Post Blepharoplasty Swelling?

I am 31 days post-op from upper and lower blepharoplasty. There was no fat removed, just skin. I believe he did something with my muscle, but i'm not quite sure what. I have a dissolvable stitch on my right eye that you can see in the picture that hasn't gone away yet, and still quite a large bag under my left eye. As you can also see, my left eye is still larger than the right. Is it normal to still have this?

Doctor Answers 14

Try to give yourself permission to heal for now.

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.

Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Possibly due to Blepharoplasty swelling

Your eyelid size is actually not changed. What you are seeing is that the left lower lid is somewhat lower than the right. This may happen on occasion due to swelling, or traction on nerves, which causes the lid to not work that well for a while. Sometimes, this goes away by itself, and sometimes it requires additonal surgery. One thing that may help would be to support the lower lid with steristrips. Your doctor should provide you with some and teach you how to do it.

You have asymmetry and bags below the lower lids. I am not sure exactly why this is. You may want to ask your doctor about massage techniques, as this will help if there is residual swelling.

Scott E. Kasden, MD, FACS
Dallas Plastic Surgeon
4.7 out of 5 stars 101 reviews

Gently massage on lower eyelids to help reduce Blepharoplasty swelling

I agree with Dr. Steinsapirs carefully thoiught out answer. You need time to heal, and I feel fairly confident you will improve. The dissolving suture will dissolve, and hopefully the lump or fold created by it will resolve. I also believe that the suture is pulling down on the Right lower eyelid.

I would massage the lower eyelids 3 times a day. Place your finger near the inside corner of the lower eyeld and sweep out and up towards your ear. This will help the swelling resolve and hopefully speed the dissolution of the suture and smooth the fold in you right lower eyelid. It will also stretch the Right lower lid and help it move up toward the eye.

I cannot tell if you have malar bags or festoons at this point--the fullness on the cheek may just be swelling.

I am certain that with time and massage yoiu will look better.

I would not make any decision about revision until you are at least 6 months post op.

Discuss your dissatisfaction with your doctor-he knows the details of his procedure and should be able to explain your progress.

If you decide to see another doctor in 6 months, your current doctors records and op notes will be important--don't burn any bridges now.

You will improve, massage is important.

Too early to judge results following lower blepharoplasty

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. 

James R. Gordon, MD, FACS, FAAO
New York Oculoplastic Surgeon
5.0 out of 5 stars 140 reviews

Swelling is normal after Blepharoplasty

The swelling that you have experienced following your blepharoplasty is normal.  I advise my patients that after surgery they will most likely experience some noticeable swelling that will subside within two to six weeks.  Patients should know some minor swelling can remain for as long as six months, and their lid contours may continue to change.  Final results may not be seen until the six month mark. There are several exercises that you can do to assist with healing as well. You may also want to massage the lower lids.  I suggest discussing your concerns with your surgeon.  Best of luck, Dr. Clevens

Ross A. Clevens, MD
Melbourne Facial Plastic Surgeon
4.7 out of 5 stars 116 reviews

Swelling after blepharoplasty

Since it has only been one month since your blepharoplasty, there is still some swelling left in the eyelids although rather minimal at this point. With respect to the muscle, the operative report from your surgeon would delineate the extent of any muscle surgery that was performed. Any dissolvable stitches should be removed because they are not doing any good at this point. If there are still large bags under the eyes, these can be removed at three months after the surgery.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 143 reviews

Nothing too out of norm after Blepharoplasty here

As you are relatively short post operatively, many of the concerns you have written about will continue to improve. Lower eyelid surgery continues to be among the most challenging aesthetic procedures we do and the time for the results to mature also take proportionately longer to achieve the final result. The lower eyelid is quite dynamic and the constant motion of the lid gives rise to some of the appearances you are noticing. I agree with lower lid stretches and tincture of time.

Richard D. Gentile, MD
Youngstown Facial Plastic Surgeon
4.4 out of 5 stars 36 reviews

It will improve with time.

Your result will improve with time as the swelling resolves and the tissues settle. It looks like you need to massage the lower lids - especially your left lower lid. However, you should discuss this with your doctor first. Some patients have also found that Arnica Montana cream is useful to help resolve the swelling and bruising faster. Good luck with your recovery.

David Shafer, MD
New York Plastic Surgeon
4.9 out of 5 stars 75 reviews

Swelling Following Eyelid Surgery

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.

Richard J. Bruneteau, MD
Omaha Plastic Surgeon
4.9 out of 5 stars 194 reviews

See surgeon about suture

Maximum swelling is usually at about 3-5 days and goes away over a few months. You should sleep with your head elevated and cut back on salt to help the swelling. Please see your surgery regarding the suture, which should be removed if it hasn't been absorbed at this point.

Jerome Edelstein, MD
Toronto Plastic Surgeon
5.0 out of 5 stars 176 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.