Swelling and Indentation on Face Due to Blepharoplasty

How long after surgery and injection are you? Steroid injections dissolve lumps but also dissolve normal fat beneath the skin. Steroid injections also cause the skin to form new blood vessels that cause the purple discoloration, which will get better but may leave small vessels behind that show on the skin. IPL or Intense Pulsed Light treatments are safe and can close down the new blood vessels and lessen the red appearance. The depression is caused by atrophy or loss of fat. In time, after... more

Without seeing pictures, it can be difficult to determine the cause of the swelling, but you may have had some residual fat that was affected by the steroid injection. Fat injection can result in an excellent contour improvement and can be very long lasting. Be sure to see someone who is experienced in fat transfer. Also, the purple color should resolve with time. Good luck. Dr. Miller

Unfortunately, the swelling after eyelid surgery goes away very quickly, within 2-3 weeks total. The most aggressive surgery of the face, including a midface lift, eyelid lift and facelift result in edema that resolves withing 4-6 months. So I think you have another issue going on. Steroids are not the cure-all that many physicians think they are. True edema may be helped by them but a Medrol dose pack would have been a more appropriate starting point. The discoloration should resolve... more

Dear Honey, Lower eyelid surgery swelling rarely persists beyond 12 weeks. So, I am wondering what issue you had at 6 months that compelled your surgeon to inject you will a depo steroid? Photographs would be helpful to answer this questions. The dent you are describing does sound like fat atrophy following a steroid injection and this would be consistent with the "swelling" related to residual fat. The dents that follow a steroid injection occasionally benefit by the placement... more

It really depends what the situation really is. You really have to come in for us to see you and to assess what can be done. If there is an indent, some type of filler can be used. Fat injections are another way to fill in a depressed area with minimal incisions. The discoloration will improve with time and if it doesn't go away over the course of the months you can have treatments to improve the appearance.

It sounds like a long acting steriod like Kenalog was injected into this area in an attempt to reduce swelling. Unfortunately a consequence of steroid injection can be tissue atrophy and formation of spider veins as well as thinning of the tissues. The fat atrophy can be somewhat reversed by injecting sterile saline into the area. This helps to dilute it out. The only other alternative is giving this some time or possiblly needing some soft tissue filling with fat.

Your surgeon's goal was to speed up resolution of swelling by injecting steroids into the cheeks. One of the steroid's effect on fat tissue is atrophy, i.e. decrease in the fat volume. This is usually long-lasting (months) but can return to almost normal volume. Sometimes, some permanent volume reduction persists. In addition, the skin can also thin out which may in part be the explanation for the purplish color you mention. My "distant" advice would be to be conservative at... more