Lower Eyelid Swelling / Eye Asymmetry After Blepharoplasty

I am 3 1/2 weeks post op upper and lower blepharoplasty. I still have swelling under eyes (looks like bags)and minor upper eyelid swelling. My left eye is slightly smaller than my right eye. When will this clear up and is there anything I can do to heal faster?

Doctor Answers 16

Eyelid swelling after surgery

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At 3 1/2 weeks after surgery, your inflammatory phase is still in the early phase of resolving and may take another couple of months to clear up.  The resolution of swelling can be enhanced by alternating hot and cold compresses several times a day.  The heat will enable your blood and lymphatic circulation to flow easily and clear cytokines and inflammatory mediators, while the cold will help to constrict and tone the tissues.  Gentle, light, upward-lateral stroking of the lower lids for lymphatic drainage will also help.  Be patient, the surgical stress does take time to clear, but as the weeks go by, the tissues will look much better and this investment in your time and money will be well worth the returns.

Differences in eyes before and after surgery

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As so many patients do, your appear to have an orbital dystopia.  Your left eye appears smaller because it is less projecting than the right eye.  Also the right eye is slightly lower within the eye bone.  These differences of the set of the eyeball within the eye bone will not change after surgery. 

It is best to point out these differences preoperatively so the patient does not think that asymmetries postop were due to the surgery when in fact they were due to differences in the eyes themselves within the orbital socket.

Some degree of swelling after surgery is normal and to be expected.  Talk to your surgeon about the appropriate activity level and which activities to avoid in the early postoperative period.

Brent Moelleken, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 195 reviews

Lower Eyelid Swelling / Eye Asymmetry After Blepharoplasty

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Hi Santa Barbara7926,

Swelling after Blepharoplasty is normal at 3 1/2 weeks.  It is best to wait before doing anything.  The main question is what did your eyelids look like before surgery.  If the left eye was smaller then the right before surgery, there is no reason to think that a Blepharoplasty would change that.  If they were the same, then probably they will end up the same.  If after 6 weeks the changes are still there, you might want to consult an Oculoplastic surgeon.

Sam Goldberger, MD
Beverly Hills Oculoplastic Surgeon

Asymmetry of eyes a few weeks after blepharoplasty.

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Asymmetry of eyes a few weeks after blepharoplasty is normal in everyone and it takes weeks to months for the last of the swelling to be gone.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 38 reviews

Swelling after blepharoplasty

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Sometimes it is harder to go through the recovery than to go though the surgery.  Having swelling in the lower lids is not  uncommon 3.5 weeks out.  I would wait until two months have gone by before making any judgments.  It is probably not possible to speed up your healing but avoid high salt diets and make sure your allergies (seasonal, that is)  are in check if you have allergies.

Francisco Canales, MD
Santa Rosa Plastic Surgeon
5.0 out of 5 stars 35 reviews

Eyelid swelling after blepharoplasty

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A patient is really at the baby phase of healing 3 weeks after a blepharoplasty.  You see the greatest change in swelling, after blepharoplasty, during the first 6 weeks of recovery.  I would definitely recommend you not worry and give everything more time.  I typically wait until 3 months to get my first set of post operative pictures, I do not consider the results final until 12 months.  Your photos are blurry on my computer but I am optimistic for you.  

Julius W. Few, MD
Chicago Plastic Surgeon

Hard to tell from this very low resolution photo what is going on.

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Dear Santa Barbara

Swelling at 3 1/2 weeks after eyelid surgery is completely normal.  From the fuzzy photo is looks like the left upper eyelid is ptotic or droopy compared to the right eye which will make the left eye look smaller than the right.  If this difference was not present before surgery, it may very well resolve in time and be due to swelling.  Occasionally the swelling can induce drooping in the eyelid and this change can persist, even eventually necessitating a surgical correction.  TIme is on your side here.  For this issue, I would recommend waiting a full year after your surgery because healing from this can actually take that long.  For the lower eyelid, to be quite frank, it is hard to make out what in going on due to the resolution of the images.  However, any swelling due to the surgery is very likely to be fully resolved by 6 months.  Being patient and letting things heal is a very tough job.  Hang in there and remember to communicate your concerns with your surgeon.  Your surgeon will be very motivated to make you happy.  My advice for both of you, don't rush, and let the surgery heal.

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

Droopy eyelids

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You may residual edema of the upper eyelids or you may have unrelated upper eyelid ptosis (droopy from weak levator muscle). I would wait a few more weeks and check with an ophthalmologist or oculoplastic surgeon.

Dr Taban

Mehryar (Ray) Taban, MD, FACS
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 91 reviews

Swelling is normal 31/2 weeks post bleph

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Dear post blepharoplasty patient.  

Unfortunately nothing heals symmetrically and there are many factors that can contribute to your assymetrical swelling.  The good news is that it is normal 3/12 weeks post op to still have swelling and it will most likely resolve.  You should try to watch the salt in your diet and keep your head elevated as much as possible to help to decrease any swelling.  

Mark Ginsburg, DO
Media Facial Plastic Surgeon
5.0 out of 5 stars 4 reviews

Post-operative Eyelid Asymmetry

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It's not unusual for patients to have significant asymmetry in the immediate post-operative period following blepharoplasty surgery. This asymmetry is often related to swelling which takes time to resolve. When this situation arises, patients are often upset with their result. After all, they had surgery to look better, not worse.

Although your pictures and history are helpful, it's difficult to make a recommendation without a physical examination. In someone who's only three and a half weeks post-op, the most likely explanation for your asymmetry is residual swelling.

Once swelling has resolved, your aesthetic result can be evaluated. It's still possible that you'll be happy with your surgical result. If you're not happy, secondary surgery may be a consideration. Revisional surgery shouldn't be performed until you're at least six months post-op. In the interim, it's essential that you maintain close contact with your plastic surgeon.

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.