6 weeks after lower eyelid surgery and i still have bags, and skin? (photo)

November 24 2012 I had lower eyelid surgery Transcutaneous Lowerlid Blepharoplasty: Pictures are pre/post to date .December 29th I went back to my PS and he performed Carbomed Carbossi Terapia . I do not know if I have marla bags, festoons, more skin that needs to be taken or what? I have been hiding in my house sinking deeper in depression from having this surgery.Most darkness from the lower eyelids are from a vitamin c eye cream which contained Retinol. It was too strong and burned the skin.

Doctor Answers 3

Treating hyperpigmentation & swelling after eyelid surgery

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I have developed a lot of experience in what to anticipate in an African-American skin type after many years of practice. In an article that I wrote called “Ethnic Considerations in Eyelid Surgery”, I emphasized that what you are experiencing is actually a common issue with people who have darker skin.

First of all, you should be aware that anyone with pigment will turn dark almost consistently after eyelid surgery. After the surgeon has removed the eye bags, the area may become dark due to inflammation and trauma. We call that process reactive hyperpigmentation, which is your skin’s response to the surgery, and is temporary. I usually reassure my patients that it passes, and to use some sun block. As time goes on, the pigmentation does get better.

In your transcutaneous procedure, your surgeon has made an incision underneath the eyelashes and lifted the skin and muscle up to reduce any puffiness related to fat pockets. Because of that, you can’t avoid some fluid that will fill up that space. It’s also not unusual that this procedure causes some pigmentation. The combination of both of can be particularly distressing. 

In my practice, I usually first observe the area. If there’s a lot of fluid, I investigate whether the patient has history of allergies, sinus problems or thyroid eye disease, which can affect the amount of fluid that gets absorbed in the healing process. In our medi-spa, I’ll have my esthetician do something called manual fatty drainage to massage the fluid out of the space that referred to as malar edema swelling festoons. If someone has had this surgery before, it can take some time for it to resolve. If someone always had some malar festoons, then we have to address that as a separate issue after everything resolves.

Remember eyelid surgery is something that takes anywhere from 6 months even up to a year to resolve. In your case, it is still relatively early. One of the strategies in my own practice is to have my estheticians help the patient get some make-up that helps camouflage this area during the healing process using our own skin care line.

My suggestion is that you continue communicating with your doctor and do something to camouflage the area so that you can go out and not feel self-conscious. Expect that things will get better. I hope this was helpful, and thank you for your question.

New York Oculoplastic Surgeon
4.4 out of 5 stars 80 reviews

6 Weeks after Lower Eyelid Surgery

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     At the very least you need canthopexy or canthoplasty, but it is a bit difficult to tell without an exam.

Blepharoplasty (eyelid lift) for Malar Festoons

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It appears that you do have some malar festoons pre operatively as well as some excessive canthal show (a lot of white portion of eye visible near the corner closest to the cheek).  Festoons can be difficult to treat and they are certainly not treated with a transcutaneous (through the inside of the eyelid) approach. This approach is best for patients with a good bit of fat and not much excess skin. I do not even know what Carbomed Carbossi Terapia treatments are. It is certainly not a standard plastic surgery procedure. I would recommend that you allow 3-6 months of healing, sunscreen for your entire face to protect the burn areas beneath your eyelids from further darkening. Then reevaluate the issue with a BC PS.

Dr. ES

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