Eyelids swollen and a bulge on the side - Can it be corrected? (Photos)

Question

In 2021 I noticed that I had two bulge at the side of my eyelids, saw a oculoplastic surgeon. I had a lacrimal gland prolapse from rubbing too frequently the skin also stretched. She recommended lacrimal gland correction, also eyelid surgery to take off excess skin. I had surgery in 2023, but now 2025 I wake up every morning with eyelids swollen and a bulge on the side. What can be the problem? No Thyroid issue. Did she not take off enough skin? Can it be water retention?

Mustafa Aydinol, MD · Answer

Hi,
I understand that it can be frustrating to continue experiencing eyelid swelling and side bulging even after surgery and following your surgeon’s advice closely.
There are a few possible reasons why you may still be experiencing this issue:
1. Residual or Recurrent Lacrimal Gland Prolapse
Even after a correction, the lacrimal gland can sometimes shift back if not adequately repositioned or if the surrounding tissue is weak. If the bulge is located near the outer upper eyelid (as shown in your photos), this remains a likely cause.
2. Fat or Tissue Repositioning Issues
If the eyelid surgery didn’t fully address herniated orbital fat or was conservative in skin/fat removal to avoid a hollow look, some puffiness may persist. This doesn’t necessarily mean a mistake was made &mdash; many surgeons prefer under-correction to avoid complications, especially in patients with stretched or delicate skin.
3. Fluid Retention or Lymphatic Congestion
Chronic morning swelling can also be related to fluid accumulation, particularly in patients with sensitive lymphatic drainage. Allergies, sleeping posture, or even sinus issues can play a role.
4. Scarring or Healing Response
Sometimes internal scarring or fibrosis from previous surgery can alter the contour of the eyelid and create fullness that mimics swelling or bulging, especially when the soft tissues don’t settle evenly.
⸻
Can It Be Corrected?
Yes, in most cases, a carefully planned revision procedure can help. This may involve: • Further lacrimal gland suspension • Refinement of residual fat pads • Scar tissue revision or internal reshaping
A consultation with a plastic surgeon who specializes in complex eyelid revisions would give you the best guidance. An MRI (often unnecessary) or USG can sometimes help evaluate gland position or residual tissue.
You’re absolutely right to listen to your body &mdash; persistent swelling 2 years post-op deserves a second look.
Best regards,Dr. Mustafa AydınolPlastic, Reconstructive & Aesthetic Surgeon

Gary M. Horndeski, MD · Answer

You appear to have excess skin.  I cannot tell if it is fluid.  You may benefit from a revision of the blepharoplasty with excision of the skin laterally.

Best Wishes,

Gary Horndeski, M.D.

Mats Hagstrom, MD (license on probation) · Answer

To get a quality assessment, it would be helpful if you can provide a complete set of proper before and after pictures.
If you don’t have before, and after pictures, then ask your surgeon to forward the pictures they took.
We need to first understand what the problem was in the first place.
I’m guessing the Design of the skin excision was slightly less than ideal.
Perhaps a brow lift may have been a slightly better option?
Your situation is too complex to get a proper assessment from the information included.
To get a proper second opinion consultation, I suggest you scheduled those in person consultations with other plastic surgeons, facial plastic surgeons, or ocular plastic surgeons in your community.
For a second opinion consultations come prepared bringing with you a complete set of proper before and after pictures and a copy of your medical records, especially your operative report.
You can request your medical record, before, and after pictures from your current provider.
Best,
Mats Hagstrom MD

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