Not Able to Ice Lower Eyelids Sufficiently After Surgery and Now Seem to Have Festoons

Question

seem to have developed fesoons. Can this be a result of not icing sufficiently post op?

Kenneth D. Steinsapir, MD · Answer

Icing helps with discomfort and a little with swelling. However, the swelling still comes and due to the anatomy of the lower eyelid, this swelling give the classic look of a festoon for many. With time this will all return to normal. Ice, don't ice, it makes little difference.

Joseph A. Eviatar, MD, FACS · Answer

Post-op festoons are related to fluid accumulation from blockage of the lymphatic system and some people have them naturally. Sometimes when you have surgery they become worse transiently. You shouldn’t have permanent festoons from the icing, but you certainly can have festoons after the surgery if you do not ice as much.

Harlow Hollis, MD · Answer

Lower eyelid swelling is common post op after eyelid surgery. The adjacent area lateral to the lower eyelid is where the festoon lives and it is not caused by this swelling although it may be aggrivated by the post op swelling. Ice early after surgery helps decrease pain and swelling but the final outcome will be the same whether or not if you use ice.

David A. Bray, Sr., MD · Answer

You will have a certain amout of swelling after blepheroplasty. The edema often will head south before it resolved. Be patient you will be fine if you didn't have them pre-op

Edwin Ishoo, MD · Answer

I am not certain what procedure you had and how long ago you had it. It is not uncommon to have lower eyelid swelling and bruising for upto a week after a lower lid blepheraplasty. It is important to have any hypertension well controlled to minimize post-operative edema. This is not a "festoon" which is frequently a term used to refer to excess or redundant Orbicularis Occuli muscle in the lower lid. This appears as overlapping curved layers or rings of tissue under the eye and managed by excision of excess muscle and suspension. If you are not yet a week out, just be patient. If it persists, you may need to talk to your doctor about treatment with a short course of steriodal or non-steroidal anti-inflammatories. In rare cases, such an appearance may be due to persistent herniation of peri-orbital fat which may need to be resected. Most likely, your case will gradually improve over 7-10 days post-operatively without any intervention. It is best to have your doctor evaluate you within the first week to make a decision on how to expedite your recovery.

Francis R. Palmer, III, MD (retired) · Answer

No, the festoons were not caused because you didn't ice your lower eyelids. Festoons of the eyelids are redundant folds of lax skin and orbicularis muscle of the upper or lower eyelids that hang, in hammocklike fashion and as such are structural issues and not swelling. Time and patience should allow the eyelid swelling to resolve with or without ice being applied. I tell my eyelid patients that ice just sppeds the process along.

John H. Hunts MD, PhD (retired) · Answer

It is not uncommon to have increased swelling of the lower eyelids following surgery, or temporary "festoons". The swelling is typically worse in the morning, and improves through the day. To reduce swelling, consider sleeping with a few pillows the first week, transition to moist warm compress after 2 days icing, and use a Q-tip to role the edema laterally like a "steam roller" first thing in morning. The swelling should continue to decrease as healing proceeds.

	Good luck!

George Commons, MD (retired) · Answer

You will be fine. Early icing speeds things along but in the end result those that ice and those that do not ice have the same endpoint. Iceing is a technique to minimize early swelling. You did not state how far after surgery you are and this is an important issue. If still in the first month swelling is comon. Best to you, Dr g commons

Not Able to Ice Lower Eyelids Sufficiently After Surgery and Now Seem to Have Festoons

Answers (8)

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