Swollen cheek a month after upper and lower blepharoplasty? Steroids help, but what do I do when I finish them?

Question

Post upper & lower bleph 2/21/17. Usual swelling & bruising very happy with the result. About 2 wks in- right cheek started to swell - worse every day. Doc said it's normal, fluid has absorbed by my body. Rx for steroid worked great until I finished the pack. Swelling back up. Yesterday morning - like a balloon on one side of my face. They sent same Rx-call back Monday. But what happens when I finish this pack? What should I do? Why can't the fluid just be drained??? DESPERATE, HELP!!!!!

Ross A. Clevens, MD, FACS · Answer

Thank you for your question. This is a question best answered by your board certified facial plastic surgeon and the surgical team. Typically, the patient is reevaluated towards the end of their steroid treatment to learn where the patient is experiencing discomfort, and how the patient can best heal. 
Best wishes,

Michael H. Wojtanowski, MD · Answer

Swelling after a blepharoplasty can last various amount of time with different patients. It can last up to 3-4 months . Usually it is worse in the morning. Sleeping with your head slightly elevated can help minimize this . I also recommend intermittent cold compresses when you have swelling . The shouldnreolve with time .

Jessica Kulak, MD · Answer

It is very common to have swelling after upper and lower blepharoplasty.  Every patient is different, so don't compare yourself to others that have had a similar surgery.  Sometimes it can take several weeks even a few months before all the swelling resolves.  Often swelling will be worse in the morning after waking up and then will get better throughout the day.  Steroids are a good option for an initial treatment as they help with inflammation, but swelling and edema especially in the malar area of the cheek just take time to resolve. Typically, the fluid can't be drained as its fluid is in the tissue and not a collection of fluid. Try to avoid a salty diet and continue to sleep  upright.

Steven Wallach, MD · Answer

Swelling of the cheek is normal after eyelid surgery. Some people's swelling can last longer than others and steroids are only a temporary fix.

Samuel Baharestani, MD, FACS · Answer

Thank you for sharing your case.  It is normal to experience swelling for several weeks after a four lid blepharoplasty.  Steroids, sleeping with the head of the bed elevated, avoiding salty foods, using warm compresses, and applying arnica are the best ways to help the edema to resolve.  Unless there is an infection, drainage is not going to be helpful.  Everybody heals differently.  Be patient and make sure that your surgeon is aware of your condition.  Good luck!

Sara A. Kaltreider, MD (retired) · Answer

It is too soon to worry about the swelling in the cheek area. The suggestions below - elevation while sleeping, avoid adding salt to diet, warm compresses... are excellent. Health issues may also prolong swelling, but ultimately the swelling should resolve. Certain medications such as ACE inhibitors may prolong swelling. Patients who are overweight or have pulmonary, cardiac or renal problems may carry the swelling for a longer period of time. This fluid is not a cystic collection of fluid, but a diffuse edema of the tissues - and therefore, can not be drained. Keep your follow up with your surgeon for reassurance. I believe you may expect gradual resolution of your swelling over the next couple of months. Best wishes.

Swollen cheek a month after upper and lower blepharoplasty? Steroids help, but what do I do when I finish them?

Answers (6)

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