Is this swelling under my left eye normal 3 months after Blepharoplasty? (photo)

My surgeon tells me this swelling is the muscle, which was never this prominent before. My eyes were just barely starting to show signs of age. Now they are worse after this procedure. I had dot laser at the same time. He says if I have it again it could help and tighten the skin and make it less prominent. Does this appear to be muscle? Have you seen this? Why is it not symmetrical?

Doctor Answers 3

Lower lid blepharoplasty

You do have some swelling in the area of the muscle, and also some hollowing right below it.  Swelling can last for 4-6 months, although this asymmetry is a bit unusual.  If you still see this at 6 months you may need to consider some filler to decrease the hollowing.  Was fat excised?  

Coral Gables Oculoplastic Surgeon
5.0 out of 5 stars 27 reviews

Lower Lid Swelling

Hi susieqmom, 

Thanks for your question. Based on the photo you provided, I can appreciate some lower lid fat prolapse (bags under the eyes). There may also be some malar edema (swelling over the cheek bone). Lower lid fat prolapse and malar edema is rarely exactly symmetrical and we see it quite frequently. Typically, the lower lid fat prolapse responds nicely to a lower lid blepharoplasty with fat transpositioning. The malar edema may be more difficult to treat. 

I would recommend you seek a second opinion with a skilled oculoplastic surgeon in your area if you have questions regarding your care. Hope this helps, good luck!

John McCann, MD, PhD
Sandy Oculoplastic Surgeon
4.8 out of 5 stars 4 reviews

Post op swelling vs. asymmetry

We would really need two things to answer this question thoroughly. 

# 1 we need the operative report to see what exactly was done. Was this a 4 lid bleph? Was the lower lid manipulated? If so, was the orbital fat was repositioned or removed? Repositioning is taking the fat from the orbit and repositioning it over the orbital rim. In my hands this is the best way to treat lower lid bags. Often times I also combine it with laser to tighten the skin and/or a lower lid skin pinch.

# 2 I would need to do a physical exam to see if it was muscle swelling or fat malposition. 

This is very treatable and asymmetries are the most aggravating part of ocular surgery as any imperfection shows. 

Hope this helps. 

Best of luck, 


Benjamin Caughlin, MD
Chicago Facial Plastic Surgeon
5.0 out of 5 stars 10 reviews

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