Can under eye skin tighten after swelling from transconjunctival blepharoplasty?

Absolutely!Manipulating the fatty tissue under the skin of the lower eyelids will cause an inflammatory response and associated swelling – regardless of whether a transconjunctival orsubciliary/transcutaneous approach is used.The inflammatory response and swelling are a nuisance because they result in the need for recovery time, but over time, they help the skin to tighten beautifully to produce a natural contour.As you are experiencing, the speed of healing is often asymmetric but that certainly is not predictive of any asymmetry after healing – so that if one eye “seems fine” the other eye will likely catch up soon.

There are 2 broad techniques for lower eyelid surgery (blepharoplasty) -- transconjunctival or transcutaneous (aka subciliary).  Selection of technique is very important in obtaining great eyelid results!  If a transconjunctival blepharoplasty is performed, and loose skin results, something must be done to address the skin-- it will not tighten back on its own.  In my practice, I would perform laser resurfacing or a skin pinch.  Make sure to seek out an experienced surgeon who has performed thousands of these procedures.Best of luck!

Many surgeons will work on the fat from the inside, or transconjunctival side.  If there is excess skin, it can be reomoved with a pinch technique, or laser resurfacing can be performed to tighten up the skin.  If you are noticing loose skin now, it will probably not tighten.     

Hello Betterman and thanks for your question.You don't mention how many days or weeks you are after surgery. AS a general answer- skin is quite elastic, so some temporary swelling (say, after surgery) usually results in the skin shrinking back after the swelling reduces. However, fi you have loose skin since before the surgery that has not been tightened or removed, then that skin would not reduce.In my practice, I make sure my patients know they can contact me and my team with questions or concerns. In my opinion, it is all part of the relationship and communicating that goes on between a Specialist Plastic Surgeon and a patient. I am more than happy to use my expertise to guide my patients.You trusted your Plastic Surgeon to do your surgery. Tell him about your concerns.I wish you well.