Is Brown Bruising Normal Five Weeks After Lower Eyelid Surgery? (photo)

This can occasionally happen after lower bleph, especially if you had significant bruising post op. You can be reassured that it will go away, the area where the bruise has collected is where there is an attachment/sling to the underlying bony orbit which is why the bruising has not dropped any further. 

Dark brown discoloration after bruising caused by surgery, injections, trauma, or any other reason.  It is caused by iron staining of the skin.  Topical products such as bleaching creams are not usually helpful in treating this condition but Q-switched lasers are highly effective.  Most of the discoloration usually clears after 1-2 treatments.  The risk of Q-switched laser treatment is very low as long as appropriate eye protection is used.

I'm a bit surprised of what I see in the photograph. I wonder if you had a small hematoma of the lid that would create prolonged discoloration. Resolution really determines on the cause of the problem the first place.

Thank you for your photo. It is not uncommon to have bruising several weeks after surgery. This brownish bruising may take several more weeks to resolve. Please be patient.

Dr. ES

Thank you for your question.  You likely had some bruising port-op and in itself, bruising can take several weeks to disappear.  Occasionally, the hemoglobin found in the red blood cell metabolized into hemosiderin, an iron component, and this can give a greying hue to the skin for several weeks, sometimes a few months. In my experience, it ultimately resolves but one has to be patient.  In the interim, make-up is likely your best solution.  Hope this helps!  Best regards,  Toronto plastic surgeon and eyelid specialist, Dr. Marc DuPere 416.929.9800

Having said that, in 20 years of doing eyelid surgery, I have never seen this in the eyelid area.  I have seen bruises persist for 6 weeks.  I would discuss your concerns with your surgeon.

    If you had a hematoma or fluid collection in this area along with the bruising apparent through the skin, this may take quite a while to improve.  It is a bit difficult to assess this with a picture alone, and I would recommend you return to your surgeon for a followup exam.  Kenneth Hughes, MD Los Angeles, CA

This is uncommon but occasionally significant bruising can lead to deposition of the hemosiderin from the broken blood cells into the surrounding tissue. This "staining" causes a deep brown hue that can persist for months. Fortunately, it will ultimately resolve with time. Be patient and talk to surgeon about camouflage makeup that the aesthetician can show you how to apply.

Bruising is expected after eyelid surgery and it usually resolves after 7 to 10 days.  Persistent bruising and discoloration of the soft tissues can occur.  There is really no magic cure as this will ultimately resolve on its own.  Occasionally alternating warm and cool compresses can help as well as on over the counter herbal product, Bromelean.  The usual antibruising dose is 500 mg twice a day between meals.