Red/Purple Under Eyes - Normal After Upper Bleph?

Question

I had an upper bleph two days ago. I froze my eyes into a popsicle and havent bent over once but my under eyes are very red/purple. the top isnt bad at all. I know im a bruiser but yikes! Anything I can do to break up the redness? should I continue ice underneath? Or just on top? I never want to see another ice cube unless its floating in a cocktail. lol

Kenneth D. Steinsapir, MD · Answer

Yes upper eyelid surgery can cause lower eyelid bruising. Totally normal. Do not over ice the eyelids to punish the bruise. It will not make a bit of difference and you can harm your skin by over icing. Try to be patient. Follow the recommendations of your surgeons. We are not your surgeons! Please do not be tempted to order anything from the internet to make the bruise go away any time sooner. These products are ineffective.

Umang Mehta, MD · Answer

It is perfectly normal for patients to have some bruising and swelling above and below the eyes after upper eyelid surgery (upper blepharoplasty). You should follow the directions of your surgeon regarding ice and other measures to prevent or reduce bruising and swelling. 

	In my practice, I advise patients to ice for 15 minutes every hour (while awake) for the first three days. For the first two weeks, I ask them to sleep on three or four pillows to keep the head elevated. Supplements such as arnica montana and bromelain can also help to reduce bruising. They are also advised to avoid heavy lifting, straining, and vigorous exercise for two weeks. 

	As for recovery time, patients are up and around the day after surgery and able to perform most normal activities within 1 - 3 days. Pain medication is taken for around 3 days on average and many patients begin working from home 3 to 4 days after surgery. Stitches are removed on day 5 or 6. In general, patients look good enough to return to work or social activities approximately 10 days after surgery, once the bruising has resolved. 

	Best,

	Dr. Mehta

David Shafer, MD, FACS · Answer

Without pictures, it is impossible to give you specific advice.  However, two days after surgery, some swelling and bruising is expected.  Some patients worse that others and other patients better than some.  It sounds like you are doing everything right.  The swelling and bruising will go away quickly but at just two days post-op there is not need to worry.  If you do have any concerns, then you should contact your surgeons office and schedule a sooner follow up visit.

	 

	Good Luck.

Stephen Prendiville, MD · Answer

It is not uncommon for a patient who has had an uncomplicated upper Blepharoplasty develop bruising 24-72 hours after the surgery. Icing the yes and using Arnica Montana in addition to limiting physical activity will be helpful, worrying will not. Remember that the human body has a pre-programmed healing process that it is going to follow regardless of circumstance. The good news is that healing from upper lid Blepharoplasty is usually fairly rapid.

Robert W. Sheffield, MD · Answer

Thank you so much for voicing out your concern. This could be helpful for other people who are in the same shoes. After undergoing blepharoplasty, one of the possible after effects of surgery would include possible swelling, bruising, as well as redness. However, you do not need to panic about this as these are totally normal. They will gradually heal on their own with or without intervention from your end.  As for icing, this may be helpful if it were done immediately after the surgery, but if it is already 2 days from the surgery, icing may not be as helpful. Bruising or redness can disappear as early as 1 week. This is specially true for younger patients. Middle-aged patients however, may need to wait out for 2 to 3 weeks for the discoloration to fade out completely. Older patients may take longer time to recover from such staining.  This can be resolved with make up though, but make sure to consult your board certified plastic surgeon for permission regarding the use of concealers. Hope you find this helpful!

Rafael C. Cabrera, MD · Answer

totally normal. I see this after a brow lift as well. notice the area is stained, not bruised. if you touch them notice they are not sore. staining clears quickly because there was no trauma. don't worry.

Peter E. Johnson, MD · Answer

The upper lid will swell a bit after upper blepharoplasty, though the swelling and in particular the bruising, will become apparent in the lower lid. Anatomy and gravity is the culprit and the red blue color in the lower lid may stay around for three weeks after. The discoloration will pass and a concealer will help in the short term.
	Best of luck,
	peterejohnsonmd

Jasmine Mohadjer, MD · Answer

It is very normal for your lower eyelids to swell and bruise after an upper blepharoplasty. The fluid accumulates there mainly due to gravity. If you can sleep with your head elevated and avoid alcohol it helps it go away faster but really it just needs time! Good luck!

Jana K. Rasmussen, MD (retired) · Answer

Bruising and/or redness is expected early on after Blepharoplasty, regardless if upper, lower or both lids are treated. In your case of upper lid lift with bruising below, it is as a result of "dependency"....water runs downhill, and since head elevation is part of the early post-op regimen, the discoloration "goes south". Early intermittent icing is helpful, but now that you are 2 days out, it is unlikely that it will help. Because bruising is expected, I usually request my patients take Arnica during the peri-operative time frame, starting pre-op and continuing post-op. Arnica taken orally now may or may not be of benefit. Tincture of time is the best therapy. If you are "young", the discoloration will dissipate around a week; "middle age" patients may take 2 to 3 weeks, (but I usually permit concealer a week out); my "little old lady" patients may have persistent discoloration up to 3 months, although that is not typical. Follow your surgeon's instructions. If there is something out of the ordinary, more specific instructions would be given to you. Be patient!

Derek Lou, MD - Account Suspended · Answer

Bruising like you describe can be quite severe or ugly looking after blepharoplasty. This is most definitely the case for some people in the days to week after their procedure, even with all the cooling pads in the world. If you have significant concerns, contact your surgeon, but what you have is likely a routine postoperative issue. Best of luck.

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