I am 31 days post-op from upper and lower blepharoplasty. There was no fat removed, just skin. I believe he did something with my muscle, but i'm not quite sure what. I have a dissolvable stitch on my right eye that you can see in the picture that hasn't gone away yet, and still quite a large bag under my left eye. As you can also see, my left eye is still larger than the right. Is it normal to still have this?
Post Blepharoplasty Swelling?
Doctor Answers (11)
Try to give yourself permission to heal for now.
I suspect that you are unhappy with your surgeon. For certain you are unhappy with your eyelid surgery. It is very important to realize that you are very early from your surgery. Yes you appear to have some issues. The real questions is how will the eyelids look when the dust settles. It is important to not let yourself by driven to distraction while you wait for the paint to dry. God knows this can happen. I have seen pretty level headed people do that way. At this time, there is absolutely nothing to do put wait out the swelling.
How long do you need to wait. Well it is true that most surgeons will be reluctant to try and judge the outcome of your surgery for 6 to 12 months. If you try to have something done before this time, you are basically making your surgeon treat swelling.
The real question is what will the results like once you have healed-is it every thing you wanted or is something further needed to allow you to realize your goal. If there is still an issue, is it significant enough to live through another round of swelling and recovery to achieve this difference and if so, can it be achieved or is the further degree of improvement so small that it is unrealistic to expect to achieve it?
I find that recovery can be very psychologically stressful and often loved ones are not as sympathetic to these feelings because unlike medically necessary surgery, you choose to have this procedure. Of course this lack of support can take its toll. Consider finding a counselor or a psychotherapist to help you deal with you feelings of anger and frustration if these are a significant part of your daily thoughts as you recover. Feeling better may not change how you ultimately feel about your surgery but it will help you channel your energy in a more productive way while you recover.
Possibly due to Blepharoplasty swelling
Your eyelid size is actually not changed. What you are seeing is that the left lower lid is somewhat lower than the right. This may happen on occasion due to swelling, or traction on nerves, which causes the lid to not work that well for a while. Sometimes, this goes away by itself, and sometimes it requires additonal surgery. One thing that may help would be to support the lower lid with steristrips. Your doctor should provide you with some and teach you how to do it.
You have asymmetry and bags below the lower lids. I am not sure exactly why this is. You may want to ask your doctor about massage techniques, as this will help if there is residual swelling.
Gently massage on lower eyelids to help reduce Blepharoplasty swelling
I agree with Dr. Steinsapirs carefully thoiught out answer. You need time to heal, and I feel fairly confident you will improve. The dissolving suture will dissolve, and hopefully the lump or fold created by it will resolve. I also believe that the suture is pulling down on the Right lower eyelid.
I would massage the lower eyelids 3 times a day. Place your finger near the inside corner of the lower eyeld and sweep out and up towards your ear. This will help the swelling resolve and hopefully speed the dissolution of the suture and smooth the fold in you right lower eyelid. It will also stretch the Right lower lid and help it move up toward the eye.
I cannot tell if you have malar bags or festoons at this point--the fullness on the cheek may just be swelling.
I am certain that with time and massage yoiu will look better.
I would not make any decision about revision until you are at least 6 months post op.
Discuss your dissatisfaction with your doctor-he knows the details of his procedure and should be able to explain your progress.
If you decide to see another doctor in 6 months, your current doctors records and op notes will be important--don't burn any bridges now.
You will improve, massage is important.
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Swelling is normal after Blepharoplasty
The swelling that you have experienced following your blepharoplasty is normal. I advise my patients that after surgery they will most likely experience some noticeable swelling that will subside within two to six weeks. Patients should know some minor swelling can remain for as long as six months, and their lid contours may continue to change. Final results may not be seen until the six month mark. There are several exercises that you can do to assist with healing as well. You may also want to massage the lower lids. I suggest discussing your concerns with your surgeon. Best of luck, Dr. Clevens
Swelling after blepharoplasty
Since it has only been one month since your blepharoplasty, there is still some swelling left in the eyelids although rather minimal at this point. With respect to the muscle, the operative report from your surgeon would delineate the extent of any muscle surgery that was performed. Any dissolvable stitches should be removed because they are not doing any good at this point. If there are still large bags under the eyes, these can be removed at three months after the surgery.
Nothing too out of norm after Blepharoplasty here
As you are relatively short post operatively, many of the concerns you have written about will continue to improve. Lower eyelid surgery continues to be among the most challenging aesthetic procedures we do and the time for the results to mature also take proportionately longer to achieve the final result. The lower eyelid is quite dynamic and the constant motion of the lid gives rise to some of the appearances you are noticing. I agree with lower lid stretches and tincture of time.
It will improve with time.
Your result will improve with time as the swelling resolves and the tissues settle. It looks like you need to massage the lower lids - especially your left lower lid. However, you should discuss this with your doctor first. Some patients have also found that Arnica Montana cream is useful to help resolve the swelling and bruising faster. Good luck with your recovery.
It is hard to appreciate that the left eye is larger than the right
I may see that the left eye is slightly larger in the bottom part of it where the white is showing. This is sometimes due to the skin being taken which can cause contraction of the skin downwards making the eye larger appearing. The bags can be due to a number of things. When it is located right under the eyelid margin it is likely coming from the fat within your orbit of the eye. This fat can be easily removed. When it is lower it is likely due to the eye muscle that surrounds your eye socket and that helps you close your eyes that is causing the bag. This is called the malar crest and it usually is due to the eye muscle hanging over the smiling muscles.
That is what I see in the picture. Midface lifts can improve these malar crests but volumizing this whole area can improve the appearance of this cheek region. The larger appearing left eye can also be due to ptosis of the right eye or swelling. Ptosis is when the eyelid margin becomes droopy in relation to the iris. Ptosis can be temporary and can last months if caused by the procedure. Other times, the ptosis can be due to an actual injury to the muscle that opens up the eye (the muscle that pulls up the eyelid margin). This can require a more formal repair and is very difficult.
Postoperative swelling is not unusual after blepharoplasty
Most of my patients have postoperative swelling, some greater than others. This is particularly true if I'm doing a lot of procedures such as lifting the cheek fat pads, elevating the muscle, repositioning fat, or performing a canthopexy (lifting the lateral aspect of the lower eyelid).
I encourage my patients to actively blink and hold the squinting position for five seconds. They repeat this five times and repeat this maneuver three times a day.
In addition, I have my patients massage from the middle aspect of the bone below the eyelid in a lateral sweeping direction.
Both of these maneuvers will help mobilize fluid and increase muscle tone.
I always ask my patient to massage the lower lids after surgery
Make sure you follow up with your physician. Lower lids can take a significant amount of time for full recovery and best aesthetic appearance.
Some people take longer to recover for example those with hypo-thyriodism. That should be always kept in mind
personally I would suggest massaging and waiting for another 2 months, with close and regular follow ups.
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.