are non-steroidal antiinflammatory drops that can be used. Occasionally, resection of persistently edematous (swollen) conjunctiva is necessary, but exceptionally rare. Although it is way too... more

Robert T. Buchanan, MD

Highlands Plastic Surgeon

ASAPS ASPS

You need aggressive dry eye treatment

Dear Annouscka, Chemosis is swelling of the conjunctiva following eyelid surgery. The conunctiva is the white covering that surrounds the eye. Just like the eyelids swell after eyelid tissue, the conjunctiva can also swell. Chemosis is common enough although an incidence of 10% is overstating how often it should occur following cosmetic eyelid surgery. Certain surgical maneuvers are much more likely to cause chemosis, which is thought to be related to disruption of the eyelid lymphatics.... more

Kenneth D. Steinsapir, MD

Los Angeles Oculoplastic Surgeon

It will go away.

Hi! Chemosis happens about 10% of the time after blepharoplasty. I sometimes use a temporary tarsorrhaphy (technical detail) to minimize this, but it can still happen. It looks terrible and it is very annoying. The good news is that it does not do any harm and that it goes away. By all means see an ophthalmologist for further reassurance and to make sure there is nothing unusual going on.

George J. Beraka, MD

Manhattan Plastic Surgeon

ASAPS ASPS

9 weeks is too long for chemosis after blepharoplasty

9 weeks is a long time to have Chemosis after blepharoplasty. Something must be continuing to inflame and irritate your eyes. Most likely your eye continues to be dry-perhaps the eyelids are too open from drooping of the lower eyelid or incomplete closure of the upper lid. Alternatively you may be ALLERGIC to the eye drops or lubricant. I have seen that happen before and it will cause chemosis. Consult your doctor or if not available, see an ophthamologist. If the eyelids are normal and the... more

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Brooke R. Seckel, MD

Boston Plastic Surgeon

ASAPS ASPS

Don't be depressed as with time it should all resolve

Chemosis takes a long time to resolve and full resolution takes 6weeks to 3 months. Although I have only experienced that once in my carrier, it can occur and it takes weeks to months to gradually resove. I would not recommed using steriod eye drops for more than a few weeks as it increases the risks of cataracts. Waiting and cold compresses may be the best remedy

Amir Moradi, MD

San Diego Facial Plastic Surgeon

Hard to tell

It is impossible to tell exactly. You may want to ask your doctor about steroid eye drops, or perhaps a small procedure to correct it. Sometimes, cool compresses and gentle massage to the closed eyelid may also help, but again, check with your doctor.

Scott E. Kasden, MD

Dallas Plastic Surgeon

ASAPS ASPS

Persistant chemosis is a tough problem

Chemosis can be a real problem and in a major US publication it has an incidence of 25%. Many things can be done to help prevent this problem but it still can occur. It seems that you have been instructed to do some of the usual things for chemosis such as eye drops, and lubiricants. Even though there can be tearing that goes down your cheeks the real underlying problem can actually be dryness of the eyes. Make sure that you eyes are closing fully at night and use the ointment in... more

Jeffrey Zwiren, MD

Atlanta Plastic Surgeon

ASPS

Chemosis is different from dry eye syndrome

Chemosis is by definition, the swelling of the conjunctiva. It is a rare poorly understood phenomenon that occurs after lower lid surgery. Dry eye syndrome is a different clinical problem that occurs due to a variety of reasons e.g undersecretion of tears, corneal exposure, etc. Both problems could occur simultanously in the same patient; however, the treatment is different. The treatment of dry eye snydrome is to address the cause. In many occasions, that could be very difficult or... more

Hisham Seify, MD, PhD

Los Angeles Plastic Surgeon

ASPS

Chemosis will heal and go away

Chemosis following upper and lower lid blepharoplasty occurs frequently. It can be almost a recurrent feedback loop, dry eye or conjunctiva becomes irritated and swells, this causes more exposure of the conjunctiva as it can billow out of the eyelid fissure, causing more irritation and swelling. Occasionally, an eye patch at night for compression with a bland ointment and topical catabolic steroid drops along with lubrication and a possible lateral tarrsorraphy are options. It can take 3-6... more

Charles Perry, MD

Sacramento Plastic Surgeon

ASPS

Visit an ophthalmologist with eyelid surgery experience or an oculoplastic surgeon

Hello, Chemosis after blepharoplasty happens reasonably frequently. Most of the time it is a small area on the outside of the sclera (the white part of your eye). The blood needs to be reabsorbed by your body and this can be a slow process. However, 9 weeks seems on the long side of resolution. I would advise you to talk to your doctor, get a recommendation for an ophthalmologist who has experience in seeing blepharoplasty patients (in this country, there are oculoplastic surgeons as well... more

Francisco Canales, MD

Santa Rosa Plastic Surgeon

ASAPS ASPS

Chemosis after blepharoplasty will settle down

Chemosis after blepharoplasty will settle down, but it sometimes can take a couple of months. Continue to use eye drops such as Natural Tears and Lacri-Lube ophthalmic ointment as a lubricant. Antibiotics are not going to make this go away at this point. It could probably take another month or so before it goes away. It is also important to make sure that there is nothing else going on besides chemosis, and a consultation with an ophthalmologist is probably warranted at this point.... more

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William Portuese, MD

Seattle Facial Plastic Surgeon

You may need to see a opthomologist

You habe dry eyes . You may need to see your eye doctor to check it. You may benefit from plugs to help with dry eye.The other thing is to use eye patch at night to make sure your eyes do not stay open. Cortisone eye drops may help .