How can I correct hollow sunken eyes after eyelid surgery? And uneven stitches? (Photo)

1 month after surgery the area of my stitches still pull, hurt. In the morning my eyes are puffy and feel a bit better appearance wise towards evening they sunk in, pull and uneven stitches are more visible. Something doesn't feel right. If I sleep long my eyes swell and feel like they r about to explode. I'm afraid this might be due to insufficient skin. My eye sockets are visible and lids too wide, stitches high. Will lids be covered over time as stitches heal and skin relaxes? I'm depressed

Doctor Answers 8

Revisional blepharoplasty

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You have high fold with mild ptosis after surgery.
Sometimes high fold make mild ptosis and always swollen eyelid.
You need revisional blepharoplasty to lower your fold and correct mild ptosis.
Ptosis correction procedure also can solve your sunken problem.

South Korea Plastic Surgeon

Hollow Sunken eyes following eyelid surgery

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Often hollow areas around the eyes could be corrected with fat grafting.  I have examples of this type of before and after images on my website.

I cannot make a recommendation for your specific situation without more and different photographs. I would need full face photos from all angles, looking straight ahead, up and down. Ideally, you would have corresponding photos before surgery. 

Michael Law, MD
Raleigh-Durham Plastic Surgeon
4.8 out of 5 stars 123 reviews

Hollowness after eyelid surgery

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Best to see an oculoplastic specialist for in person evaluation given your complicated issues. In general, filler (or fat) can be injected to improve hollowness around eyes.

Mehryar (Ray) Taban, MD, FACS
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 91 reviews

Aggressive blepharoplasty

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has left you with minimal skin and a high scar.  You should discuss your concerns with your surgeon about what the gallery of surgeons have thought and if brushed off, get a second opinion with someone who has considerable experience with salvaging such situations.  I'm sorry but there are no easy or reliable fixes here and your surgeon will have to be very experienced.

Curtis Wong, MD
Redding Plastic Surgeon
4.8 out of 5 stars 33 reviews

What can I do to improve a hollowed results after blepharoplasty? Do I need eyelid surgery revision?

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Based on the photos you provided, I think your concerns are valid. In addition, at this point after surgery I would not expect the result to change that significantly. It appears that you've had an excessive amount of tissue removed during your blepharoplasty surgery. Once removed, it is very difficult to re-create the normal contours and relationships that once existed. My preferred treatment for this issue is to attempt to replace some of the volume that has been lost by utilizing injectable fillers such as Restylane, Belotero or Juvederm. This type of in office treatment should be performed only by physicians with the highest level of experience, the familiarity, and comfort around the eyes. 

Jeffrey M. Joseph, MD
Newport Beach Oculoplastic Surgeon
5.0 out of 5 stars 17 reviews

Hollow Sunken Eyes After Blepharoplasty

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I am sorry to hear that you are having such difficulties after your recent eyelid surgery.  Your concerns are certainly valid, and it does appear that a more aggressive amount of tissue (skin, muscle, and fat) was removed during your surgery.  It also sounds like you are experiencing significant issues with dry eye symptoms and possibly some lagophthalmos, which is an inability to close the eyes completely, particularly when sleeping. Temporary dry eye symptoms are relatively common in the immediate post-operative period following eyelid surgery, but they do need to be treated with aggressive lubrication in the form of over-the-counter artificial tears during the day and lubricating eye ointment inside the eyes at bedtime.  At times, other treatments are also required to alleviate dry eye symptoms, but you would need to consult with an Ophthalmologist or Oculoplastic surgeon for a full examination to determine whether such treatments would be beneficial in this case.  

With regard to the appearance of your eyes, it does appear that they appear more hollow in your post-operative photos.  Volume replacement to improve the sunken appearance can often be achieved in this area with injection of facial fillers.  Restylane would be the best choice for this treatment.  Fat grafting is sometimes done in this area as well, but this is not my preference due to the risks of scarring and asymmetry in such a thin skin area of the eyelids.  Consultation with a skilled Oculoplastic surgeon who is comfortable managing these type of issues would be a good idea at this point to address your concerns.  Best, Dr. Gregory Lewen

Gregory D. Lewen, MD, FACS
Miami Oculoplastic Surgeon

This is a classic over aggressive blepharoplasty.

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Some surgeons think this is their job when the perform blepharoplasty.  Incongruously, if you lined up 100 surgeons ( not to pick on them), at least half of them would say that surgery was performed absolutely correctly.  I think we can all agree that you looked much better before surgery.  You may be short of skin in these eyelids.  In addition to your aesthetic concerns, the big problem here is that your eyes are dry.  That is why you are so uncomfortable.  Generally the first step is very aggressive medical management of the dry eye.  This includes artifical tears, lubrication with ophthalmic ointment at night, and measures like punctual occlusion, restates, etc.  There are surgical maneuvers of course.  Fat grafting in the upper eyelid has not proven to be a reliable method due to the scaring is produces.  One of the challenge situations in these circumstances is weakness of the blink function that occurs after aggressive surgery.  Repairing the position of the lower eyelid can also help the upper eyelids close.  A detailed consultation with an oculoplastic surgeon who focuses on managing these types of situations is warranted.  You eyelid surgery may not understand the basis for the eye discomfort or even have the appropriate equipment to exam the eyes.

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

High upper lid crease

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Hi. Sorry to hear that on you are having trouble. Swelling can persist at 1 month post op. Eventually it should resolve. If it is most prominent when you wake up, it may help to elevate your head while you sleep. From the photos you provided, it looks like your upper lid creases are higher and you are more hollow than your pre op photo. This may benefit from a revision procedure or filler injections if it does not improve. An in person exam is necessary to determine your options. Hope this helps. Best regards, Ira Vidor, M.D.

Ira Vidor, MD
Newport Beach Oculoplastic 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.