It's Been Two Months and I Still Have Large Milia After Eye Lift- Normal? (photo)

Question

Two months after eye lift and I still have several large milia and the incision line is very red.

Mehryar (Ray) Taban, MD, FACS · Answer

What you have is NOT normal. It looks like a granulomatous (inflammatory) reaction to either foreign body (such as ointment) or worse infection, specifically myobacterial. It is important you talk to your surgeon and get second opinion from an oculoplastic surgeon.

Larry S. Nichter, MD, MS, FACS · Answer

Your photo does not appear to be typical milia in that it appears to be an inflammatory process that could be a simple as reaction to suture material, or contact sensitivity to an ointment or something more serious such as an infection. See your plastic surgeon for advise and treatment at this time.

Malena Amato, MD, FACS · Answer

It appears that your incisions are not typical 2 months postoperatively. Infection or inflammation can be the issue. I would first speak with your surgeon and consider a consultation with an oculoplastic surgeon for treatment which may include antibiotics steroids or possibly Culture, drainage or debridement. Good luck.

Harlow Hollis, MD · Answer

Yes, like every one has said, this is not normal........even 1 week after surgery it should not look like this. . Looks like a cellulitis. Probably needs antibiotics and possibly an incision ad drainage after a course of antibiotics if a pocket of pus apears. Definately needs medical care........see your surgeon.

	PS: Thanks for the photo, it really helps us to help you.

Edward Szachowicz, MD, PhD · Answer

Milia are common in eyelid incisions and can be treated by unroofing the milia with a tiny needle. Occasionally a small piece of skin is trapped below the surface of the incision causing a sebaceous cyst. The cyst(s) need to be removed.

	In my practice, all patient incisions with upper blepharoplasty get 3-4 laser treatments with the Fraxel restore skin resurfacing laser. The FDA has shown that these treatments improve surgical scars.

	I may also suggest a scar gel to incisions that are persistently red, if other causes of inflammation are not seen.

Jeffrey Schiller, MD · Answer

Two months is late for that amount of swellilng and redness. I would be concerned that your body is reacting to a buried stitch, or that you have some kind of low-grade, indolent infection such as atypical mycobacterium. Please follow up with your surgeon.

Glenn M. Davis, MD, FACS · Answer

From the photo submitted I would advise getting in to see your surgeon. Are both upper eyelid this way or only one? Milia are not uncommon after bleph but the amount of redness and the size of these are not expected. There may be more to this than simple milia and infection should be ruled out.

Vincent P. Marin, MD, FACS · Answer

It seems like your eyes are significantly more red than one would expect for 2 months post-op. I would see your physician to determine if there is something else causing your discomfort. Milia are small white "bumps" on the skin and can be seen at your incision line. This may be present but cant be totally appreciated from your photo.

Chronic inflammation can lead to darkening of the skin - post-inflammatory hyper-pigmentation and this should be treated after you have determined the cause.

Best of luck.

Chronic inflammation can lead to darkening of the skin - post-inflammatory hyper-pigmentation and this should be treated after you have determined the cause.

Best of luck.

Edwin Ishoo, MD · Answer

If there is redness and inflammation 2 months after an upper Bleph., in my practice I would unroof and open the milia in the office with a small needle and make sure there is no retained suture causing the inflammation. That usually takes care of the milia derived inflammation within a week. I would also use topical steroids occasionally or possibly in combination with retin-A or hydroquinone to decrease the inflammation and reduce the dyspigmentation. You should definitely discuss this matter with your facial plastic surgeon and come up with a plan to manage this matter.

Chris Thiagarajah, MD · Answer

Though it is unusual to have swelling and redness this late, it is definitely possible. Healing is a bell curve and you are just on the end where the people who take longer to heal are. I would check back with your oculoplastic surgeon and have them double check but this most likely will take some time. In terms of the "milia" I would give that time as well. 

	In terms of eyelid surgery, most people are 90% back to normal in 10-14 days but not everyone. Some people will take 3 days, others will take 6 weeks. Some even 3 months...

It's Been Two Months and I Still Have Large Milia After Eye Lift- Normal? (photo)

Answers (12)

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