Swelling, Ridges, and Hardness After Blepharoplasty

Question

I had lower Blepharoplasty done 6 weeks ago. One eye was perfect, the other had a ridge of swelling under the stitches and I noticed that a hardish area that is slightly raised was developing. I've been told to massage this area, but it still looks odd. Although I'm still seeing the surgeon, I feel that this will not correct itself. I feel that this should of been dealt with straight away at an earlier stage. Can you please advise me?

Kenneth D. Steinsapir, MD · Answer

Dear Leonardst
Without photographs and possibly a personal consultation, it is hard to know exactly your issue.
A great deal of healing takes place after eyelid surgery.  Issues that are present early after surgery (and you are early from surgery) have a way of improving over time.  Message will help.  Even without message this issues will improve with time.  As a rule of thumb, because of this tendency of all issues improving over time, it is best to wait 6 to 12 months before deciding that revisional surgery is needed.

William Portuese, MD · Answer

Incisions on the lids undergo a red and lumpy, bumpy phase at approximately six to eight weeks after the surgery. This will settle down and go away over time, usually in the next month or two. This is a normal healing process. If there is a red, hard, raised area that is hot, red, and tender, this might indicate an infected cyst that might have to be aspirated with a needle.

Samson Lee, MD · Answer

Unfortunately, like many things in cosmetic surgery, it takes a considerable amount of time for small irregularities to resolve. Massage or simple steroid injections can help. I would recommend waiting 6 months at least before considering any revision procedure as most of these small imperfections will resolve slowly with time. I wish you the best of luck.

George J. Beraka, MD (retired) · Answer

Hi.  If one side looks as you describe it , it may well become a permanent problem.I don't think massage will help at 6 weeks.
It is hard to tell what is wrong. Talk to your surgeon and get another opinion. Sometimes Kenalog injections are helpful.
If you do need a revision, in Manhattan we wait 6 months before going ahead with a secondary blepharoplasty.

Brooke R. Seckel, MD, FACS (retired) · Answer

Massage should help. Be sure to express your concerns to your surgeon.
The scar should be lightening and settling down at 6 weeks. If there is a defined lump, ask your surgeon if it could be a stitch abscess.
Topical steroid creams can help raised scars but ask your surgeon if she/he approves. If used you must avoid the eye itself.
I also use 1540 laser for scars that persist after 6-8 weeks. You will need scleral shields for eye protection if laser scar therapy is chosen

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