Swelling Under Eyes After Upper Eyelid Blepharoplasty

I don't understand why my lower eye area would be swollen after an upper bleph. It looks like pockets of fluid after an upper eye bleph. How long will the swelling last?

I also had restyalne injected before upper bleph in the lower eye area. Is this the problem? It looks bad. Will the swelling to away at the lower eye area?

Doctor Answers 12

Lower eyelid Swelling after Upper Eyelid Surgery

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It's common to have swelling and bruising in other areas of the face and eyes, even though plastic surgery was not necessarily performed in those areas. This extension of facial bruises & swelling is due to gravity and the natural movement of fluid in the tissues.

Ice to eyes after cosmetic eyelid surgery is most useful during the first 48 hours. I advise cosmetic patients to keep fresh, clean ice pack over surgical wounds while they are awake only for the first 2 days. After the first 2 days, ice does help control swelling but is much less effective. I still recommend using ice for the first week, as tolerated. Each plastic surgeon has a preference based on the procedure and each specific patient.

Keep your head elevated at all times, and avoid bending over. Sleeping on top several pillows or in a chair also helps reduce facial swelling after cosmetic surgery.

I advise patients to strictly avoid lifting, straining, or any strenuous activity (including sex) for at least 2 weeks following facial plastic surgery. This activity restriction helps healing during the recovery period.

Some plastic surgeons also prescribe a steroid pill, such as prednisone, to control post-procedure swelling and help in recovery.

Although, most swelling after eyelid surgery resolves in a couple weeks, it really takes longer for the final swelling to go away.

Speak with your eyelid surgeon regarding swelling.

Swelling of lower eyelid after Blepharoplasty is common

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With all facial plastic surgery the swelling from surgery will gravitate downward due to gravity. From upper blepharoplasty to the lower eyelids, from lower blepharoplasty to the cheeks, from cheek or midface lift surgery to the jawline and neck. This swelling will resolve. Taking homeopathic Arnica Montana and Bromelaine can help.

Upper eyelid lift

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Yes, it is not uncommon to have lower lid swelling after upper eyelid surgery because the swelling moves to dependent positions due to the effect of gravity, before it finally resolves. If you had a recent filler treatment prior to surgery, while the filler is not the cause of the swelling, it may take longer for the swelling to go away since multiple procedures in the same time frame can contribute to prolonged swelling. By one month after surgery, most of the swelling should resolve but everyone heals differently.

Anita Mandal, MD
Palm Beach Facial Plastic Surgeon

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Lower lid swelling after upper blepharoplasty

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The lower lids are swollen after upper blepharoplasty because of gravity and dependent edema.

We do not recommend Restylane injections into the eyelid area for fear of injecting into the orbital septum, which can create a longstanding puffiness that may last several years. It is still acceptable to undergo a lower blepharoplasty even though you had the injections performed.

Swelling of the Lower Lids After Upper Eyelid Lift

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It is VERY common if not the norm for the lower lids to get swollen after an upper lid lift. This is due to that annoying thing called gravity. Swelling from the upper lids track down the deep planes of the tissues which connect to the lower lids.

I have my blepharoplasty patients use cold compresses for 48 hours then warm compresses to help the edema subside. Sleeping more upright, such as in a recliner, can also help. Despite what you might hear, eyelid surgery takes longer to recover from then typically advertised.

Surgery and Restylane increase eyelid swelling

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Eyelid surgery routinely causes some swelling. Fluid in the eyelids is affected by gravity, so you can get swelling in your lower eyelids even when you have had upper eyelid surgery.

Restylane is hyaluronic acid, a natural substance that attracts and holds onto water. If you have Restylane in your lower eyelids, you are much more likely to collect fluid there after you have had eyelid surgery.

If your surgery was done recently, your eyelid swelling will naturally get better over time. It can be minimized by keeping your head elevated as much as possible, limiting your salt intake, and controlling any ocular allergies that might be present. If your swelling persists, your doctor may consider dissolving some of the Restylane with hyaluronidase so that your lower eyelids won't attract so much fluid.

Good luck!

Nancy Swartz, MS, MD, FACS
Philadelphia Ophthalmologist

Swelling of the lower eyelid with upper eyelid surgery.

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This is very common and may be aggravated by the Restylane use but should be markedly improved by 7-10 days. If it lasts more than 6 weeks you may want to consider the off label use of hyaluronidase. In the meantime, sleep with your head elevated, consider cool compresses and inquire about the implementation of manual lymphatic drainage.

Post-Operative Eyelid Swelling

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It's not unusual for patients to develop swelling in the periorbital region after upper lid blepharoplasty. In the vast majority of patients this swelling is transient and resolves in about one to two weeks following surgical intervention. Unfortunately, in some cases, swelling may be persistent, lasting for several months following surgery.

It's not uncommon for this swelling to extend into the surrounding soft tissue. When this happens, gravity can have a significant impact upon the location of the swelling. This often results in dependent edema which not only impacts the upper eyelids, but the lower eyelids as well.

When this situation arises, it's important to avoid strenuous activity, maintain head elevation and utilize low salt diets. When these steps are take, resolution of swelling is facilitated.

If you're concerned about post-operative swelling, it's important to consult your plastic surgeon. Your surgeon should be able to address your concerns and alleviate your anxiety.

Lower eyelid swelling post upper lid surgery

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Your question is helpful for many patients who often have similar concerns. The swelling (edema) following upper eyelid surgery migrates downward to the lower lids due to gravity. There is nothing unusual or worrisome about this. Fortunately, the swelling typically improves significantly during the 2 weeks post op period. Thank you for the question.

Swelling after blepharoplasty

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Maximum swelling is usually at about 3-5 days and goes away over a few months. You should sleep with your head elevated and cut back on salt to help the swelling.

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.