Lower blepharoplasty 3 weeks ago, developed chemosis on right eye 48 hrs later. Any suggestions? (photos)

The bulge you see is the swollen orbicularis muscle which is under the skin. Some people have a very prominent muscle here which can remain swollen for a while after the surgery.  Looks pretty good on the other side, so should resolve with time.  You can see that the right lower lid is a little low - may be a reason for the chemosis.  Unfortunately the chemosis pushes down on the lid so keeps it low.  You should massage the lid upward to help improve the lid height and this can also help the chemosis.  Use a lot of lubricant drops to keep the eye moist which also helps with the chemosis. 

The muscles around the eye are not very strong, especially the lower eyelid muscles. Any swelling associated with the surgery will keep the muscle from working as efficiently as it did before surgery. The swelling from the surgery weighs more than the fat that was removed. Another cause of postoperative weakness is weakness of the nerve that supplies the muscle. As the swelling subsides, the muscle strength recovers and helps the tears that normally keep the eye, and especially the cornea, moist. Until that time, it is imperative to keep the eye lubricated with artificial tears during the daytime and with the lacrilube at night so that you don't have to wake up every hour or so to put drops in the eye. A general rule is that if the "white" of the eye is red and swollen, it means that you aren't getting enough moisture in the eye. Support of the lower eyelid after surgery with tape can reduce the swelling and help protect the eyelid until the muscle strength fully recovers.  Massage of the eyelids vertically, not horizontally will help the muscle get stronger, reduce the swelling that you have under the eye, and help the tears become more efficient. Avoid sleeping under a ceiling fan or AC vent to keep the eye from drying out, or use a "daytime sleeper" mask to prevent the air from drying out the eye at night. With a little time and "physical therapy" of the eyelid, the swelling and redness should resolve. (I would massage the left eye as well. It appears a little weak as well)John Standefer MD 

Swelling 3 weeks after blepharoplasty seems to be not directly related to the surgery. Maybe an infection or allergic reaction. It s better to consult your surgeon for further evaluation. Btw the result looks very good