Puffiness 3 Weeks After Blepharoplasty

Three weeks after my lower blepharoplasty, my right eye became puffy and "bubbled". Last week, they were still looking great; smooth, tight, no circles, bruising gone. Then I woke up yesterday and they were puffy with circles, the right eye worse, looking as if I never had surgery. Today, the left eye went down and has improved, still a bit puffy but the right eye is worse. It looks as if I were punched in the eye, but without bruising. I don't understand why last week they looked great and now look as if I never had the surgery. What happened, and what can I do about this?

Doctor Answers 6

Check with your surgeon

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DemiGirl, While there are many factors that may contribute to delayed swelling around your eyes - including lymphatics, thin tissue, gravity - it is best that you have your surgeon examine your eyes soon to make sure that you do not have something more serious, such as infection or cellulitis, going on.

Be patient for your blepharoplasty results

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As everyone else has said, let your surgeon examine you, but most likely it will resolve on its own.

Time is your friend

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For post-operative questions or problems it is always important to contact your treating surgeon.

This may be within the range of normal healing since you're only 3 weeks out (although usually my patients have a large portion of the swelling resolved at this point). It sounds like the swelling had improved but some degree of swelling returned. After any surgery channels (called lymphatics) are disrupted imparing the body's ability to return fluid that may accumulate it tissue. Over time the body restores these channels.

In my San Francisco practice it recommend my bleph patients to sleep with their head elevated, use cool compresses and of course contact me if swelling does not improve.

Other causes could include reaction to suture or even seasonal allergies.

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Lymphatics heal slowly

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The lower eyelids drain the swelling through channels called lymphatics. These channels are injured during the blepharoplasty. Anything that causes excess fluid build-up around the eye can cause the swelling which you describe.

Things that can cause the swelling include:

  • Salty foods
  • Spicy foods
  • Sleeping on your face
  • Allergic reactions to foods or topical creams

However, with time, up to 6 months, the lymphatics improve and so will you.

Robert M. Freund, MD
New York Plastic Surgeon
4.8 out of 5 stars 34 reviews

Intermittent swelling after eyelid surgery is normal

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Usually intermittent swelling is normal post-blepharoplasty.  This may change with activity level, diet, amongst other things. The eyes may also be a bit more sensitive to changes after surgery and one response is swelling.

If the eyes feel irritated or dry, check with your doctor.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Follow up

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Great questions, I agree that the best thing you can do is schedule a follow up appointment with your surgeon. Being that you are only 3 weeks out of surgery, this could be a normal part of the healing process. Its most likely is just delayed swelling. Although, since there are no pictures provided to help give you an exact answer, schedule a follow up appointment with your surgeon. Best of luck!

Dhaval M. Patel
double board certified
Plastic surgeon
Hoffman Estates

Dhaval M. Patel, MD
Hoffman Estates Plastic Surgeon
4.8 out of 5 stars 99 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.