Extensive Swelling and Loose Skin After Lower Transjunctival Blepharoplasty and Pearl Fat, Did the Surgeon Overfill? (photo)

The swelling subsided considerably the first week but it feels very firm just below my eyelid and wobbly more closer to the lower end of the hematoma. 1. Did the surgeon graft too much fat under my eyelid? 2. I can still feel a slight foreign body scratch in my right eye when I look down. I was informed by my surgeon that I can feel the suture. Will this need treatment? 3. Is there a risk of a permanent fluid retention under my skin as my skin is very expandable (according to the Dr)? Thanks!

Doctor Answers 4

Fat Grafting of the eyes

Stay in very close contact with your plastic surgeon and follow instructions very carefully. It is soon after surgery. One questions people should always ask is whether or not a physician will overfill.

Hopefully with time the swelling will subside and tou will be pleased with the result. Fat grafting can provide beautiful, natural looking results  in the upper and lower eyelid and in almost all areas of the face, provided the fat is grated in the ideal amount and possition by a very experienced plastic surgeon

Raleigh-Durham Plastic Surgeon
4.8 out of 5 stars 118 reviews

Wait three months

Postoperative swelling can last even longer than the usual 2 week period. Furthermore fat transfer survival is between 40-60% and overfilling is the rule rather than the exception.

The suture may be the cause of your irritation and once the swelling as subsided a bit more, it maybe possible to remove that suture.

See your surgeon.

A.J. Amadi, MD
Seattle Oculoplastic Surgeon
5.0 out of 5 stars 37 reviews

This may just be swelling related to the fat pearls rather than hematoma.

That was a big surgery you had.  1. Did the surgeon graft too much fat.  From your 2 week follow up photo it sure does not look like that is the case.  Remember that not all fat survives.  It is best to judge what was achieved with volume at 4 months not 2 weeks. 2. I can still feel a slight foreign body sensation.  I recommend that you have your eye surface examined by an ophthalmologist to see if you are scratching the corneal surface.  Most likely you are having dry eye symptoms related to eyelid swelling.  3. Is there a risk of permanent fluid retention?  Sure but based on the 2 week f/u photo, it looks like with patience this will all settle down.

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

Puffy eyes after bleph

Your surgeon is right, puffiness is very common after surgery especially when fat is added and you have lax skin.  I would not do anything yet as it is still very early in the post op period.  I would follow your surgeons advice and see what happens over the next 6 weeks.  As far as the suture goes, if it is bothering you it can easily be removed .  Good luck.

Steven Schuster, MD, FACS
Boca Raton Plastic Surgeon
4.0 out of 5 stars 6 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.