I had a lower bleph with fat transfer 2 weeks ago. I am worried about the results, including lumps and festoons. (photos)

Question

Two weeks ago I had upper and lower blephs. The uppers are fine but I have a hard knot in each of my tear troughs where the fat was repositioned. I also have festoons under each eye. Are hard knots normal with fat transfer at this stage? Should the festoons go away after a few weeks? Should I use heat and massage to help spread out the lumps? Will that make the festoons worse. As you can see, my lower lids look pretty bad.

Jerome Edelstein, MD · Answer

Hello,This soon after surgery you can expect to have swelling and some contour irregularities due to the fat placement/swelling/sutures. I recommend that you follow up closely with your Plastic Surgeon and ask them what they advise for safe treatment at home as you heal. they can examine you to rule out any issues and ensure that you are on track. Hang in there

Kenneth D. Steinsapir, MD · Answer

However, they can damage the healing eyelid.  Speak with your surgeon before torturing your poor eyelids.  I see 2-3 new consults each week regarding unsatisfactory lower eyelid fat grafting.  I personally think this is a very difficult technique.  The grafted fat is inflammatory and causes scaring and irregularity.  Festoons are common.  Time is very helpful here.  Be very careful about steroid injections which can cause unpredictable skin and fat atrophy.  I also think you are going to have a lower eyelid contour issue.  Generally it is best to wait 6 to 12 months before considering revisional surgery.

Brian M. Derby, MD, FACS · Answer

First and foremost, I am sure the procedure was performed in your best interest. Time and benefit of the doubt should be provided to your surgeon. At two weeks, you are way too early in the postop recovery period to even begin assessing final results. Give it time, hang in there, and refer to your surgeon for recommendations on massage. Without an operative report to refer to, I would be remiss in offering recommendations on massage treatment.

Vasdev Rai, MD · Answer

Your own surgeon is your best bet since only he or she knows details of your operation and realistic expectations from it. Fat grafts have unpredictable behavior with no guarantees.

William Marshall Guy, MD · Answer

Hello KWH,At this stage you are still very swollen.  In addition, the fat repositioning leads to even more swelling.  The hard knots are likely sutures that were used to help reposition the fat in the new location and should improve with time.  Your eyelid are showing some malposition but I would attribute that to the excess swelling at this point.  You should consider talking to your surgeon as sometimes we will initiate massages at this point to help get the eyelid into a better position before the scar tissue sets in.  I hope this helps and good luck.

I had a lower bleph with fat transfer 2 weeks ago. I am worried about the results, including lumps and festoons. (photos)

Answers (8)

Answer: You should discuss your concerns with your surgeon

Answer: You should discuss your concerns with your surgeon

Answer: I had a lower bleph with fat transfer 2 weeks ago. I am worried about the results, including lumps and festoons.

Answer: I had a lower bleph with fat transfer 2 weeks ago. I am worried about the results, including lumps and festoons.

Recommended reading

Everything you need to know about Eyelid Surgery

Our mission is to create a world where every investment in modern beauty is Worth It.

I had a lower bleph with fat transfer 2 weeks ago. I am worried about the results, including lumps and festoons. (photos)

Answers (8)

Answer: You should discuss your concerns with your surgeon

Answer: You should discuss your concerns with your surgeon

Answer: I had a lower bleph with fat transfer 2 weeks ago. I am worried about the results, including lumps and festoons.

Answer: I had a lower bleph with fat transfer 2 weeks ago. I am worried about the results, including lumps and festoons.

Browse related questions

Recommended reading

Everything you need to know about Eyelid Surgery

Our mission is to create a world where every investment in modern beauty is Worth It.