Eye Bags and Swelling 8 Months Post-Blepharoplasty

My doctor doesn't know why the swelling and eyebags 8 months post-procedure won't go down. For the last 2 months, I've been using a special cream that he gave me, with little success. He says he removed enough fat, and there isn't a need to remove more.

I have more swelling on my left side, I believe due to the suture knot not being trimmed short enough. It is somewhat noticeable and causes a little discomfort at times. I can feel it though my skin, at the corner of my eye. He said he will trim this for me next month. I'm desperate for other opinions as I'm now trying everything from drinking green tea, eating more cucumbers, massive vitamin intake, etc.

Anything to help my body not retain the excess fluid? What can I do to improve the condition? I'm open to suggestions and professional opinions. Thank you all for your time.

Doctor Answers (12)

Prolonged swelling after lower eyelid surgery

+3

I concur with the other recommendations and highly advise you seek an additional opinion by a board certified plastic surgeon, oculoplastic surgeon, opthalmologist, ear nose and throat physician, and/or internist.

Swelling of the lower eyelids has a variety of causes and surgery is not always the answer:

  • This includes condition such as thyroid disease.
  • If the condition is caused by inflammation antiinflammatory medications and drops may be beneficial.

Surgical treatments may produce improvement but other causes should be thoroughly evaluated first. It is difficult to tell if the swelling in your lower eyelids is due to extra fat (surgically treatable) or to edema. If it is the latter you may see improvements with facial manual lymphatic drainage.


Chicago Plastic Surgeon
5.0 out of 5 stars 41 reviews

A tricky balance

+3

It is difficult from the looking up photograph to see exactly what the problem is. It appears as though there is hollowness immediately below the eyes, some retraction of the eyelids, and fullness, perhaps with irregularities from ? fat injection below that at the eye-cheek junction. It appears that your eyes are quite prominent.

Often when prominent eyes are operated on through a lower eyelid (subciliary) incision, the eyelids can pull down, as though seeking a lower position on the spherical globe (eyeball). This can present a problem visually and also functionally as the cornea becomes chronically dry.

The issue you had pointed out, however, was none of the above; rather it was the persistence of fat below the eyes. In your photo this seems to be primarily low down at the eye-cheek junction, and does not consist at all of typical lower eyelid fat that can be removed readily.

Consultations with surgeons skilled in the midface and revision lower eyelid surgery should clear this issue up further.

Although we have written many publications and chapters on your topic, we are never quick to reoperate. Any revision to lower eyelid surgery with lid retraction would typically involve midface advamcent (some type of cheeklift), plus canthopexy. Canthopexy alone can give the eye a severe look with an uptick at the corner but unaltered central roundness of the eye, a characteristic "done" look. Also, grafts such as LiveFill (nontraumatized fascial fat grafts) placed directly in regions of hollowness can help. If there is lumpiness from fat injection, this is usually removed directly.

Patients having revision lower eyelid surgery must be realistic about their outcomes, which are usually subtly better and not completely curative.

Brent Moelleken, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 90 reviews

Swelling of eyes

+2

It is not very common to have swelling 8 months after surgery. If there is an eye irritant that can cause swelling. If your eyes do not close well, that can also cause swelling. It is hard to tell without examining you. If you have fullness in your lower lids, then perhaps there is still some fat that is prominent and may need to be removed.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 15 reviews

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Swelling and lump

+2

I have experienced the bump at the corner of the eye. For some reason this is not uncommon, and is usually (in my patinerts) scar tissue (I use a resorbable suture). A small snip and it is over.

Your sweliing is another story. It may be that there is more fat there, but I would tend to believe your surgeon, as he was there to observe the anatomy. So, going on the assumption that this is swelling, one thing that might help is kenalog (steroid) shots. This must be done based on exam, and carefully, as steroids have possible complication.

Interestingly, if you lay with your head to one side, the lower side due to gravity will tend to swell more.

Scott E. Kasden, MD
Dallas Plastic Surgeon
4.5 out of 5 stars 45 reviews

Kitty eyes?

+2

Kitty,

It is difficult to tell from this picture, but it does appear that you have some residual lower lid fat that needs to be removed. Also, you are looking up so that may be causing the scleral (white) show below your iris. If it is showing from a direct frontal view you may need a canthopexy/canthoplasty procedure. This would raise the outer part of your lid giving you a more cat like appearance, but would correct the scleral show. You may also want to ask what is in the cream that you are using. You may be experiencing a reaction to the cream. And maybe its time for a second opinion.

Kenneth R. Francis, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 31 reviews

A surgical revision may correct the problem.

+2

At 8 months, it is very unlikely that this problem will get better. Most patients see dramatic results within 4-6 weeks following an eyelid procedure. From the picture, it is difficult to tell if you also have some abnormal show of the "whites" or conjunctiva of the eye. This could be corrected at the same time as further fatty removal and lid tightening. Discuss surgery with your doctor. Get a second opinion with a consultation. Our answers may guide you, but examination by a Board Certified Plastic Surgeon or Oculoplastic Specialist would be more helpful.

Topical medications and teas are nice, but they didn't do the trick before the 1st surgery and they won't work now.

David A. Dreyfuss, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 1 review

Unfortunately, this will not go away without a surgical revision.

+2

To Beachnutkitty,

Operating on the lower eyelids can be quite challenging, and your problem is not that rare and it is difficult to correct. You do not have more fat that needs to be removed, and the stitches are not causing this. The problem seems to be a sharp line between your inner cheeks and you lower lids, with some swelling and some rounding of the eyes.

You probably need another eyelidpasty with tightening and lifting of the outer corners of the eyes (a canthoplasty). The sharp edge under the swelling can be smoothed either by redraping some of the remaining eyelid fat or with fat injections.

These procedures are tricky and not free of complications. I suggest that you consult an oculoplastic surgeon who specializes in eyelids.

Best of luck.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon
5.0 out of 5 stars 9 reviews

Lower eyelid hollowness may be misinterpreted as swelling

+1

Your lower eyelids appear to be very hollow with some bits of retained fat. Like other doctors have commented, it's hard to accurately assess your situation from the one photo in the upward gaze.

The easiest and most cosmetically desirable solution is carefully placed Restylane to the lower eyelids to restore the fullness and camouflage the fat. 

Incidentally, you also seem to have a malar mount (pillow) on the right cheek which can also be camouflaged with filler.

Jonathan Hoenig, MD
Beverly Hills Oculoplastic Surgeon
5.0 out of 5 stars 32 reviews

Swelling after surgery

+1

I would give it 4-6 more months. Up to a year or so in some patients, eyelid swelling can exist. These people are rare but theories are that the lymphatics are cut during the surgery and need time to regenerate. The lymph system nornally drains the fluid from our tissues. This may take some time....

Chris Thiagarajah, MD
Washington DC Oculoplastic Surgeon
5.0 out of 5 stars 6 reviews

Be patient with swelling after eyelid surgery. Home remedies don't work.

+1

You may have swelling even after 8 months.  This is unusual but not unheard of.  These vitamins and creams you are using are ineffectual and I would skip them if I were you. 

It is possible some additional fat might need to be removed especially from your left eye.  But it is too early to make that judgment.  As long as you are making some progress, albeit modest, observation should continue. 

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 7 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.