Lower Eye Lid Blepharoplasty Surgery 20 Days Ago - Healing Normally or Brewing Complication?

Without having a photo or knowing the particular surgical technique that your surgeon performed, it is very difficult to comment. That being said you may have some residual swelling that sometimes takes longer to resolve or this could be some inflammation around a suture ("suture granuloma") that the nurse alluded to. The stabbing pains if not severe or constant may be due to normal healing, particularly of the nerves. This is sometimes described as "prickly/ pinecone/ shooting pains". If the pain is severe and /or constant, you need to be seen by your doctor or another surgeon who should be covering his patients while he/she is away. All scars become less noticeable over time yet this visibility of scars varies considerably based on surgeon technique, patient's healing/health. A patient can help minimize the appearance of scars by massaging the eyelid incisions with Vitamin E, starting 3 weeks after your surgery IF your doctor gives you permission to do so. 

It's difficult to say what is occurring without an exam. If your surgeon is not available there should be someone filling in during the absence. New swelling and pain warrants further evaluation. The scar will fade in time. Be sure to keep it protected from the sun.

Difficult without pictures to say. Trust your highly qualified surgeon's opinion combined with close monitoring . Your incisions will continue to improve.

Dr. ES