I'd recommend you discuss your concerns with your surgeon. If you are comfortable with the care you are getting, and your surgeon is very experienced with lower eyelid surgery, I'd be patient. I'd expect improvement over the next month. If you are two months out and still have a problem then I'd get concerned and consider a second opinion.
Andrew Campbell, M.D.Facial Plastic SpecialistQuintessa Aesthetic Centers
Healing after eyelid surgery
As you begin to heal, the swelling and tone of the lower lid should improve. It does take time and in some patients, it can be a little longer than others. The same goes for the dry eye. Depending on your predisposition for dry eyes, it can take up to 12 weeks for resolution. You should follow up with your physician to inform him or her of your concerns so they can monitor and treat as appropriate.
Drooping lower lid after blepharoplasty
You are describing either retraction of the lower lid margin or ectropion of the lower lid margin. This should show steady improvement week by week after surgery. If it shows no improvement, it is not related to swelling, and septal issues could be the source of the problem. Many surgeons have their patients massage the lower lid upward multiple times a day to soften the tissues and separate adhesions of the septum that are pulling downward. If ectropion is the issue temporarily splinting the eyelid with a bolster, steri-strips or tape might help. Chemosis or swelling of the conjunctiva can play a role also. Your eyelid can be revised or corrected at any time with an office procedure - so there is no reason for you to have to deal with it over months, particularly if the lid is obviously not in a normal position and you don't feel like you can be seen in public because of the eyelid. Return to your surgeon and get the answers based on your examination. If you are not happy, then a second opinion would be in order. Best wishes!
The dry eye needs medical management.
If your surgeon is not familiar with how to treat dry eye, please see your general ophthalmologist. The lower eyelid droop is a different matter. These generally do not recover on their own. Do not let your surgeon "put a stitch in." You may need the tissue that can be removed when that stitch is put in. Often surgeon minimize what they plan to do to reposition the lower eyelid. However, this tissue needs to be conserved for a definitive repair. Provide medical management is working, this revision surgery show be done if needed about 6 to 12 months after the original surgery.
Dry eye and droop post lower blepharoplasty
Without an examination it is difficult to give an opinion, other than I would recommend you get a consult from a board certified ophthalmologist/plastic surgeon now rather than waiting. Massage upwards sometimes helps, as does taping, but I would recommend it is worth getting a second opinion, now before scarring holds things down. It may not be needed, but without an examination, one can not be sure.