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7 weeks post lower/upper bleph, still swollen and discolored under eyes. (photos)

7 weeks ago I had an upper/lower bleph with fat repositioning and a 20% tca chemical peel under my eyes. I still have swelling and brown discoloration under my eyes which makes me appear worse then before i had my surgery. I am currently using a skin bleaching cream twice a day to attempt to lighten the dark circles and I am icing my eyes to try and reduce swelling. What else can I do to fix these issues and when do you think this will (or can ) resolve? What is a realistic time limit for final results ?

Doctor Answers 5

Discoloration after TCA peel

April 14th, 2014
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  • This looks like post-inflammatory hyperpigmentation from the peel.
  • It is especially common in an olive skin that is not prepared with hydroquinone and tretinoin before the peel.
  • It often lightens over 6 months.
  • Hydroquinone alone is not enough. It may improve with 4% hydroquinone + 0.5% tretinoin in the evening and a glycoliccream in the morning. You must use a zinc oxide/titanium dioxide sun block at all times or the color promptly returns. 
  • Discuss with your surgeon adding these creams. .
  • The skin may still be too sensitive after the peel.
  • If you respond to the creams, glycolic peels or 15% TCA peels might further lighten the color. Best wishes. 
Elizabeth Morgan, MD, PhD
April 14th, 2014

Discoloration after TCA peel

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
  • This looks like post-inflammatory hyperpigmentation from the peel.
  • It is especially common in an olive skin that is not prepared with hydroquinone and tretinoin before the peel.
  • It often lightens over 6 months.
  • Hydroquinone alone is not enough. It may improve with 4% hydroquinone + 0.5% tretinoin in the evening and a glycoliccream in the morning. You must use a zinc oxide/titanium dioxide sun block at all times or the color promptly returns. 
  • Discuss with your surgeon adding these creams. .
  • The skin may still be too sensitive after the peel.
  • If you respond to the creams, glycolic peels or 15% TCA peels might further lighten the color. Best wishes. 
Elizabeth Morgan, MD, PhD

Pigmentation under the eyes

March 30th, 2014
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Dear Mich18,

I understand it is quite frustrating for you to have problems with pigmentation and swelling so long after your surgery.  However, I would advise to be patient.  It is possible (although fairly uncommon) to have prolonged swelling and bruising after blepharoplasty, especially when it's combined with the fat grafting.  Hydroquinone cream is unlikely to be of help in this situation and cold comprises may actually make the swelling worse.  I would recommend warm (but not hot!) compresses 2-3 times daily and a very gentle tapping massage around the eyes.  Be prepared that it might take another 2-3 month for things to start getting better.

Best wishes!
Dr. Konstantin

Web reference: http://www.bestcosmeticsurgeryny.com

Konstantin Vasyukevich, MD
March 30th, 2014

Pigmentation under the eyes

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Dear Mich18,

I understand it is quite frustrating for you to have problems with pigmentation and swelling so long after your surgery.  However, I would advise to be patient.  It is possible (although fairly uncommon) to have prolonged swelling and bruising after blepharoplasty, especially when it's combined with the fat grafting.  Hydroquinone cream is unlikely to be of help in this situation and cold comprises may actually make the swelling worse.  I would recommend warm (but not hot!) compresses 2-3 times daily and a very gentle tapping massage around the eyes.  Be prepared that it might take another 2-3 month for things to start getting better.

Best wishes!
Dr. Konstantin

Learn more: http://www.bestcosmeticsurgeryny.com

Konstantin Vasyukevich, MD

7 weeks post lower/upper bleph, still swollen and discolored under eyes.

March 28th, 2014
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Thanks for the question and excellent posting of photos. You have slight hyperpigmantation due to the TCA + surgery. I recommend 4 to 8% hydroquinone creams twice daily... 
Darryl J. Blinski, MD
March 28th, 2014

7 weeks post lower/upper bleph, still swollen and discolored under eyes.

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
Thanks for the question and excellent posting of photos. You have slight hyperpigmantation due to the TCA + surgery. I recommend 4 to 8% hydroquinone creams twice daily... 
Darryl J. Blinski, MD

I simply can't agree with Dr. Common that you look "fine."

March 27th, 2014
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I don't know precisely what you looked like before surgery but I clearly see your mid cheek groove coming down your mid face.  The discoloration almost looks like you are still bruise.  You might ask your surgeon to consider performing IPL to remove any residual blood elements in this area.  As frustrating at this sounds, I think you are probably still swollen and I would anticipate that in one or two months you will be substantially better.  I don't think that your issue related to your surgeon doing something "wrong."  I think the issue is that you have a very thin mid-face that just does not hide swelling well. Try to be patient and don't have goofy things done while you are healing.  This is not the place to go wild with steroids.  Do your best with make up and please let yourself heal.  I do not think that bleaching cream is going to help here.  I also do not think that you are helping yourself by icing.  My advice would be to leave this area along and let it heal for now.  Repost and let us know how you are doing with this.

Web reference: http://www.lidlift.com

Kenneth D. Steinsapir, MD

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

March 27th, 2014

I simply can't agree with Dr. Common that you look "fine."

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}
I don't know precisely what you looked like before surgery but I clearly see your mid cheek groove coming down your mid face.  The discoloration almost looks like you are still bruise.  You might ask your surgeon to consider performing IPL to remove any residual blood elements in this area.  As frustrating at this sounds, I think you are probably still swollen and I would anticipate that in one or two months you will be substantially better.  I don't think that your issue related to your surgeon doing something "wrong."  I think the issue is that you have a very thin mid-face that just does not hide swelling well. Try to be patient and don't have goofy things done while you are healing.  This is not the place to go wild with steroids.  Do your best with make up and please let yourself heal.  I do not think that bleaching cream is going to help here.  I also do not think that you are helping yourself by icing.  My advice would be to leave this area along and let it heal for now.  Repost and let us know how you are doing with this.

Learn more: http://www.lidlift.com

Kenneth D. Steinsapir, MD

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

Wound healing takes one year

March 27th, 2014
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7 weeks is just the beginning of wound healing.  You look fine.  All is NORMAL.  Relax and enjoy your surgery.   You will be just fine.  My Best,  Dr C
George Commons, MD
March 27th, 2014

Wound healing takes one year

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7 weeks is just the beginning of wound healing.  You look fine.  All is NORMAL.  Relax and enjoy your surgery.   You will be just fine.  My Best,  Dr C
George Commons, MD

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