Blepharoplasty Eyelids Still Look Swollen After 2 Years, Is this Normal? (photo)

Question

I had blepharoplasty in korea... first, the no-cut procedure, then a year later the laser procedure. I loved the shape of my eyelids after the no-cut, but after the laser my eyelids were much larger. I assumed after 6 mo to 1 yr the swelling would reduce, the eyelids would be smaller. Now it's been 2 yrs and the eyelids appear still swollen. My right eyelid also has a raised scar on the crease. My derm rec putting mederma on it... Is this normal? Should I wait it out? Or freakout?? Thanks.

Kenneth D. Steinsapir, MD · Answer

Dear Hae

	It is not the laser that does the surgery, it is the surgeon.  Your surgery was too aggressive exposing too much upper eyelid platform.  It also appears that the upper eyelid margin was over rotated.  Interestingly you hold your eyebrows very high.  This might be a means of compensating for upper eyelid ptosis.  If you have upper eyelid ptosis, you certainly don't show it in these photos.  However, this is why we do consultations in person.  Lowering the upper eyelid fold is very difficult, essentially impossible.  To achieve this appearance, we rely on various methods including filling the sub brow area with hyaluronic acid fillers, ptosis surgery when appropriate.  Things you may have read about fat grafting are pretty inaccurate. This turns out to be a very crude method of improving the upper eyelid fold.  You need to see a surgeon who specializes in addressing these types of problems.  Unfortunately, there are not very many of us.

Charles S. Lee, MD, FACS · Answer

Your preop photo is not clear enough but my best guess is that you have some muscle weakness preoperatively and needs to be corrected in order to get a nice result. An in-person consultation is definitely needed to get a proper evaluation.

Philip Young, MD · Answer

It seems maybe that you have developed some tissue above your lash line. It could be caused by elevating the tissue inferiorly from the eyelid crease incision. The other possibility is that the crease was made higher and then tacked inferiorly to create your crease at a lower position creating excess skin and tissue below the crease. It may require another procedure to lower your crease, remove tissue above the lash line and recreation of the crease.

Suzanne Kim Doud Galli, MD, PhD, FACS · Answer

Prolonged swelling for 2 years after blepharoplasty is not the usual postoperative course. Scars usually mature after 12 months but scar treatments may still be helpful. That being said, you may consider having your eyes and incisions evaluated by another surgeon. It is possible that you a require a different procedure to improve your lid function and aesthetic.

Blepharoplasty Eyelids Still Look Swollen After 2 Years, Is this Normal? (photo)

Answers (4)