One month post-op from Lower Bleph with complications. Is this normal? (Photos)

I am a 1 month post op. I have hard lump in the corner of my left eye and two under right eye. They don't look as bad in the picture as they do in person. Is this normal? I am using FML ointment in my eyes four times a day. I had the Frost stitch on both eyes . The right eye stitch was for one week, the left eye was stitched for 14 days.

Doctor Answers 7

There is nothing normal about your post operative appearance.

You are having a complication of lower blepharoplasty with frank ectropion, paralytic lower eyelid, and chronic corneal exposure.  This will get better with time.  However, I suspect that while it will get better with time, it will not heal to a point where you will not feel like more needs to be done to make lower eyelids better.  Generally the most important thing initially is dry eye management.  The lower eyelid functions as a windshield wiper for the eye surface and clearly your lower eyelids are not doing their job.  Provide the eye comfort can be managed, it is idea to let the eyes heal a full 6 months or more before deciding if reconstruction is needed.  Avoid being talked into having a "stitch" or "tuck" of the eyelids performed.  These will not fix the issues, use up important resources needed for the definitive fix, and can actually make the eyelids worse.  If your surgeon is not also a board certified ophthalmologists, you should be seen by an oculoplastic surgeon or general ophthalmologist because they will be more knowledgable regarding dry eye and chronic corneal exposure.

Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Lower eyelid blepharoplasty complications

At one month post-operatively you are still healing. Any lumps/bumps may be residual swelling and/or internal sutures. Give these lumps/bumps more time to resolve. As long as you see improvement in the appearance every week, they will likely smooth out with time. As for your lower eyelid "drooping," it appears you have some cicatricial (scar-like) ectropion/lower eyelid retraction. This is likely to improve a little with time but may not completely resolve and may need to be addressed with additional, "reconstructive," surgery. In the meantime, upward massage of the lower eyelids may help "soften" things. You also want to make sure to keep the eyes lubricated well as there may be a tendency for some dry eye. Revisional surgery should not be considered sooner than 6 months after surgery.Good luck!

Katherine Zamecki, MD, FACS
Danbury Oculoplastic Surgeon

Postoperative problems after lower eyelid surgery

I am sorry to hear of your difficulties after your lower eyelid surgery.  Based on your photographs, you appear to have a common condition of lower eyelid laxity (the margin of the lower eyelid position below the colored part of the eye known as the lower limbus).  With surgery of the lower eyelids, swelling, scarring and gravity all tend to pull the eyelid position down.  Add in the eyelid laxity, and the post surgical result may be an inferior malposition of the eyelids.  Unfortunately, this is an all too common problem encountered after lower eyelid blepharoplasties.To combat this potential problem, Frost stitches (sutures placed from the margin of the lower eyelids to the forehead) are usually placed to maintain proper lower eyelid position during the early healing phase in recovery, as was done by your surgeon.  If lid malposition occurs or persists, a secondary procedure for tightening of the loose lower eyelids may need to be performed.Good luck with your ongoing recovery!

Daniel M. Calloway, MD
Jacksonville Plastic Surgeon
5.0 out of 5 stars 46 reviews

One Month Postop

From your history, it sounds as if this was a revision lower lid blepharoplasty with initial moderate to severe lower eyelid ectropion.  You will most likely have improvement in the swelling and "lump' described.  The lower lid retraction may also improve but only time will tell.  Best to stay in close contact with your Surgeon at this critical juncture. 

Stephen Prendiville, MD
Fort Myers Facial Plastic Surgeon
4.8 out of 5 stars 93 reviews

Droopy lower eyelids after surgery

It appears you have ectropians(drooping of the lower eyelids). You are early in the healing process so they hopefully will come up. I would let the surgeon see you. If it doesn't resolve it can be repaired down the road if necessary.

Byron A. Long, MD
Marietta Oculoplastic Surgeon
5.0 out of 5 stars 3 reviews

Lower lid surgery

You are still relatively early in the healing process.  From your photos, the lower lids where the lashes are appear to be weak and not "sticking" to your globe.  I recommend you return to see your surgeon and discuss your progress and see what else he/she recommends during healing to help.

Jason J. Hall, MD, FACS
Knoxville Plastic Surgeon
5.0 out of 5 stars 11 reviews

Lower eyelid blepharoplasty

thank you for your question. It seems like your lower eyelids have some laxity that was not repaired during surgery, causing the eyelid to be pulled away from the globe.  I highly recommend you talk to your surgeon so he/she can have a plan to fix the problem.

Ana Carolina Victoria, MD
Miami Oculoplastic Surgeon
4.5 out of 5 stars 5 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.