1 month post blepharoplasty and I have a large bag under my left eye. Is this normal? Is it swelling? (photo)

Dear Daisy
I suspect that you are unhappy with your surgeon. For certain you are unhappy with your eyelid surgery. It is very important to realize that you are very early from your surgery. Yes you appear to have some issues. The real questions is how will the eyelids look when the dust settles. It is important to not let yourself by driven to distraction while you wait for the paint to dry. God knows this can happen. I have seen pretty level headed people do that way. At this time, there is absolutely nothing to do put wait out the swelling.
How long do you need to wait. Well it is true that most surgeons will be reluctant to try and judge the outcome of your surgery for 6 to 12 months. If you try to have something done before this time, you are basically making your surgeon treat swelling.
The real question is what will the results like once you have healed-is it every thing you wanted or is something further needed to allow you to realize your goal. If there is still an issue, is it significant enough to live through another round of swelling and recovery to achieve this difference and if so, can it be achieved or is the further degree of improvement so small that it is unrealistic to expect to achieve it?
I find that recovery can be very psychologically stressful and often loved ones are not as sympathetic to these feelings because unlike medically necessary surgery, you choose to have this procedure. Of course this lack of support can take its toll. Consider finding a counselor or a psychotherapist to help you deal with you feelings of anger and frustration if these are a significant part of your daily thoughts as you recover. Feeling better may not change how you ultimately feel about your surgery but it will help you channel your energy in a more productive way while you recover.

It's not unusual for patients to develop swelling following blepharoplasty surgery. In some cases this swelling may be prolonged and take time to resolve. Although swelling is the most likely explanation for the puffiness of your lower eyelids, other explanations may also be possible. Since fat wasn't removed during your procedure, retained fat is also a possible explanation.Although, your history and pictures are helpful, it's virtually impossible to make this differentiation without a physical exam. Even a physical examination might not totally clarify the issue.For this reason, a conservative approach is probably indicated in someone who's only four weeks post-op. This should include head elevation, low salt intake and eyelid massage. After six months, if no improvement has occurred, revisional surgery should be a consideration.It's important to maintain close contact with your plastic surgeon. If revisional surgery proves necessary, your surgeon should be able to outline a treatment plan that addresses your anatomic findings and aesthetic goals.

At 1 month the eyelids are still in the healing phase. If they remain puffy or asymmetric at the 6 month point, then an enhancement can be performed. It is MUCH better if your surgeon was overly cautious and under corrected your lids rather than over correcting them, because it is easier to fix.