6.5 months post op lower blepharoplasty. What can I do to make swollen pockets of fluid/bruising go away? (Photo)

Question

Six and a half months after my lower blepharoplasty, I still have small swollen pockets of fluid/bruising that are obvious. They are about the size of a quarter. Surgery was February 28, today is September 17. What can be done to make them go away? I posted this question before and several doctors mentioned they would like to see a picture, so I've included them in this post. I do have a follow-up with my surgeon on Wednesday.

Bryson G. Richards, MD · Answer

The issue you are describing are visible festoons. This isn't necessarily your lower eyelids. They can be "wet" festoons that appear as swollen pockets of fluid, or "dry" festoons that are just skin excess along the eyelid/cheek junction. A direct excision can remove these and smooth out your lower eyelid/cheek junction. The lower eyelid blepharoplasty looks great.I hope this helps and I have included a sample photo.

John J. Martin, Jr., MD · Answer

This swelling can occur after a lower lid surgery, and unfortunately is tough to eliminate.  With time it should improve.  Laser resurfacing will often help by tightening the overlying skin.  Microneedling with radiofrequency may also help to tighten the area.

Kenneth D. Steinsapir, MD · Answer

You asked if these pockets of fluid and bruising would go away? What you are showing is not likely to represent pockets of fluid or bruising at this point. However, they are consistent with significant bruising and swelling after lower eyelid surgery.  If you experienced severe bruising after your lower blepharoplasty, that is a likely basis for why you have these skin irregularities. These are not fluid pockets. These are likely skin irregularities from organized scar related to severe bruising. Ironing these out is likely to require reconstructive lower eyelid surgery in my opinion. In your after photographs, you are looking down into your camera. This tends to hide shortening of the lower eyelid. In considering surgical improvement of the festoons, an assessment of the lower eyelid should be performed as any contributing issue in the lower eyelid should be addressed as part of surgery to improve the skin irregularities. I do not believe that more time or minimally invasive methods will smooth out the cheeks.  There is no substitute for a detailed personal assessment.

Jeffrey Joseph, MD, FACS · Answer

Thank you for the question.  Although difficult to tell by picture alone, you may have malar edema. Although there is no quick means of resolving this, it happens and limiting your salt intake and some lasers can speed up the process.  Discuss with your surgeon to get their ideas.

Lucas Bryant, MD · Answer

Thanks for your question. I agree with the other comment that you need to make sure and follow up with your surgeon about this. Without actually performing the procedure, knowing what your photos looked like beforehand, and knowing what type of procedure was done etc, it's very difficult for us to offer any advice. There are a variety of interventions that can be offered to treat your concern, but knowing WHEN and WHICH ONE should be entrusted to your board certified surgeon.  Warm regards.

Ross A. Clevens, MD, FACS · Answer

Thank you for your question. When you follow-up with your surgeon tomorrow, you will likely receive a better timeline to reach your full recovery. There are touch-up lasers that can improve laxity and skin appearance. Feel free to ask your board certified facial plastic surgeon about your recovery expectations during your consultation tomorrow.
Best wishes,

Michael Elam, MD (retired) · Answer

Dear smudgetoes, It is good you are going in to see your surgeon for follow up.  As he/she knows best what techniques were used during your procedure, where you are in the recovery phase and can then best advise you of options to promote your healing. Best regards, Michael V. Elam, M.D.

6.5 months post op lower blepharoplasty. What can I do to make swollen pockets of fluid/bruising go away? (Photo)

Answers (7)

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