Ask a doctor

Swelling Under Eyes After Upper Eyelid Blepharoplasty

I don't understand why my lower eye area would be swollen after an upper bleph. It looks like pockets of fluid after an upper eye bleph. How long will the swelling last?

I also had restyalne injected before upper bleph in the lower eye area. Is this the problem? It looks bad. Will the swelling to away at the lower eye area?

Doctor Answers 10

Upper eyelid lift

Yes, it is not uncommon to have lower lid swelling after upper eyelid surgery because the swelling moves to dependent positions due to the effect of gravity, before it finally resolves. If you had a recent filler treatment prior to surgery, while the filler is not the cause of the swelling, it may take longer for the swelling to go away since multiple procedures in the same time frame can contribute to prolonged swelling. By one month after surgery, most of the swelling should resolve but everyone heals differently.

Palm Beach Facial Plastic Surgeon

Lower lid swelling after upper blepharoplasty

The lower lids are swollen after upper blepharoplasty because of gravity and dependent edema.

We do not recommend Restylane injections into the eyelid area for fear of injecting into the orbital septum, which can create a longstanding puffiness that may last several years. It is still acceptable to undergo a lower blepharoplasty even though you had the injections performed.

William Portuese, MD
Seattle Facial Plastic Surgeon
5.0 out of 5 stars 67 reviews

Swelling of lower eyelid after Blepharoplasty is common

With all facial plastic surgery the swelling from surgery will gravitate downward due to gravity. From upper blepharoplasty to the lower eyelids, from lower blepharoplasty to the cheeks, from cheek or midface lift surgery to the jawline and neck. This swelling will resolve. Taking homeopathic Arnica Montana and Bromelaine can help.

Andrew Jacono, MD
Great Neck Facial Plastic Surgeon
4.5 out of 5 stars 89 reviews

Lower eyelid Swelling after Upper Eyelid Surgery

It's common to have swelling and bruising in other areas of the face and eyes, even though plastic surgery was not necessarily performed in those areas. This extension of facial bruises & swelling is due to gravity and the natural movement of fluid in the tissues.

Ice to eyes after cosmetic eyelid surgery is most useful during the first 48 hours. I advise cosmetic patients to keep fresh, clean ice pack over surgical wounds while they are awake only for the first 2 days. After the first 2 days, ice does help control swelling but is much less effective. I still recommend using ice for the first week, as tolerated. Each plastic surgeon has a preference based on the procedure and each specific patient.

Keep your head elevated at all times, and avoid bending over. Sleeping on top several pillows or in a chair also helps reduce facial swelling after cosmetic surgery.

I advise patients to strictly avoid lifting, straining, or any strenuous activity (including sex) for at least 2 weeks following facial plastic surgery. This activity restriction helps healing during the recovery period.

Some plastic surgeons also prescribe a steroid pill, such as prednisone, to control post-procedure swelling and help in recovery.

Although, most swelling after eyelid surgery resolves in a couple weeks, it really takes longer for the final swelling to go away.

Speak with your eyelid surgeon regarding swelling.

Houtan Chaboki, MD
Washington DC Facial Plastic Surgeon
5.0 out of 5 stars 61 reviews

Swelling of the Lower Lids After Upper Eyelid Lift

It is VERY common if not the norm for the lower lids to get swollen after an upper lid lift. This is due to that annoying thing called gravity. Swelling from the upper lids track down the deep planes of the tissues which connect to the lower lids.

I have my blepharoplasty patients use cold compresses for 48 hours then warm compresses to help the edema subside. Sleeping more upright, such as in a recliner, can also help. Despite what you might hear, eyelid surgery takes longer to recover from then typically advertised.

Surgery and Restylane increase eyelid swelling

Eyelid surgery routinely causes some swelling. Fluid in the eyelids is affected by gravity, so you can get swelling in your lower eyelids even when you have had upper eyelid surgery.

Restylane is hyaluronic acid, a natural substance that attracts and holds onto water. If you have Restylane in your lower eyelids, you are much more likely to collect fluid there after you have had eyelid surgery.

If your surgery was done recently, your eyelid swelling will naturally get better over time. It can be minimized by keeping your head elevated as much as possible, limiting your salt intake, and controlling any ocular allergies that might be present. If your swelling persists, your doctor may consider dissolving some of the Restylane with hyaluronidase so that your lower eyelids won't attract so much fluid.

Good luck!

Nancy Swartz, MD
Voorhees Ophthalmologist
5.0 out of 5 stars 7 reviews

Swelling of the lower eyelid with upper eyelid surgery.

This is very common and may be aggravated by the Restylane use but should be markedly improved by 7-10 days. If it lasts more than 6 weeks you may want to consider the off label use of hyaluronidase. In the meantime, sleep with your head elevated, consider cool compresses and inquire about the implementation of manual lymphatic drainage.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 55 reviews

Swelling after blepharoplasty

Maximum swelling is usually at about 3-5 days and goes away over a few months. You should sleep with your head elevated and cut back on salt to help the swelling.

Swelling after upper eyelid blepharoplasty

Immediately after upper lid blepharoplasty there is swelling of the upper eyelids.

With your face in an elevated position, even on pillows at night, the swelling of the upper eyelids will gravitate inferiorly and can cause some swelling of the lower eyelids. This will then gravitate downward to your cheeks (to a lesser degree) and then ultimately dissipate.

If only an upper eyelid blepharoplasty was performed, I would expect swelling of the lower eyelids in cheeks to completely dissipate within 1 to 2 weeks.

If you had Restylane injected into the lower eyelids, there will be desirable or
undesirable swelling of the lower eyelids related to the Restylane.

If the Restylane
was injected just prior to the upper lid blepharoplasty, then most of your swelling
may be related to the Restylane. Restylane eventually absorbs and disappears. When this will happen depends on the amount and the depth of injection.

Sigmund L. Sattenspiel, MD
Freehold Facial Plastic Surgeon

Sweeling of Lower Lids caused by Upper Lid Blepharoplasty or Tear Trough Restylane.

The skin of the lower lid is the thinnest skin in the body and will reflect any injury above it. (As such, surgery or trauma to the forehead or the upper lid will be reflected with bruising and swelling of the lower lid). If Restylane is applied too superficially OR if an excessive amount is placed, it too will result in lower lid puffiness.

Post-surgical lower lid swelling SHOULD subside significantly by a week after surgery. Persistence of the swelling would suggest that it is due to the tear trough Restylane and your options would be to "wait it out" for 6-8 months or to dissolve the Restylane by injecting it with Hyaluronidase.

Hope this helps.

Peter A. Aldea, MD
Memphis Plastic Surgeon
5.0 out of 5 stars 78 reviews

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.