Why is swelling under eye hard it's been a month? Why my neck looks so bad? (photo)

Question

I had full face lift to include upper and lower eye lid surgery with fat grafting. Under my left eye I'm swollen and it feels hard to the touch, on the right eye I have like fluid retention to the interior of the eye. My incision under my chin looks terrible and I have a double chin. Surgery was performed on 10/10/2013.

Kenneth D. Steinsapir, MD · Answer

It is very normal to go through a lumpy bumpy stage of healing in the 4 to 6 week range.  At a month,  your work looks rough.  I really to not care for how your surgeon did your eyelid surgery by extending the incisions so far.  Also it is nice when the lower eye incision is tucked closer to the eye lashes.  From your photos it looks like you will have many more week of facial swelling before things really settle down.  It may be that you will ultimately need revisional surgery but it is certainly possible that things will settle down with acceptable results.  For this reason, try to be patient.  If the whole process begins to weigh on you mentally out look, consider seeing a psychologist for emotional support while you heal.  No one likes this type of extend heal especially when the outcome is uncertain.

Kristina Tansavatdi, MD · Answer

The amount of swelling around the eyes is not unreasonable after the procedure you had done. I often tell my patients to expect swelling for 4-6 weeks after fat grafting to the area around the eyes. Some of the fat consistently dies and we often place more expecting this to happen. It appears that you also had a lower eyelid lift where they went through the eyelid skin and muscles for the approach. Any over-manipulation of the eyelid muscles can prolong healing in this area. Therefore, the two procedures in combination can lend to the longer healing time. The chin also has asymmetric swelling or possibly residual fat. I would talk to your surgeon about some techniques to speed up the recovery such as some light massage on the chin area and under the eyes via manual lymphatic drainage.

Chase Lay, MD · Answer

sometimes fat grafting can result in very dramatic swelling and bruising.  The fact that he had a facelift performed at the same time as your eyelid surgery and fat grafting makes sense.  This prolonged swelling and difficulty sometimes is seen when you perform a face or neck procedure that essentially prevents fluid and swelling resolution of eyelid procedures or fat grafting performed at the same time.  Not knowing the details of the facelift if you had an aggressive facelift or a deep plane facelift I wouldn't be too surprised by these prolonged issues.  However, all that being said a month is a bit of a long time.  Make sure you follow up with your plastic surgeon closely and don't be alarmed if they say he need to be patient because you will have to be patient.Again, U appeared to be healing slower than average but having had the facelift at the same time as these other procedures will prolong her situation.  The longest I've had significant swelling and bruising with eyelid procedures coupled with a facelift was approximately 5 weeks which was difficult for both the patient and myself.  This patient had had chemotherapy and radiation for a malignancy below the neck 5 years prior which may have contributed to some degree but ultimately she healed fine.Follow up with her plastic surgeon and see if there is anything that can be done such as steroid injection, oral steroids, and he need to rule out any ongoing infection.  Fortunately and infection would be unusual at this time.

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