Just had lower blepharoplasty 5 days ago and developed chemosis in both eyes. Left more than right. What can I do to help heal?

My eyes are feel dry and irritated. I've been putting in drops of Thera Tears. I see my surgeon in three days but in the meantime is there anything I can do to alleviate the irritation. Also, I feel like I have "puppy dog eyes". They droop slightly at the ends. Will this disappear after my swelling has gone down?

Doctor Answers 6

Treating chemosis after lower lid blepharoplasty

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Chemosis occurs not infrequently after lower lid blepharoplasty. It can be exacerbated if your eye is not well-lubricated. Contact your surgeon's office, as he/she may want to start treatment with steroid eye drops and/or oral steroids, or other treatments (taping, temporary tarsorrhaphy, etc).

Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 64 reviews

Chemosis is not uncommon after lower eyelid blepharoplasty.

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We think that this occurs because of disruption of lymphatic flow after the surgery. The swelling of the conjunctiva will make your eye dry, so you will need to use a lot of artificial tears throughout the day. You should also use an artificial tear ointment or gel at bedtime. Your doctor may want to put you on an anti-inflammatory drop as well if the chemosis is pronounced. If it does not resolve there are other things that can be tried such as pressure patching, temporarily closing the eye with sutures, or even draining the fluid. It can be stubborn, but will eventually resolve!

John J. Martin, Jr., MD
Coral Gables Oculoplastic Surgeon
5.0 out of 5 stars 31 reviews

Artificial tears and ophthalmic ointment is what you need.

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If your surgeon was not an oculoplastic surgeon, then they lack the training, skills, experience, and even the equipment needed to treat this condition. Swelling causes chemosis but drying makes it persist. Under these circumstances using an artificial year every 30 minutes during the day and a bland ophthalmic ointment like refresh PM at bed time is very helpful. See you ophthalmologist for real help.

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

Steroid drops may help

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It depends on the severity of chemosis. For mild cases, lubrication [over the counter ointment is available, just ask your pharmacist to help] is usually enough. However for more severe cases, I may consider using steroid drops to help decrease inflammation.

If not responsive to that over a couple of weeks, there are some other "tricks of the trade" that your Oculoplastic surgeon can try, such as compression eye patch.

I would not start massaging [or other 'eye exercises'] this soon after surgery.

A.J. Amadi, MD
Seattle Oculoplastic Surgeon
5.0 out of 5 stars 42 reviews


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Chemosis is not that uncommon after lower lid blepharoplasty, with the incidence most frequently cited around 10% (although higher in other studies). There are different drops you can be given to help with the swelling in addition to lubricants. In addition, lower eyelid taping can be of benefit as well. It almost always resolves but may take a couple weeks or longer. I would contact your surgeon to see if they can give you some relief prior to your next visit. Best of luck.

A. Joshua Zimm, MD
New York Facial Plastic Surgeon
5.0 out of 5 stars 38 reviews

Just had lower blepharoplasty 5 days ago and developed chemosis in both eyes

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Hi there, I would see your doctor sooner than 3 days. He or she can give you a stronger lubricant for your eyes and start you on eye exercises. Hope this helps and good luck!

Lenore Sikorski, MD
Orange County Dermatologist
4.4 out of 5 stars 25 reviews

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.