Extremely Red Eyes After Blepharoplasty and CO2 Laser

Question

I had an upper and lower Blepharoplasty on Jan 15, 2009, performed with a CO2 Laser and the area below my eyes is still extremely red. Is this normal?

David Shafer, MD, FACS · Answer

Redness after laser resurfacing is expected.  It will subside with time, but it may last awhile.  It is okay to cover it with makeup the best you can.  When it heals, you should have nice smooth skin.

Kenneth D. Steinsapir, MD · Answer

Dear Kele
A picture is worth a thousand words and would be very helpful here to know exactly what you are talking about.
CO2 Laser resurfacing creates a profound thermal injury of the skin that must be healed.  This can take many months to resolve.  However, it can also be indicative of the formation of a subdermal scar.  Your treating surgeon should be closely monitoring your progress.  When the subdermal collagen formation, which is a necessary part of why laser firms the skin, is too much, scar and excessive skin contraction can occur.  This type of reaction can be modified with 5-FU, topical and injectable corticosteroids if necessary.
Persistent inflammation in the skin can also lead to post inflammatory hyperpigmentation which may need treatment.
I would encourage you to contact your treating surgeon can discuss your concerns with that person so you can be reassured or, if necessary, treated.

Mark Berkowitz, MD · Answer

As an Ocular Plastic Surgeon in Sterling Heights, Michigan  Laser Blepharoplasty is one of my favorite procedures.  I am not clear from your question whether you are asking about the skin or the eye itself being red.  So I will answer both!
In regard to the skin: Laser eyelid surgery caused a controlled thermal injury to the skin like a sunburn.  It can take weeks, up to months, for the rosiness to improve.  It should be easily covered by mineral make up.  Your cosmetic surgeon should have you on an after care skin care regimen to hasten this redness and improve texture as well.  If the skin is extremely red or purple after 6 weeks you need to speak to your physician as it is possbile that you may have an infection.
In regard to your eyes: redness after blepharoplasty ( 6 weeks post op) is most likely related to dry eyes.  This is especially true this winter in Michigan with the heat on so much.  Your eyes are more open after the surgery and more air is hitting against them drying them out.  If artificial tear drops 4x per day and a humidifer at bedside do not improve the problem you should speak with your ophthalmologist and make sure there is not an infection.  It is also important to have your cosmetic surgeon make sure that your eyes fully close after the surgery and this is not leading to dry eyes at night.

Robert W. Sheffield, MD · Answer

Hi! Thank you so much for bringing your question up! Procedures like CO2 laser and blepharoplasty all have after effects that patients may or may not experience. If you experience them though, they are not entirely uncommon. One of these surgery after effects include redness. As far as I am concerned, this is one of the things that I notify my patients prior surgery so they would know what to expect.  Redness can improve on their own, however, the speed is not like the usual redness that would go away after a few minutes or hours. Redness from surgery procedures and lasers may take a while to subside. Some may take 3 months but others may take up to 6 months to completely heal. If the redness still bothers you or stays longer than indicated, you can consult your board certified plastic surgeon for evaluation. He or she can help in determining how long the redness may still take to fade away. Hope you find this helpful!

William Portuese, MD · Answer

The lower eyelid skin after carbon dioxide laser will remain red and swollen for upwards of six months depending upon skin type. This is a normal reaction to the CO2 laser. Carbon dioxide laser is a thermal burn to the skin, and it takes six months to heal.

Christopher L. Hess, MD · Answer

Although the CO2 laser is the gold standard for ablative skin resurfacing the problem with it is the redness. I've seen it last for 6 months. So hang in there and remember, your eyes will eventually look fantastic.

Shain A. Cuber, MD · Answer

The laser causes different skin reactions in different patients. In some patients, the redness can go away in 2-3 weeks. These are usually fair skinned patients. In some people, it can take 4-5 months, and these are usually darker skinned patients. The redness always goes away and barring any final pigment abnormalities the final result should be nice. You can certainly wear makeup to cover up the redness in the meantime.

Amir Moradi, MD · Answer

Co2 laser targets water in the skin generating heat and destruction of the superficial layers. Due to transfer of heat and thermal damage to the deeper skin tissue an inflammatory process takes place which leads to redness of the skin. This redness usually takes about six months to clear dependinng on the amont of energy that was used. One needs to be patient as the majority resolves without any problems.

Kenneth R. Francis, MD, FACS · Answer

Kele,
CO2 laser resurfacing can redden your skin for up to several months after treatment.  Your surgeon may be able to give you some advice or treatment to decrease the redness.  I suggest returning to him/her for follow up.  Good luck!

Steven Wallach, MD · Answer

Redness after laser treatment on the lower lids can be normal, even after a few months. You have to be patient and it should get better over time.

Extremely Red Eyes After Blepharoplasty and CO2 Laser

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