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

Paul M. Parker, MD, FACS · Answer

Your lower eyelids are still swollen from the procedure, fat transferred and sutures used to hold them in place. Beneath that you have malar edema or swelling over the cheekbones. Both of these issues should get better over time. Follow up with you surgeon because there are some safe things  they can show you to do to speed your recovery. Heat is not a good idea at this point.

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.

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: Tincture of Time in Postop Recovery

Answer: Tincture of Time in Postop Recovery

Answer: You should discuss your concerns with your surgeon

Answer: You should discuss your concerns with your surgeon

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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: Tincture of Time in Postop Recovery

Answer: Tincture of Time in Postop Recovery

Answer: You should discuss your concerns with your surgeon

Answer: You should discuss your concerns with your surgeon

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.