What are these puffy pouches that have formed after upper blepharoplasty. (photo)

Swelling in this region of the  upper eyelids is very common after upper eyelid blepharoplasty. Reason being The lymphatic channels are located laterally. Swelling coalesces in the inner corner of the eyes and has difficulty getting to the outer part. Speak with your surgeon but what I usually recommended patients is they gently massage the eye from inner corner to the outside pushing the swelling laterally. This seems to help tremendously. If for whatever reason after six months the swelling and the redundancy of skin is still there, you may need to speak with your surgeon about the possibility of a revision.

You don't mention when you had your surgery, but if it was in the last couple of months, I'd recommend patience. Discuss your concerns with your surgeon. They may recommend massage and/or a steroid injection.Andrew Campbell, M.D.Facial Plastic SpecialistQuintessa Aesthetic Centers

It looks like you have a double crease at this point. When was the surgery?  It looks like you are early in the post-op healing phase.  So as the swelling goes down this may flatten out.  Give it time to heal.  If it still is uneven at about 6 months you can have the excess skin between the 2 creases excised.  

Presuming from your post that you had epicanthal folds (Asian type) eyelids, this appears to be a soft tissue fold, likely skin and muscle.  It also appears that your surgery was recent and thus some of this is swelling.  You should be massaging this frequently and give it alt least 6 weeks to improve before undertaking any other treatment.  Steroid injection after a few weeks might help.  Excising these could cause a lack of skin in the upper lid, so this should not be done until exhausting other possibilities.

Hello and thanks,It looks like you have some swelling in the upper skin flap above the incision that is not terribly unusual. However, i am not sure how long ago your procedure was, so it may be something that resolves easily or could need to be addressed. I would definitely stay in close contact with your surgeon to make sure your outcome is to your liking. Good luck,

Your incisions are prominent which suggests that your surgery was performed within the past week or two. Often there is a double crease early after surgery. It is likely that when the swelling resolves above and below the incision, this may flatten out/ smooth out nicely for you. If your results are not pleasing to you in 4-6 months, revision is an option. I agree with Dr. Martin that removal of the skin between the two creases is an option to eliminate the double crease appearance later if it persists. The epicanthal area might settle back into the contour of the medial canthus. Don't jump in too quickly with additional surgery - it might look a lot better to you in two more weeks. As an oculoplastic surgeon, I don't recommend massage of incision lines in the eyelids - or anywhere around the eyes for that matter. The tissues are very delicate  - massage can widen the incision, dehisce the eyelid crease and have bad effects on the levator. You definitely don't want to massage now with fresh incisions. If your surgeon is an oculoplastic surgeon, he/she should advise you appropriately. If you are still not comfortable with how things are going, you could seek a second opinion. Best wishes.