When can I get dermal filler for my upper eyelid after upper blepharoplasty?

Question

I recently had an upper bleph and unfortunately I developed hypertrophic scars. The surgeon treated me with steroid shots to flatten the scars. I’ve been wanting to get eyelid fillers with another surgeon since the bleph was too aggressive and left me with hollow eyes. How long do I have to wait to get the filler after the steroid shot? Thank you!

Anna Chacon, MD, FAAD · Answer

I’m sorry you’ve had such a difficult recovery. One of the most frustrating outcomes after an upper blepharoplasty is feeling that the surgery was too aggressive, leaving the eyes looking hollow, skeletonized, or overly deep-set. The fact that you also developed hypertrophic scars requiring steroid injections makes the timing of any filler treatment even more important.

The Short Answer

In general, after an upper blepharoplasty, I prefer to wait at least 3–6 months before considering upper eyelid filler, and 6–12 months is often safer if there has been significant scarring, revision concerns, or steroid treatment.

After a steroid injection (such as Kenalog/triamcinolone), I would typically wait at least 6–8 weeks, and in many cases 2–3 months, before injecting filler into or near the treated area.

Why the Steroid Matters

Steroid injections can continue to affect the tissue for several weeks to months by:

Reducing collagen production
Thinning the skin and soft tissue
Causing temporary volume loss or atrophy
Altering how filler distributes within the tissue

If filler is placed too soon after a steroid injection, the result can be less predictable. You may initially appear more hollow because of the steroid effect, and then the tissue may change again as the steroid wears off, making it difficult to judge how much filler is truly needed.

The Upper Eyelid Is Different From Under-Eye Filler

Upper eyelid hollowing is one of the most technically demanding filler areas on the face. The skin is extremely thin, and after surgery there may be:

Scar tissue
Altered anatomy
Reduced fat support
Changes in blood supply and tissue mobility

Because of this, many experienced oculoplastic and facial plastic surgeons are much more conservative with upper eyelid filler than with tear trough filler.

A Useful Timeline

A practical approach is often:

0–6 weeks after steroid injection: allow the steroid to settle; avoid filler.
6–12 weeks: reassess the scar and the degree of true hollowing.
3–6 months after the last steroid injection: consider conservative filler if the tissues are stable.
6–12 months after blepharoplasty: ideal for determining the final surgical contour, especially if the surgery was “too aggressive.”
One Important Question

Do your eyes look equally hollow now, or did the hollowing become worse after the steroid injections?

That distinction matters because:

If the hollowing was present immediately after surgery, it is more likely due to excess fat or skin removal.
If it became noticeably worse after the steroid shots, some of the volume loss may be steroid-related and partially improve over time.
What I Would Consider Before Filler

For post-blepharoplasty hollowing, I usually want:

Soft, mature scars (not pink, thick, or actively remodeling)
No ongoing steroid treatment planned
Stable eyelid position for at least several months
Good ability to close the eyes completely
No significant dry eye symptoms, which can sometimes be exacerbated by overly aggressive upper blepharoplasty.
My Honest Impression

Since you’ve had hypertrophic scarring treated with steroid injections, I would be more conservative than usual. If your most recent steroid injection was recent, I would not rush into upper eyelid filler immediately. In many cases, waiting about 2–3 months after the last steroid injection and ideally closer to 6 months after surgery if possible provides a much more accurate assessment of the true residual hollowing and leads to safer, more predictable filler results.

The encouraging part is that post-blepharoplasty hollowing can often be improved with very small, carefully placed amounts of hyaluronic acid filler or fat grafting, but the key to a natural result is allowing the scars and steroid-treated tissues to fully stabilize before adding volume back to the area.

Anna Avaliani, MD · Answer

Your doctor should be guiding you on all of these questions. It is up to them to decide when it is safe and possible to do the procedure. In theory fillers are being placed in a completely different area where the steroids were injected, so you don't have to wait for anything. Upper eyelid filler should be ideally injected by an oculoplastic surgeon who is comfortable to do so. It can definitely off set the sunken looking eyes after blepharoplasty and fat pad removal . Best of luck.Best, Dr.Anna Avaliani

Leonard Grossman, MD · Answer

I would not recommend using fillers for treating hollow eyelids. Fat Grafting is the best option in my opinion. Hope this helps and good luck from New York City Plastic Surgery

When can I get dermal filler for my upper eyelid after upper blepharoplasty?

Answers (3)

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