Very tight eyelids following lower blepharoplasty, unable to massage upwards. (Photo)

You are vertically short of skin and tissue in the eyelid.  Massage and time can be helpful.  However, I am concerned that your eyelids are now too low.  The big test is really eye comfort.  This is unlike to improve much but the improvement that you do get will take a couple of months to develop.  Fixing this is highly complex and expensive but highly successful.  Follow your surgeons advice for now, avoid steroid injections which will atrophy the eyelid, and quick fix canthal surgery which will be unsuccessful and use up tissue needed for a definitive repair.  Read my free ebook cited below which has detailed information about this issue.

Keep massaging the lower eyelids. There are some scar medications that can be injected to help. Also do squinting exercises. If still problem after 3 months, see an oculoplastic specialist.

You are having some issues with cicatricial ectropion here. If you can't push the lid up then there is some scarring in the lid preventing this.  Some 5-FU injections can help loosen the scar tissue and make the massage easier.  Warm compresses are also good.  The lid may come up with time.  If it is still low at 6 months you will need a repair. 

Since your surgeon has seen you in person, I would definitely follow his or her advise. You are still fairly early in your recovery so yes, there is a good change that things will relax. It will take about 3 months for 80% of the swelling to subside so wait until the 4-6 month mark before assessing your final results. My best,
Dr. Sheila Nazarian
@drsheilanazarian on Instagram

Hi lowerbleph23, Thanks for your question and photos. This is a common issue with transcutaneous lower lid blepharoplasty when combined with skin excision. In the photo of you looking upwards, there appears to be an ectropion (or outward bowing) of your lower lid. However, in the photo of you looking straight ahead, your lower lid position looks fairly normal. At just 3 weeks post-op, unless you are having eye irritation, blurred vision or pain, I would encourage you to remain patient and continue with the lower eyelid massage as best you can. If you continue to have concerns, I wouldn't hesitate to contact your surgeon to discuss. Good luck!