4 weeks post op Chalazion surgery, I'm swelling and have ptosis. Can it improve over the next few months?

If you had multiple chlazions removed you may still be swollen and inflammed.  This can cause a temporary ptosis.  It would be very unlikely that a chalazion removal would damage the levator muscle.  So it should come back up with time.  If you are getting multiple chalazions you should consider going on Doxycycline to help improve the secretions from your glands.  It is not a good idea to be removing chalazions on a regular basis as this will cause scarring of the eyelid with possible complications in the future.  It can also affect your tear production.     

Yes, your ptosis may improve over the next year.  The added weight on the eyelid from the swelling may be causing the ptosis.  If this is the case as the swelling goes away the ptosis will improve.  Sometimes, the chalazion and the manipulation to try and make it better can cause the muscle to stretch which causes ptosis.  This may need a surgical repair.  Either way I would wait at least 6 months to see if it resolves on its own.

Chalazions and eyelid swelling can cause mechanical ptosis.  This almost always improves as the chalazia resolve but can sometimes be permanent.  It can take 6 months for complete resolution of the ptosis and I would wait before considering surgical correction of the ptosis.

Thank you for your question and photos. Swelling of the lid and decreased movement is normal after this kind of surgery.  As the swelling resolves, the lid ptosis should improve significantly. Follow your doctors instructions closely.  Best wishes.