Will Lower Blepharoplasty Make Edema Under Eyes Worse?

Lower blepharoplasty can be very helfull in removing bulging fat from your lower lid. Fluid that accumulates each morning however is fluid within you tissues. This fluid is not in a single descrete pocket that can be removed. Surgery will likely make the fluid bags worse during the healing phase but should return to the pre operative state with time.

Lower blepharoplasty and swelling are temporary and the bags should be gone after surgery. I would need to see photos to give you a proper answer to your question to see exactly where the swelling is.

If you are having a blepharoplasty done, it would be best if a transconjunctival approach is used.

Making a skin incision approach will possibly damage the lymphatic drainage channels as well as adversely affect the eyelid muscle. This might lead to worsening "festoons".

The blepharoplasty will not likely change the swelling aspect of your eyelid problem. If you have thin, crepey, redundant skin, I would recommend an Erbium laser skin resurfacing approach to tightening the skin, without actual skin excision.

Posting a photo really would be ideal to get a better recommendation.

With blepharoplasty, fat is removed and sometimes fluid can become worse. Unless fat really needs to be removed, filler under the eyes can be a better option than surgery. You should really consult with a surgeon who specializes in eyelid surgery (like an oculoplastic surgeon) to see if there is swelling and if surgery is necessary. The technique for removing the fat bags can make a difference, whether through the conjunctiva or through the skin.  It is a possibility that the swelling may get worse.

The primary goal of a lower blepharoplasty is to remove the puffiness created by the 3 fat pads in the lower lids that create the puffy or tired look on the lower lids.  Malar edema, which is a fluid retention in the cheek pad, is not affected by the lower blepharoplasty.  If malar edema is present, it will not get any better or worse with a lower blepharoplasty.

If you are having a blepharoplasty it may become worse during the healing process but then it should return to normal. It is important to note that while a lower blepharoplasty will help with any loose or excess fat/skin someone may have under their eyes, it will not help with edema as this is a separate issue having to do with fluid building up in your skin.

without photos can't tell. but if the swelling is malar bags, then beware, they will get worse. hard to say how long. post pics if u want more speific info

It is hard to offer useful advice without seeing pictures, but here are some general thoughts.  It is important to distinguish between the puffiness that occurs in the lower eyelid as a result of herniation of the lower eyelid fat compartments and a much more superficial puffiness that occurs due to excess fluid under the skin at the eyelid/cheek junction.

 

This second more superficial type of fullness will not be corrected by a blepharoplasty and may even temporarily be made worse by the surgery.  It will usually settle down after a while.

There is no magic procedure that will correct this, nor is there a particular surgical approach that will avoid exacerbating this superficial swelling.  If you have this type of situation, often referred to as "malar puffs" in the plastic surgery literature, it may be temporarily aggravated by eyelid surgery, whether the approach is through an incision beneath the eyelashes or through a transconjunctival incision.

 

I hope this information is helpful to you.

I am concerned with the history of the recurrent lower lid swelling and increasing fat herniation especially without a medical history or proper pictures. Medical etiology of this condition must be investigated prior to any surgery. Although transconjunctical approach will take care of most of the fat and minimize lymphatic disruption of the lower lid skin, you will still need to have skin removed for best result. I believe the recurrent edema will certainly worsen after surgical blepharoplasty for months and maybe years. If tear troughs are the main problem, you may consider soft tissue filler injection to improve the contour.

Morning Jay,

 

I have to agree with Dr. Amadi's approach and recommendations.  That being said, there is no substitute for a good physical and eval.  I'd see a good Oculoplastic surgeon before proceeding for a couple reasons:

1.  It's always good to get a few consults.

2.  You want to ensure there are no medical issues (thyroid disease, etc.) contributing to this.

 

Most likely you'd see a nice improvement with potential for occasional fluid retention but get an evaluation first.  As a double-trained Facial Plastic & Oculoplastic surgeon I want to stress the importance of the medical evaluation. 

 

Best of luck

 

Chase Lay, MD