Fluid Retention Due to Blepharoplasty?

I recently had a lower Blepharoplasty done 8 weeks ago. Just the removal of fat tissue, nothing elese. I hardly had any bruises after the procedure but the lower lids have always been a little puffy.

My surgeon, after examined them, said it was due to fluid retention and would get better over time. However, my eyes have been looking the same, 3 days post operation. If they haven't changed after 2 months, how would I expect them to ever change? Or, could my problem due to something else?

My surgeon said he cannot tell the condition will be permanent or not and there is nothing I can do. Can I do something to improve my condition? Any response will be appreciated.

Doctor Answers 13

Fluid retention after blepharoplasty can be problematic in some patients.

Fluid retention after blepharoplasty can be problematic in some patients. Altitude, air pressure changes, hormones, and allergies can all affect fluid retention. A low-salt diet would be recommended at this point. At three to four months after the surgery if there is still fluid retention, one has to consider whether or not there is residual fat that was missed at the original surgery.

Seattle Facial Plastic Surgeon
4.5 out of 5 stars 107 reviews

Swelling post blepharoplasty not uncommon

It is not uncommon to have swelling post blepharoplasty. As more time goes by, you will notice somedays they will be swollen and some days they will be less swollen.

This happens anytime you remove fat from the body. When I do VASER Liposuction on the body, I remove the fat. Swelling happens amost every time because that is the way the body works. I tell all my patients that they must wear their compression garments for a full 4 to 6 weeks to get a really good result. By wearing compression garments, it minimize the swelling.

Unfortunately, there is no good way of minimizing the swelling post blehpharoplasty. I would suggest that you try to keep your head up at night when you are sleeping. This sometimes can minimize the swelling.

Eventually as more time goes by, you will see the swelling go down. I always tell my patients that they will not get the finale result for at least 3 to 12 months.

Hope this helps.

Andrew Y. Kleinman, MD
Westchester Plastic Surgeon
5.0 out of 5 stars 4 reviews

Wound healing is long term process

Your results are satisfactory and the effects of surgery can take as long as a year to settle. I have seen mild edema (swelling) in lids past six months, so be patient.

Richard Gentile, MD
Youngstown Facial Plastic Surgeon
4.5 out of 5 stars 30 reviews

Your Blepharoplasty results look nice

It looks like your surgeon did a nice job. He seems to have removed the appropriate amount of fat. Although it's difficult to tell from the pictures it does appear that you have a small amount of SOOF fat. This is okay and will keep you looking young. However, this is likely what you are referring to. So take heart and enjoy this nice outcome.

Some edema normal after Facial Surgery

It is unlikely to to get significant general body fluid retention after head and neck surgery, BUT some edema or fluid retention in the areas in which surgery was done is normal. After eyelid surgery, some swelling of the face is normal and can last up to two weeks, some swelling of the eyelids will persist for three or more months depending on what kind of surgery was done. Some eyelid surgery is combined with a cheek lift (or mid-face lift) and then the swelling can last even longer.

Raj K. Gupta, MD
Pontiac Plastic Surgeon
5.0 out of 5 stars 2 reviews

Your after picture looks very nice.

In comparison to your before picture, your after picture looks very nice. You have a smooth lower lid and lid/cheek junction. Unless there is something that is not apparent in the picture, you should be very happy with the result.

David Shafer, MD
New York Plastic Surgeon
5.0 out of 5 stars 70 reviews

Swelling around eyes can last months

It looks like you a very nice result. The swelling around the eyes can take months, even up to a year to completely resolve. I would be patient.

Revision surgery this early is most likely to create more swelling, not less. It should get better on its own.

Robert M. Jensen, MD
Medford Plastic Surgeon
5.0 out of 5 stars 39 reviews

Wait for the Blepharoplasty swelling to resolve

I agree with Dr. Beraka. You have a very nice result, and I think it would be easier to mess it up than improve it.

You may try head elevation on an extra pillow to sleep. Another noninvasive idea is to wear a sleep mask that will put gentle pressure on the lids to help swelling.

Minimal swelling after Blepharoplsty will resolve

Looks like you have a really good result. Minimal swelling that you may still have and may be hard to see in photos will probably gradually go away over time. Enjoy the results of your surgery.

Stella Desyatnikova, MD
Seattle Facial Plastic Surgeon
4.5 out of 5 stars 20 reviews

Puffiness is normal Asian orbital and eyelid anatomy

Let's start with your preop photo. In the region of your lower eyelid/upper cheek, you have a "roll" below the lash line on both lower eyelids. Then there is a second "bulge" below the "roll", that many people would call a "lower eyelid bag." The upper "roll" is a very common finding in the asian eyelid, and corresponds to the orbicularis muscle and its attachments to the muscles around the eye. The lower "bulge" is orbital fat that is visible through your thin eyelid skin and is accentuated by the hollows above and below it.

As we age, we lose volume in our face, and our skin thins. This allows the underlying hollows to become unveiled. Surgery to remove fat alone does not correctly address these hollows. In contrast, volume enhancing procedures to fill the hollows hides bulges and rolls to provide a natural appearing result.

Your surgery to remove fat can only affect the lower "bulge", and that's exactly what we see in your post-op photo. Where there was once a bulge, there is now a hollow area. The "roll" of orbicularis muscle is still there, but less defined since it descends into the hollow area of fat removal just below. This leaves your eyelid looking a little hollow, and accentuates your tear trough deformity. The tear trough is the hollow area below your eyelid that starts near the nose at the inner corner of the eye, and curves down toward the cheek. If you touch this area with your finger, you can feel the orbital rim bone where there is the hollowing.

In my opinion, you look a little too hollow now in the lower eyelid and tear trough area. This accentuates the fullness of the orbicularis roll by the lashes, and may make you feel "puffy", because the lower eyelid contour does not smoothly integrate into the cheek. After you have had sufficient time to heal, I think you would be a good candidate for a volume enhancing procedure to fill the hollow areas. Options include fillers such as Restylane, or a fat transfer procedure. This would softly improve the contour of your lower eyelids and upper cheek.

Tanuj Nakra, MD, FACS
Austin Oculoplastic Surgeon
5.0 out of 5 stars 16 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.