Bruising Question with Upper Blepharoplasty. Thanks.

Does removing the skin only in an upper blepharoplasty operation typically result in less bruising versus removing/impacting the fat and the muscle?

Doctor Answers 19

Bruising with Blepharoplasty

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Hello and thank you for your question.

A skin-only upper blepharoplasty should theoretically result in less bruising compared to a procedure that removes fat. Yet, the most important aspect when performing an upper blepharoplasty is that the plastic surgeon chooses the appropriate technique. 

Whether or not fat is excised truly depends on your individual upper eyelids. There is no cookie-cutter approach to plastic surgery procedures and although you are concerned about bruising, more importantly, you should be concerned about having the procedure done with a fully trained plastic surgeon who can perform the appropriate operation. 

Remember that bruising is only temporary and will resolve over time. During the immediate postoperative period you will want to use ice sporadically to help decrease any swelling and bruising. Some patients bruise even with a skin-only upper eyelid blepharoplasty due to the local anesthetic that is injected at the start of the procedure.

Hope this helps answer your question. All the best!

Alex Zuriarrain, MD, Plastic Surgery

Miami General Surgeon
5.0 out of 5 stars 29 reviews


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Hi there.  Please note that either technique may result in bruising.  At the same time, more "extensive" approaches such as skin/muscle excision elevate the incidence.  Hope this is helpful.  Best wishes.

Anand G. Shah, MD
San Antonio Facial Plastic Surgeon

Bruising after an upper blepharoplasty

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An upper blepharoplasty  addresses removal of herniated fat, excess skin, and redundant muscle. Each procedure is customized depending upon the needs, goals and anatomy of each eyelid. There is a direct correlation between the amount of surgery performed and the  amount of bruising. It's important to perform the  correct procedure for each individual patient  irrespective of the temporary bruising that may or may not occur after eyelid surgery. For many examples, please see the link below to our eyelid surgery  photo gallery

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 157 reviews

Blepharoplasty technique

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Yes a simple skin removal technique should be less traumatic and have less bruising and swelling than a blepharoplasty that involves  muscle and fat removal. However the choice of technique is made on the basis of necessity. If you have excessive visible fat and there is a need to remove some obicularis muscle it should be done. You need to be prepared and accepting of the standard recover period for normal surgery or perhaps the timing is not right for you to have the surgery

Bruising Question with Upper Blepharoplasty. Thanks.

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The simple answer is YES. Please understand that the less invasive procedure, the less chances of bruising. However, will it get you the results that you wan? I have seen countless patients who have had previous upper blephs with little or no fat removal. It is always obvious particularly towards the inside of the upper lid where it meets the nose. I have often found bulging fat that gives a very unattractive look to the patient. Bruising will go away.................fat that is not removed, does not. All the best in your journey.

Skin only blepharoplasty

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yes, in general a skin only blepharoplasty would have a better healing time versus one that included excision of muscle and or fat.  No matter how invasive or less invasive surgical procedure is you always want to plan accordingly.  You could absolutely still have bruising with this procedure and should probably work under the assumption that you will just to be safe.  For a skin only blepharoplasty you will probably have your sutures are removed anywhere from 5-8 days after surgery depending on what the surgeon used to close the incisions.  You will certainly still have swelling at that time but likely it will not be terribly noticeable.

Chase Lay, MD
Double board-certified facial plastic surgeon

Chase Lay, MD
Bay Area Facial Plastic Surgeon
4.9 out of 5 stars 80 reviews

Bruising Question with Upper Blepharoplasty.

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In general, less invasive procedures have a lower risk of bruising. However, having a skin only upper blepharoplasty still puts you at risk for bruising. I would never promise someone a no-bruising blepharoplasty regardless of the approach as bruising can result from something as simple and universal as the injection of lidocaine at the beginning of the procedure. I hope this information is helpful for you.

Stephen Weber MD, FACS
Denver Facial Plastic Surgeon

Bruising Question with Upper Blepharoplasty?

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Bruising is generally less with an upper lid skin only removal, but varies significantly from patient to patient. Patients who have a history of easy bruising may bruise more than patients who don't have that history.

I would suggest that you find a surgeon certified by the American Board of American Plastic Surgery and one who is ideally a member of the American Society for Aesthetic Plastic Surgery (ASAPS) that you trust and are comfortable with. You should discuss your concerns with that surgeon in person and have him or her give you a  list of medications, herbs, supplements that you should avoid before surgery or that you can take in order to minimize bruising. 

Robert Singer, MD FACS

La Jolla, California

Robert Singer, MD
La Jolla Plastic Surgeon
4.6 out of 5 stars 22 reviews

Bruising with upper eyelid procedures

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Bruising can occur with skin only upper bleph or if muscle and fat are also removed. The eyelid skin is quite thin and is closely adherent to the underlying orbicularis oculi muscle (the muscle that surrounds the eye). This muscle can cause bruising just from injecting around it. So to answer your question, you can expect bruising either way and the pre op and post op instructions from your surgeon will give you methods to minimize the risk of bruising. 

Dilip D. Madnani, MD, FACS
New York Facial Plastic Surgeon
4.8 out of 5 stars 104 reviews

Extent of blepharoplasty

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Skin only upper lid blepharoplasties are more straightforward and may result in less bruising; however, in any procedure, if adequate hemostasis  (stopping the bleeding) is not obtained, bruising will develop.  Procedures where muscle is removed are less common as we have recognized the important of maintaining volume in the upper lid.  In procedures where fat is removed, adequate control of bleeding is very important to avoid a hematoma that may impair vision.  Bruising can develop even in the most controlled procedures.  My recommendation is to follow your postop instructions carefully to obtain the most expeditious recovery.

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.