Can't Open Eyes 25 Days After Blepharoplasty

While it is common to have swelling after surgery, by 25 days you should be seeing improvement and you should be able to open your eyes. It is hard to tell from the picture, but your upper lids look more red than I would expect as well. You may have an underlying infection or other issue which needs to be addressed. You should contact your surgeon soon for an evaluation.
I hope this is helpful.
David Shafer, MD
Shafer Plastic Surgery
New York City

Please visit your surgeon for further evaluation.  25 days is too long and is not normal.  Hope this has resolved already by time this question is answered

In most cases, swelling and bruising after upper blepharoplasty resolves within 2 weeks. Your photograph seems to indicate there is still bruising (which may be resolving as seen by a yellow-purple tint to the skin)and some redness at the incision sites.
In cases when bruising was severe after surgery, it can take longer to heal. Rarely, a hematoma (collection of blood) can form in the eyelid which can also cause swelling to last longer.
Other rare causes of your concerns could be an injury to the tendon of the muscle that lifts the eyelid (not usually the muscle itself), or a bit of connective tissue called the orbital septum can get caught in a suture. Either of these cases might need a re-operation to fix.
Luckily, most of the time, your problem will resolve with time. If it does not improve after a few months, further treatment might be necessary. It may be a good idea to consult with an oculofacial plastic surgeon.

While it is difficult to observe the area from the picture you submitted, pain, tightening and trouble opening your eyes 25 days following your surgery warrant a call to your surgeon to ensure that you do not have any underlying issues.  Do not delay.

The eyes always swell significantly after surgery. That being said, by 25 days post op I would expect more improvement. This can be affected by other medical problems, medications, diet (you want a low salt diet to reduce swelling) and possibly infection. The one thing you really want to rule out is infection so please contact your surgeon. Try and sit with your head above 30 degrees most of the day and even at night if possible.Best of luck.DrC

Thank your for your question and pictures.  Unfortunately eyelid surgery does cause swelling however 25 days post op is not typical.  Please seek advice from your plastic surgeon as soon as possible, there could be an underlying infection.All The Best

At 25 days after upper blepharoplasty surgery, in most patients the swelling has resolved enough that they do not have trouble opening their eyes. Every patient heals differently, but I would advise paying your surgeon a follow-up visit to make sure that you don’t have some kind of infection or complication slowing your recovery. I hope this helps.

At this point, it is typical for the swelling to have subsided enough that opening the eyes isn’t as problematic as you describe. While each patient recovers at a different rate, I think your recovery seems to be a little slower than it should be. I suggest you have your surgeon examine your results to make sure you’re on track to a proper recovery. In the meantime, please follow your surgeon’s instructions closely to help with healing.

Your single digital photo is not a substitute for an examination, but you appear to have good eye closure which is important. You should discuss your concerns with our surgeon since every person and procedure is different. Upper Blepharoplasty incisions tend to soften and heal uneventfully with time.Wishing you well.Dr Joseph

Your symptoms and photo are not normal for 25 days after surgery.  The photo looks like a week after surgery, not 4 weeks.  It is certainly not normal to have difficulty opening the eyes at this point.  Contact your surgeon and if they don't share you level of concern, get a second opinion.

The vast majority of swelling resolves in about three weeks in most patients who undergo blepharoplasty. Occasionally it may persist for longer periods of time, but this is very unusual. The severity of your swelling is very concerning. Not only do you have severe swelling, but you also have painful scars and inability to open your eyes. This may indicate that this is more than just routine swelling.

A careful evaluation should be undertaken to determine the cause of your persistent swelling. There are several possible explanations that should be explored. These may include allergies to topical ointments that are commonly used following blepharoplasty, persistent low grade infection, severe hypertrophic scarring and the possibility of injury to the eyelid muscles that lift the eyelid.

It’s important that you stay in close contact with your surgeon. Your surgeon may be able to recommend treatment for your swelling that will make you more comfortable and accelerate your recovery. In most cases, elevation of the head and cold compresses will be enough to eventually alleviate your concerns.