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Christopher L. Hess, MD answers: Persistent puffy eyes after blepharoplasty, TCA peel and tightening

I had upper and lower Blepharoplasty a year ago with a lot of complications.  I have very sensitive skin. The stitches did not dissolve and I had a hard time healing from the TCA chemical peel done afterwards.

It has been a year since the surgery and my one eye looks as if I did not even have anything done to it. The lower lids are very puffy again. My plastic surgeon has been trying many things to get the skin to tighten but so far nothing has worked. I am considering having him do a revision and this time removing some extra skin. I paid for something and I am still waiting for the results.

He does not want to do another TCA because it took so long to heal the first time. He has been doing some kind of skin tightening now for over 5 months with no results yet. I am having my last one done on Wednesday then we go back to the drawing table. What do I do as a patient? Is there something I should be asking from my surgeon? I am dark skinned Hispanic and I freckle and scar easily.

Persistent puffy eyes after blepharoplasty, TCA peel and tightening
Christopher L. Hess, MD
12 months ago

I find it interesting how many are willing to not answer this question. Okay, first your brows are fine, no brow lift is needed. Yes, your upper lids still have a little extra skin that could be removed. The real problem is at the lid cheek junction. Another physician addressed this but not, in my opinion, the correct procedure. Your problem is that the cheek fat/tissue is falling due to age and gravity. This causes the deformity that you have now. Removing skin of the lower lid would be a disaster. You need elevation of the cheeks, first then removal of the skin. Therefore, you need a midface lift and removal of lower lid skin.

I do these together all the time. The reason is that when you elevate the midface you get extra skin in the lower lid.

A second opinion with another Board Certified Plastic Surgeons is a good idea.

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