2 weeks after my double eyelid surgery, eyelids are still swelling, red and itchy. Can I apply Tobradex? (photos)

Thank you for your question. You submitted two photos, and state you have had Asian eyelid surgery 2 weeks prior. You’re concerned about itchiness, redness, and swelling, so you’re asking if Tobradex can help alleviate these symptoms.
I can give you my opinion based on just the photos alone. A little background: I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial plastic and reconstructive surgeon. I have been in practice in Manhattan and Long Island for over 20 years. Asian eyelid surgery is a significant part of my practice. I treat patients from around the world for both first time surgeries, as well as revision surgeries for complications or undesirable results after Asian eyelid surgery done elsewhere.
The main person you should ask this question to is your doctor. If you have been doing follow-ups with your doctor, then your doctor naturally has experience from practice, and from treating you as to what looks right and what doesn’t.
Asian eyelid surgery is like other eyelid surgeries in some ways, and very specific in others. In Asian eyelid surgery we create a connection between the skin and the levator muscle to create the crease. With Asian eyelid surgery, there is a natural progression where swelling can be significant from the incision in the crease area, all the way to the margin (where eyeshadow is applied). That area can be swollen, and it can be swollen for several months after surgery.
As far as redness and itching, two weeks after surgery, it’s not unusual to have redness. We have to differentiate the cause of itching. It’s normal to have a certain amount of low-grade itching that’s an awareness the skin is healing, but that’s different from itching related to allergies.
I have my patients apply antibiotic ointment to the upper eyelids for several days after surgery. I have them stop the antibiotic ointment after a few days because of the concern of developing contact dermatitis, or an allergy to the antibiotic. Very often, people think when they have for example, redness, which is a typical sign of contact dermatitis, they may think they have an infection. So they apply more antibiotic ointment, which further aggravates the contact dermatitis. I tell people after several days of antibiotic ointment to stop it.
To help the skin heal, it is optimal to have a moist environment, so I’ll have them use something in the petrolatum family such as Aquaphor. It’s also very important I advise people to not use anything else. Very often, people are very eager to have their incisions heal well and avoid scarring. They may find different remedies, and over-the-counter skin treatments to prevent scarring, but a lot of those can be irritating. So I tell them, “Don’t put anything other than Aquaphor.”
From the photos alone, it’s very difficult to tell whether you’re having allergies versus some normal itching. It’s part of the normal healing process to have some itching. For short-term symptomatic relief, there may be a role for a topical steroid. I think it’s very important you speak to your doctor about this, or even better see your doctor because they will be able to tell pretty quickly. Photos are helpful, but photos are not as accurate as we would like them to be. Often, the intensity of the colors, and the details can be either exaggerated or not as well-defined, so nothing beats a personal examination and evaluation.
To answer your question, it may be helpful to use Tobradex, but I would still be careful about whether that same Tobradex was used after the surgery, or whether you might be causing more problems by continuing to use it.
Again, meet with your doctor and discuss these concerns and issues. I see my Asian eyelid surgery patients more frequently than I do non-Asian eyelid surgery patients. In the first month, I’ll see them at 1 week, then 2 weeks later, and then 2 weeks after that just to watch them during this initial period where swelling and incision healing can be concerning. I’d rather see them in person, rather than just tell them to come back after a month but that’s my personal approach.I hope that was helpful, I wish you the best of luck, and thank you for your question.This personalized video answer to your question is posted on RealSelf and on YouTube. To provide you with a personal and expert response, we use the image(s) you submitted on RealSelf in the video, but with respect to your privacy, we only show the body feature in question so you are not personally identifiable. If you prefer not to have your video question visible on YouTube, please contact us.

Hello,I would recommend following up closely with your surgeon to ensure the best results.    

All the described symptoms: redness, swelling and itchiness are expected 2 weeks after double eyelid surgery.  Typically, I would tell my patients to apply antibiotic ointment for the first week after their surgery and apply icepack to the lids the first couple of weeks.  Tobradex at this point is usually not necessary.  I also recommend scar gel and sunscreen about 3-4 weeks out and follow up with your surgeon closely.  Good luck!Goretti H. Taghva MD