Bruising after a Lower Blepharoplasty?

I had lower blepharoplasty in October. The procedure went well and so far I am very pleased. I still have some bruising and I faithfully using warm compresses, at least twice a day to help with the bruising. My doctor operated inside the lower lid, since I do keloid. Any other suggestions to help with the bruising. I use an eye concealer when I go out.

Doctor Answers 7

Treatment for Lower Blepharoplasty Bruising

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The proactive measures I take prior to surgery are to place my patients on Arnica Montana 4 or 5 days before surgery. I also supplement them with naturally occurring bromelain found in fresh pineapple. I have my patients eat a quarter of a pineapple starting 4 days before surgery as they will not be able to have any pineapple until after their surgery. Thereafter, if they are still floridly bruised, I tell them to prepare to have some 560 wavelength Sciton laser approximately 4 to 6 days after their surgery as this will help metabolize the bruising in their tissues. Also before surgery I would have you avoid the use of non-steroidal anti-inflammatories like Advil, Motrin, Aleve, etc. as this affects your platelets.
Now your postoperative bruising resolution is still facilitated by the bromelain in pineapple and the Arnica Montana placed under your tongue a few times a day. If you should have some discoloration after your surgery, this is something that I carefully counsel patients about by using sunblock as this can lead to some pigmentation that occurs from your sun exposure in your early peri-operative period.

Lower blepharoplasty skin change

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This sounds like you have hyperpigmentation changes in the operated area. Sometimes after a blepharoplasty where there has been significant swelling and bruising a residual color change brought on by both melanin production and blood breakdown products can leave a dark "cast" for 6 months or more. A combination of warm soaks and bleaching creams are the therapies of choice. You also have to be sure that some color change is not simply looking through the skin to venus (bluish) vasculature under the skin.

Pigmentation changes

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This sounds like a pigmentation change, rather than bruising, since it's now 3+ months from surgery.  Bruising would have been gone by now.
I agree with the suggestion for "bleaching creams".  Speak with your surgeon about this option.

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Bruising would be uncommon this far out after surgery.

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However, the inflammation of a surgery may cause some hyperpigmentation.  This can be improved with bleaching creams or IPL treatments.  The lid can also appear bruised if there is an hollowing under the eye which can occur after fat excision.  You can discuss these issues with your surgeon to see if he can figure out why you might appear bruised.  Reposting with pictures would also help!!    

Long term bruising after blepharoplasty?

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It is unlikely that you still have bruising. Sometimes, hollowness can cause "dark areas" (shadows) which can look like bruising. Rarely, there can be skin changes too. Discuss with you surgeon and/or see an oculoplastic surgeon.

Consider reposting with photographs.

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It is improbable that you are still bruised from surgery in October.  It is more likely that you are describing something else.  It could be hyperpigmentation or simple a deepening of the apparent skin pigmentation due to how the skin now lays due to the removal of lower eyelid fat.

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

Eyelid Bruising

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Some patients are more prone to bruise following lower eyelid surgery.  If you have the surgery done from inside the lid (transconjunctival approach), you can still bruise, as a small amount of blood can come up to the surface during healing and color the skin.  The main issue with bruising for darker skin patients is the bruising forming pigmentation of the skin.  For my patients at risk for this, I start them on a bleaching cream.  This reduces the chance that the bruise can stimulate pigmentation and turn the lower eyelid skin darker over time.  In the meantime, arnica cream may be of some limited help.

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.