Going on 5 weeks post-op lower bleph (Photo)

Third post follow-up. Had a 4-week checkup with my ps and he was positive about the healing and felt confident that the puffiness is swelling that will improve. He wanted to give an injection to soften the firmness under the lids but I couldn't do it that day as I had work. I'm still very concerned about the right eye being puffier and looking like residual fat bag. Look at it everyday and barely see any changes! Will it ever improve like the left eye? I'm very grateful for this site.

Doctor Answers 8


Thank you for your question. I agree with your facial plastic surgeon that your healing is going well. Similar to the before photo, your swelling underneath the right eye will heal in time as well. Because tissue is being removed, one will always look better than they would have had they not had the surgery. Keep in mind that eyelid changes do not occur as rapidly after surgery as changes in other areas might. Always consult with a board certified facial plastic surgery.  

Best wishes,

Melbourne Facial Plastic Surgeon
4.7 out of 5 stars 93 reviews

Puffy eye

It might get better and it might not. Best to give it  6 months or longer. Best of luck with your results.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 24 reviews

Hey, there is no question that you look better with the surgery.

At the same time, because there is still lower eyelid fullness, it is completely understandable that you are disappointed.  Five weeks after this surgery is still pretty early.  If this eyelid contour issue does not resolve by 3 to 4 months, then I would encourage you to seek second opinions.

Kenneth D. Steinsapir, MD
Los Angeles Oculoplastic Surgeon
4.9 out of 5 stars 23 reviews

Lower blepharoplasty modest improvement

You certainly have improvement from pre and post op! I think some of your concerns has to do with the technique that was used. It is clear that a transconjunctival lower blepharoplasty was accomplished, but without some fill to the cheeks and a slight pinch of skin, I think you are going to see some excess. 
If you think about the aging process, we don't gain weight around the eyes. Rather, there is facial sag that makes the eye bags appear more prominent (look at a baby) and laxity in the orbital septum/skin that is holding back you eyebags. 
I think when all is done swelling (which I would wait a full 2 months), you could consider fillers to your cheeks carefully placed to tent up the periocular skin area. 

Lily Lee, MD
Pasadena Plastic Surgeon
5.0 out of 5 stars 22 reviews

Post-op lower blepharoplasty

You are still healing - so not to worry! The process of healing continues for many months, 6-12 or more - but during that time frame you should notice that the fat pad area becomes softer to gentle touch. Typically the lid returns to normal soft texture between 4 to 6 months. During that time, the contour improves considerably. If there is any residual puffiness there after 6-12 months (the longer the wait the better), then it can be corrected with touch-up surgery. Between now and then - you could elevate your head on pillows at night - if you are a side sleeper, try not to sleep on your left side - avoid heavily salted foods. Surgeons have different post-operative instructions and treatments. I don't inject anything into the lid after surgery as this just adds volume to the fat pad area and leaves a repository of medication which may also be palpable - others have different opinions. It looks like you are off to a great start on your healing - best wishes.

Sara A. Kaltreider, MD
Charlottesville Oculoplastic Surgeon
5.0 out of 5 stars 3 reviews

Swelling after lower eyelid surgery

you are healing well. The swelling may take longer, you have to be patient. Follow up with you surgeon regarding your treatment. 

Kevin Sadati, DO
Orange County Facial Plastic Surgeon
4.9 out of 5 stars 179 reviews

Swelling after lower blepharoplasty

Hi Pekkle,

Thanks for your question and photos. It is really early to tell exactly how things will turn out. A blepharoplasty swelling can be gone in a couple of weeks or last months depending on how your body heals. It certainly looks better but NOT perfect. You seem to have some residual fat and/or excess skin laxity.  You may benefit from some filler to improve the nasojugal fold or crease you see in your photos. But the only person that knows what was done is your surgeon. Please seek their advice as to see what you may need, filler, time, or skin removal in the future. Regardless of what it looks like now, the issues can be corrected in the future if necessary. Please be patient and discuss your concerns with your plastic surgeon! I recommend lymphatic massage in the mean time to help remove some of the swelling that may remain! Good Luck!

All the best,
Carlos Mata MD, MBA, FACS
@blepharoplasty @swelling 
facebook @breastdoctor
twitter @docmata
instagram #drcarlosmata
Board Certified Plastic Surgeon

Perfect results don't often happen

but marked improvements do and you have a marked improvement at this time.  The swelling could continue to improve and it also may not.  Bottom line, you have a significant improvement over where you started from and further flattening/tightening can be achieved with minor office procedure such as laser or ThermiSmooth.

Curtis Wong, MD
Redding Plastic Surgeon
4.8 out of 5 stars 32 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.