Why Did Eyebags Remain After Blepharoplasty?

Question

Should I still have bruising after 3 months, and why do I still have bags under my eyes, just lower than the original ones?I had Blepharoplasty to get rid of the bags, and the ones I have now are worse than the original.  I still look tired.

Kenneth D. Steinsapir, MD · Answer

Dear Voodoo
Three months after blepharoplasty, there is likely no bruising left.  However, changes in the lower eyelid as a result of eyelid surgery can alter the appearance of the lower eyelid dark circle giving the suggestion of a bruise.  In either case, this and a new lower eyelid bag is not such a great thing after lower eyelid surgery.  
You are at a point after surgery where you might still have some residual swelling but you are also at a point were you close the final result.  So this is a good time to decide if you are happy with the result.  
I certainly think it is reasonable to open a dialog with your surgeon regarding how thing are going and your concerns.  Most surgeon will want to wait about 6 months before entertaining a revisional procedure.  
If you are experiencing a lack of confidence with you original surgeon, it is not unreasonable to look around for a second opinion.  The ASOPRS website is a good place to find a well qualified eye plastic surgeon. 
Dr. Steinsapir

Michael A. Persky, MD · Answer

Hi Voodoo,
Unlike the men sited in The Constitution of the United States of America, not all blepharoplasties are created equal.  The procedure is not a commodity, but rather an operative procedure that is very dependent upon the surgeon.
The results not only depend upon the surgery and the surgeon's expereince and skill, but most importantly on the pre-operative examination, evaluation, and diagnosis.
Usually after 3 months after lower blepharoplasty most bruising and swelling has resolved.   Best to discuss your concerns with your surgeon.  If you still have concerns or questions then consult with qualified eye surgeons in your area.
Good luck and be well.
Dr. P

Anita Mandal, MD · Answer

Bruising at 3 months after eyelid surgery is highly unusual but not impossible. However, what appears to you as bruising may very well be a dark shadow as a result of hollowing from too much fat removal in certain areas. The persistent eyelid bags could be due to swelling from allergies, etc that could be a pre-existing problem. It could also be too to uneven fat removal or a fat pad that was missed or not fully removed during surgery. If your surgeon performed fat transposition, the persistent bags could also result if the fat was not repositioned properly. You may need to have revision surgery after a consultation to determine the cause.

Richard D. Gentile, MD · Answer

If your concerns are small crescents of swelling below the orbital rims .. these are malar crescents which are caused by different factors and are more common in Smokers. If you are a smoker and continue to smoke you can expect little improvement in this area other that that which will occur with longer post op recovery times.

Lenore Sikorski, MD · Answer

I would ask another doctor in your area to take a look at you.  It may be that you had festoons or edema under your eyes prior to surgery that are more noticeable now. It would important to bring a before picture with you to a consultation appointment.  Usually by three months all the swelling and bruising is resolved.

Charles Perry, MD · Answer

I would recommend discussing this with your plastic surgeon as it may be that you are referring to malar festoons, which may not be addressed with Blepharoplasty surgery, and can actually worsen with swelling and reveal prolonged bruising through the lymphatic channels. Your physician will know best after they examine you. I have seen prolonged swelling after eyelid surgery and it can take months to get better.

George J. Beraka, MD (retired) · Answer

Hi,
Unfortunately, poor results after lower eyelid plasty are not rare. The surgery has to be individualized for the particular anatomy (there are several different ways to do the lower lids),and performed very skilfully.
The good news is that your result can almost certainly be improved with a revision. You may need a canthopexy, fat repositioning, fat injections, or a mid face lift.  This is quite tricky.  You need a real eyelid expert.  My web site has links to the plastic surgery societies, where you can find names near you.
And I would wait another 3 months.

Why Did Eyebags Remain After Blepharoplasty?

Answers (7)

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