Red bump on eyelid 2 months after eyelid surgery. Doctor has me on antibiotics and ointment but no change after 4 weeks. (photo)

Question

Hello,3 weeks after my upper and lower Blepharoplasty I started noticing a red bump along the suture line of the left upper eyelid and 4 weeks later along the suture line of the right eyelid.My surgeon decided to put me on various antibiotic both oral and ointment.After 4 weeks on treatment there as been no improvement and no worsening of the red spots which remain sensitive yet not painful.I have attached pictures and hope that someone will be able to help me find out the cause and the possible treatment for this issue.Thank uou

James H. Rogers, MD · Answer

Based on your history and your photos, the bumps you are experiencing are most likely either inclusion cysts or reaction to sutures placed deeply at the time of surgery. The latter will typically become inflamed and the area will open, extruding the sutures and then resolving. Inclusion cysts are very common after eyelid surgery and most resolve on their own. Occasionally, it is necessary to unroof a cyst with a sterile needle to correct the problem. Follow your surgeons instructions regarding care and further treatment.

Philip S. Schoenfeld, MD, FACS · Answer

The photos that you have provided demonstrate the presence of a suture granuloma of the upper eyelid incision site.  I suspect that there was a dissolvable suture placed in the upper eyelid for closure that will soon dissolve but may need a small steroid injection to calm it down.  I no longer use dissolvable sutures in the upper eyelids as issues with potential inclusion cysts, granulomas, and track marks are more common than you might think.

Dallas Buchanan, MD · Answer

Thank you for your pictures and questions. While a physical exam would be helpful, this looks to be most consistent with a suture granuloma or superficial abscess in the area. I would agree that treatment with antibiotics seems reasonable and some warm compresses in the area might also help. Stay in touch with your surgeon and if it does not resolve with antibiotics, then discuss other treatment options. Chances are, time will heal all.Best of luck!Dallas R. Buchanan, MD, FACSOwner & Board-Certified Plastic SurgeonVIVIFY plastic surgery

John J. Martin, Jr., MD · Answer

This looks like  a suture granuloma from a buried stitch.  They usually go away with some antibiotics.  If no improvement, may need injection of a steroid.  And if that doesn't work need to excise it.

Basim A. Matti, MBChB FRCS · Answer

Hello
This does look like a suture granuloma, if you have taken antibiotics and this has not settled I suggest you return to your Surgeon for advice.  This may need excising or a steroid injection.  Good luck!

Daniel M. Calloway, MD · Answer

Postoperative epidermal inclusion cysts are common along the incision lines, esp in upper eyelid blepharoplasties.  Simple unroofing is generally curative.  Once infected, it should be treated with warm compresses and oral antibiotics, and drained when possible.  Generally a common, and limited postoperative problem.

Red bump on eyelid 2 months after eyelid surgery. Doctor has me on antibiotics and ointment but no change after 4 weeks. (photo)

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