Crease Under Eye After Blepharoplasty

Hi, 5 weeks ago I had upper eyelid surgery to fix heavy eyelids and lower eyelid surgery to remove bags. Over the past week, I have noticed a crease forming about 4mm under the incision on my left eye (right eye in the picture). I am worried that something has gone wrong, the fat has moved and is going to leave me with a fairly noticeable bag. I know it is early stages yet but my surgeon is on holidays and I can't ask him. My right eye is smaller (didn't realise before surgery). I am 45

Doctor Answers 8

Your photos seem pretty reasonable....

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....for two months out. And there will be more improvement as things progress. Things can settle even up to a year after surgery.

There is nothing significantly worrisome that we see here this far out from surgery. You do have some natural eye asymmetry that was present before surgery [left eye is higher than the right eye]. Patients often recognize an old problem after surgery because they are more focused on their eyes post operatively. This is one of the reasons surgeons take preop photos.

Be patient. You are on the right track.

Seattle Oculoplastic Surgeon
5.0 out of 5 stars 42 reviews

Early Postoperative Crease in Lower Eyelid

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It is not unusual to have irregular swelling in the early postoperative period.  I would agree with some lower eyelid massage.  It is also imperative that you follow up with your surgeon upon their return from the holidays.

Michael Sundine, MD
Orange County Plastic Surgeon

If you have concerns about your eyelid surgery, check back with your surgeon.

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Eyelid surgery takes some time to completely heal.  If you have concerns about you results, check back the the surgeon who did you procedure. 

Mark Taylor, MD
Salt Lake City Dermatologic Surgeon
4.2 out of 5 stars 18 reviews

Postoperative fears after eyelid surgery

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I would suggest eyelid massage 10 times a day 5 weeks after blepharoplasty. There is nothing to do at this point. I would wait at least 6 months before becoming concerned.

The two sides are quite different.

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Dear Panic

First time does improve so much.  What is a concern today may be much less of an issue as time goes by.  It is important to allow the eyelids 6 to 12 months to heal before addressing any issues that bother you.  There are occasional reasons to violate this rule but generally this has stood the test of time.  In looking at the photos, it appears that you left eye sits higher in the head than the right eye.  Also the left eye appears to be a little more prominent that the right eye.  The right upper eyelid is also heavier that the left upper eyelid.  Both upper eyelids do appear to be slight ptotic which just might be from lid swelling.  The forming crease in the left lower eyelid should simply be observed for now.  If it persists, a small amount of filler (Restylane) could be used to touch this in if it does not resolve in time.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Crease or hollow after lower blepharoplasty

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We can see the crease under the right eye, and it appears more as a hollow. As long as you are comfortable, you will have to wait it out and see what your surgeon has to say about the asymmetry.

Best of luck,

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 44 reviews

Has the fat moved?

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  You are right!  You are still in the "early stages" of healing.  Give it time and be patient!  Have confidence in your doctor and ask him/her opinion!  Chances are you will be fine.  It takes time to heal and final results aren't apparent for 6-12 months.

Lawrence Kass, MD
Saint Petersburg Oculoplastic Surgeon
4.8 out of 5 stars 140 reviews


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Quite often after blepharoplasty there is swelling and the  skin below the incision can line can look thicker than the top.  This usually gets better with time.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.