What is this bump under my lower eye? I had a midface lift, septal reset, canthopexy and orbicular muscle suspension (Photo)

Thank you for your question.

The contours in the photo suggest a small amount of fatty tissue primarily from the lateral compartment may be the source of the problem.

If you discuss this with your surgeon, they may be able to reduce it through a transconjunctival approach.

The alternative would be to enhance the cheek tissue with filler or fat transfer if it corresponds to your aesthetic vision.

During lower eyelid surgery, sometimes a complete removal of pseudo herniated fat pads is not performed and this can lead to a persistent bulge. Other possibility may be persistent injectable fillers in your under eye, if that was performed before surgery. I hope this helps. Sincerely, Dr Joseph

The short answer is that you had a lower eyelid blepharoplasty and there is some residual lateral fat pad herniation. A transconjunctival approach would likely all that would be necessary to address this area.

Based on this photo and short of in person evaluation, my first thought is a fat compartment/bag. In person consultation with a board certified plastic or oculoplastic surgeon would help. Good luck.

The point is that it is impossible to know without an in person examination. Often with these procedures, one sees irregularly healed lumps of fat. They do not always heal smoothly. An examination by an experienced surgeon who regularly fixes botched blepharoplasty permits an educated guess about the likely cause of this. That will determine what strategy is most appropriate for this. Generally fixing these is done through a transconjunctival approach. You need to find the right surgeon for this. That is not necessarily the original surgeon. This is no muscle bulge.

Dear kid,
This is a question for your surgeon. Only he or she knows exactly what procedure was performed and can answer the question satisfactorily. Good luck!

Normally, I would think it may be protrusion of the lower eyelid fat pads, but considering the amount of surgery, you’ve had I think it’s difficult to give you an accurate assessment based on the information provided.
Best,
Mats Hagstrom MD