Steroids if no steroids after lower bleph?

I am assuming you are talking about oral steroids with your question.  Many surgeons will use a 6 day course of low dose steroids which are tapered over the 6 days, and patients say this can help significantly with their swelling. A low dose is used to help diminish side effects.  Some patients will complain of poor sleeping with the steroid.  And if you are a diabetic, you will have to carefully monitor your blood sugar as the steroid can make your glucose levels rise.

Steroids can be used in a variety of forms and to treat various conditions.  Some surgeons may use steroids with cosmetic surgery and others may not.  Generally speaking, I do not prefer to use injectable or oral steroids with cosmetic surgery unless there is a specific issue I am treating.  For lower blepharoplasty, I prefer to use an eye drop with a steroid in it to help prevent swelling that can develop in the eye after surgery.  I generally have patients use these drops for a week after the procedure.      

Steroids are immensely helpful when used correctly.  They are not without profound potential complications that can vary from tissue atrophy to actual permanent loss of vision. For this reason, considerable clinical judgement is needed to best use this product.  If your surgeon is contemplating injecting steroids after eyelid surgery, it means you are having a complications and honestly many of these are not benefited from steroid injection.  The reason for this is that the lid is generally pulled down after surgery ( a common indication for steroid injection after lower eyelid surgery) not because of scaring but rather from motor nerve damage due to the actual surgery.Oral steroids are another matter.  This can be useful if there is unusually severe swelling after surgery.  Risk for tissue damage is small.  However, there can be significant side-effects including psychosis.  In 20 years of practice, I have had to admit two patients to psych hospitals for a couple of days as a result of steroid related psychosis.  It does cause one to respect the power of these medications.Still there can be very good reasons for using these medications despite the potential risks. Making these decisions and advocating for you is the job of a good cosmetic surgeon.