Hollowing of Lower Lid After Blepharoplasty? (photo)

I'm a 51yo Asian male and had upper/lower lid bleph from an oculoplastic surgeon to address droopy eyelids and eyebags. I chose a doc who had a reputation for being conservative with correction. I'm 3 weeks post-surgery and concerned with the hollowing under my eyes. Doc told me to wait 2-3 months for final result, but am not sure it'll get better after all the swelling goes away. Would hollowing decrease over time? What would be the best option to correct this later? Thanks for any input!

Doctor Answers 7

Communicate with your doctor..

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Full surgical healing takes several months. It's important to understand that the eyelid and cheek area are connected and the perception of hollowing can be related to age related volume loss below the rim of the eye socket. Communicate with your surgeon. It appears that your eyes will look better but you may want to address the area below your eyes to get achieve a better overall appearance to your face.

New York Oculoplastic Surgeon
4.4 out of 5 stars 80 reviews

Hollowness in eyes

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They may look hollow because the lids are swollen and this can exaggerate your concern. Follow your surgeon's advice.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

A combination of issues...

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Looking at your photos, I tend to agree with comment made by Dr. Ovchinsky: you had some tear trough hollowing even beforehand, with some cheek soft tissue deficiency. YOur surgeon has done a nice job addressing your eyelid bags, but the transition between the eyelid and cheek [tear trough], and the cheek itself is volume deficient.

Adding fillers or fat [more long term solution, but also higher risk procedure] would address these issues.

Your surgeon is correct:  post op results at three months should be final.

Good luck

A.J. Amadi, MD
Seattle Oculoplastic Surgeon
5.0 out of 5 stars 42 reviews

Hollowing of the lower eyelids after blepharoplasty

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If you pay a close attention to your preoperative photos, you will see that you had some hollowing, or so called "tear trough", which likely became accentuated after fat removal.  3 weeks after surgery is not enough time to either judge or do anything else.  Give it at least a few months to heal. Filler is always an option if it still looks hollow then.

Alexander Ovchinsky, MD
New York Facial Plastic Surgeon
4.9 out of 5 stars 32 reviews

Tincture of time is very helpful.

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Generally removing lower eyelid fat can accentuate lower eyelid hollowness and one sees that in your very early post-operative results.  On the other hand, the very full lower eyelid bag is clearly better.  Will you ultimately be happy with the effects of your surgery?  This is largely subjective.  However, it is essential to give yourself time to heal.  It will be much easier to judge the overall effect of surgery at 4 to 6 months rather than at 3 months.

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

Hollowness 3 weeks after a Blepharoplasty

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Your surgeon is correct that you should wait a couple of weeks to see the final result.  Hollowing does not typically decrease overtime.  If you have continue to have hollowing after your healing is complete, you can opt to have an injectable filler (Restylane) to correct the area.  Some may suggest to have fat grafting in the area.  Fat grafting is an option, but make sure you understand to risks and benefits.  Fat grafting in this area must be done precisely and accurately.  

Hollwness after Lower Bleph

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3 weeks post op is too early. At least 3 months is necessary for all the swelling to go down.

At this point in the post op picture, the hollowness is minimal. Hopefully this will continue to get better. If the hollowness looks worse after the swelling goes down, it can be improved by a small amount of filler.

Raj Chowdary, MD (retired)
Allentown 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.