4 weeks after upper and lower blepharoplasty and really worried. My Dr. is published and his specialty is eyes. (Photos)

I'm worried about my upper & lower surgery. At 4 weeks, I am puffy on my upper cheeks. 1st dr. told me if I only had my skin pulled without moving fat to fix malar bags, I would not be happy. I went with a dr. who said not to worry. 2 days ago, I got folds at the inner corner that makes me look Asian. 1 eye is bigger than the other. left eye seems pinched in the corner. Scar below my lashes on the left looks brown. I was awake & went to a dr. who specialized in eyes. Im hideous & 63 yrs old

Doctor Answers 9

I totally agree that you have legitimate concerns.

Your upper blepharoplasty was over aggressive and has left your with upper eyelid ptosis.  The lower eyelids are pulled down and cause chronic corneal exposure and drying.  You need to heal from this surgery.  You need ongoing care to manage your dry eyes.  I am not optimistic that lower eyelid massage will make much difference.  You need to heal.  Unless you are having dry eye that is not responding to dry eye management, I recommend waiting at least 6 months before having the eyelids reconstructed.  It is not too early to actually identify surgeons who can help you if you have lost confidence in your surgeon.

Los Angeles Oculoplastic Surgeon
4.9 out of 5 stars 23 reviews

4 weeks after upper and lower blepharoplasty and really worried. My Dr. is published and his specialty is eyes.

Yes appears as very early ectropion of bilateral lower lids. Best to seek in person second opinions.

Healing after blepharoplasty of the upper and lower lids

Your photos show that you have substantial improvement in the upper lids and lower lid preseptal contour (bags are better). Many factors may lead to swelling that takes time to resolve - medications, skin quality, sleep position, activities, salt intake, etc. As the swelling resolves, the orbicularis muscle regains its strength. Consequently the lower lids may elevate. In the postoperative photos, your eyes are in slight upgaze which shows more of the sclera below. You have some brow ptosis which is contributing to the lateral eyelid fold. Bottom line - you will continue to have improvement in the cheek puffiness, erythema/ brown of incision lines, edema of the lateral upper lid folds. Healing is not easy or quick - but gradual improvement is a sure thing over the next 2-4 months. Stay in touch with your surgeon for followup of your progress. Best wishes.

Sara A. Kaltreider, MD
Charlottesville Oculoplastic Surgeon
5.0 out of 5 stars 3 reviews

Some options

I certainly understand your concerns and worries.  This is the point of maximal contraction of scars and the lower eyelids will soften and improve some.  I have had very good luck altering the biology of scar tissue using injectable substances such as 5-FU and fillers.  These agents can help modify the scarring process and often reduce the need or amount of reconstruction.  This procedure can often be done at this stage but you would need to see an surgeon familiar with these options

Postblepharoplasty lower eyelid retraction

It appears you have post-blepharoplasty lower eyelid retraction/ectropion. Recommend massage lower eyelids upwards, do squinting exercises, and using lubricating eye drops. After 3 months from surgery, revision surgery can be considered.

Mehryar (Ray) Taban, MD, FACS
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 58 reviews

Problems after blepharoplasty

I would recommend you discuss your concerns with your surgeon. I know you are not happy with your result yet, but you not "hideous". Be patient and listen to your doctor. Malar swelling can take a very long time to improve. I agree that these things can take six months or even longer.Andrew Campbell, M.D.Facial Plastic SpecialistQuintessa Aesthetic Centers

Andrew Campbell, MD
Milwaukee Facial Plastic Surgeon
4.7 out of 5 stars 26 reviews

Concerned after eyelid surgery

I agree with Dr. Heher.  You are only 4 weeks after your procedure and are still healing. Give yourself a minimum of six months before evaluating your results.   How the results of one eye compares to the other takes at least that long.  Be patient and have confidence in the doctor in whose care you entrusted your eyes.  Good luck!

Lawrence Kass, MD
Saint Petersburg Oculoplastic Surgeon
4.9 out of 5 stars 114 reviews

4 weeks after surgery

The healing process takes many months.  Swelling and tightening of the skin continues for the first three months and then starts to improve.  This frequently occurs asymmetrically.  The most important thing is to be patient. Best of luck!

Katrinka L. Heher, MD
Boston Oculoplastic Surgeon
5.0 out of 5 stars 7 reviews

Blepharoplasty and really worried.

first thing first, you are not at all hideous, infact you look much better than your preop.Your doctor has done a good job, yes iam aware and understand your concerns. If you look carefully in preop the eyes were different in size originally, but it has become accentuated after surgery because of the improvement in both lids,if your doctor had made you notice this in counselling you would not be so anxious.relax ,dont rush in to next surgeon,get back to your surgeon and voice your concerns, i believe it is best to wait for atleast 6 months, by then you will start noticing improvements, f you wait for a year you will start loving your results.  please continue massaging with contratubex after consulting your doctor.

hope this helps

Thangavel Ayyappan, MBBS, MS, MCh, DNB
India Plastic Surgeon
5.0 out of 5 stars 2 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.