Is puffiness after Mohs Surgery normal?

The eyelids are a bit more prone to swelling than the rest of the face, and a small amount of persistent puffiness is common, even after 5 weeks.  This is because eyelid skin is thin (revealing everything underneath) and surgery can disrupt the lymphatics of the area (leaving more fullness).  At two weeks, we start scar massage and silicone therapy, and occasionally add compression tape.  Keep in mind that scars take 12 months to fully mature, so time will help further.  Best of luck.

Puffiness following eyelid reconstruction is not uncommon. It typically resolves by 6 months as lymph flow improves. There are a number of maneuvers you can perform to assist in its resolution; cold compress, massage, head elevation and time.

I dont typically use steroid injections as they can cause hypopigmentation (white skin) and fat atrophy (hollowing).

One cause of puffiness around the eye can be redundant orbicularis occuli muscle or sub cutaneous tissue. This will not resolve with expectant observation and may require a debulking procedure. Another cause could be damage to the orbital septum and periorbital fat herniation which also may require a revision. If puffiness doesnt resolve after 6 months you could look into these causes further.

Make sure you have close follow up with your surgeon and explain any concerns you may have.

Best of Luck!