Lower eyelid swelling, bruising and lumps 3 weeks after blepharoplasty (Photo)

In my opinion, you are in trouble.  It appears that you have a profound vertical compromise in the lower eyelid position after blepharoplasty.  This can cause chronic corneal exposure and dry eye symptoms.  You have a very obviously under eye skin incision that is several millimeters under the lashes.  Normally this incision is made to hug right under the eyelashes to help hide it.  The lower eyelids appear to be hollow and there is a significant right cheek festoon. The festoon may nor may not resolve on its own with more time.  The incisions will fade but I suspect that they will always be somewhat visible.  The compromised vertical height of the lower eyelid does not get better without very complicated lower eyelid reconstruction.  I recommend that you let the eyelids heal a full 6 to 12 months before making a decision regarding revisional surgery.  If you are having dry eye symptoms (sandy, gritty, burning sensation in the eyes during the day or at bedtime) consider seeing your general ophthalmologist or an oculoplastic surgeon for an assessment.  This is not something that your surgeon even has the appropriate equipment to assess and manage.  Please consider posting in 6 to 8 weeks to let us know how things are going.

At three weeks you should continue with whatever regimen your surgeon recommends.  Massage of the lower lid may be relevant as your lower lid ( at least in the photo) may be a bit low.

Hi Ingrid, Having had your procedure just 3
weeks ago, you’re still in recovery phase which generally takes several weeks. The
post op instructions you would have been given still ring true – for the first three
to four weeks after the surgery, any activities that increase blood flow to the
eyes should be avoided, including bending, lifting, sporting activities, and
even crying. Dark sunglasses are
recommended to protect the eyes from irritation caused by the sun and wind. Be
patient with yourself – you may notice that your eyes tire easily for the first
several weeks of the recovery period – take frequent naps. Understandably, the recovery process can seem long for you especially
in the early stages of recovery when your face appears swollen and bruised. But
after a few weeks you will notice a welcome change in your appearance. The
results of your surgery – eyes that look younger and more alert – will remind you
why you chose to undergo the procedure in the first place.

The recovery after lower lid blepharoplasty may take many months, but usually the appearance improves week by week. Surgeons have different approaches to post-blepharoplasty instructions, but you may want to keep your head up while sleeping (above your heart - lots of pillows) and avoid highly seasoned/ salty foods. If you sleep on your side, the "down side" may be more swollen then next morning. Many factors can contribute to swelling - medications (ACE inhibitors for blood pressure), history of allergies and eye-rubbing, history of thyroid problems, smoking history, strenuous activity early after surgery, and many others. These factors may prolong healing, but healing will continue. The lumpy feeling is a part of healing process - inflammatory cells are clearing out the bruising and swelling. This takes time. I believe you will be pleased with your eyelids after complete healing (doubt you will need additional procedures - but this is a decision much later - 6 -12 months). Stay in touch with your doctor - he/she will be able to give you advice and reassurance.