Tightness and Swelling Post-Blepharoplasty (photo)

I had incisional double eyelid and lower blepharoplasty a month ago. One of my eyes isn't recovering well; the eyelid is still swollen and feels a little tight. The other eye is also bigger than the other. Is this normal, and will it eventually get better?

Doctor Answers 13

Swelling takes severeal months

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Swelling takes several months at the least when performing asian eyelid surgery. The problem of doing anything with two side by side structures - eyelids, ears, breasts - is that swelling may not happen at the same rate. if you sleep on one side, then your swelling will be different from side to side. If a small blood vessel bled a little after surgery - a normal occurence, then that side will be more swollen. in the end, be patient and let the healing process take its course.

New York Plastic Surgeon
4.8 out of 5 stars 34 reviews

Wait a little longer for swelling after Blepharoplasty to resolve

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One month after surgery is still quite early to make a determination of the final result. When you reach the three-month mark, then you will have a much better idea of how the folds and eyelid position will look. It is not unusual to have some eyelid asymmetry in the early period, but after approximately 3 months you will have a much better idea of the final shape and position and your surgeon can determine if you need to have your lid and crease position revised.

Charles K. Lee, MD, FACS
San Francisco Plastic Surgeon
5.0 out of 5 stars 16 reviews

After Asian Blepharoplasty, healing will take months

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After surgical procedures, the healing process will continue for months, although in most cases, a good deal of swelling improves in the first month or two. In the case of lower blepharoplasty, there is sometimes a risk of tightness where the lower lid can pull downward. This can often be improved with upward massage on the eyelid during the recovery period. If your right eye is more prominent (it naturally bulges forward more), this can also make that eye appear to be more open. These issues can be addressed by your surgeon. Good luck!

Brett S. Kotlus, MD, MS
New York Oculoplastic Surgeon
5.0 out of 5 stars 63 reviews

Tightness and swelling after blepharoplasty will improve

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The tightness and swelling of your lower eyelids will improve, but after a month I would expect you to be less swollen. Ask your doctor is he/she approves of massage which can help the swelling and also may help the retraction of your right lower eyelid.

The fact that your right eye looks larger is due to the retraction of the right lower eyelid-this may require future revision of the right lower eyelid does not soften and stretch upward with time. See your doctor and be sure to continue to moisturize the eyes.

This can take a little longer to resolve itself

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I can see that from your picture your right eye is a little bigger. This can happen with lower eyelid blepharoplasty when this procedure entails taking skin and fat. The skin resection and the scar contracture is what can cause the lower eyelid to retract downwards revealing more eye in your right eye. This can take a while to resolve on it own. Sometimes, steroid injections can help.

In the long run, it may require other procedures to improve this. This is one reason why I don't prefer the lower eyelid blepharoplasty as a procedure and believe in restoring volume to the lower eyelid and cheek region. I also prefer fat injections for this area for a longer lasting effect and more natural looking results. Sometimes this takes up to a year for the tightness to get better and for things to look better. Patience can be a virtue during this transition.

Philip Young, MD
Bellevue Facial Plastic Surgeon

Still too soon to tell

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One month after eyelid surgery is still too soon to tell the final results. Prolonged swelling is possible. Some things that may help: Try to sleep on your back, avoid salty foods (soy sauce, MSG!) and limit activity. Warm compresses can reduce swelling and gentle stretching exercises can help your lower lid come up.

Of course, speak to your surgeon for his/her recommendations.

Jonathan Hoenig, MD
Beverly Hills Oculoplastic Surgeon

Eyelid surgery

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Eyelid assymetry is normal. I am sure you had some asymmetry before surgery. ALso differential swelling is also possible. Make sure that your eye is not irritated. If it is , it probably is just dry and need to be lubricated with saline drops or gel. You should follow closely with your doctor to make sure it is nothing else.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Wait till all swelling are resolved

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it is too early to see the final result and you should wait. You also need to discuss this with your surgeon. The difference between left and right eye is common and you need to compare to the preop pictures.

Kamran Khoobehi, MD
New Orleans Plastic Surgeon
4.7 out of 5 stars 152 reviews

Asymmetric Swelling After Blepharoplasty

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It is not uncommon to see asymmetric swelling especially if the eyes are asymmetric to begin with, but the unevenness should subside at about 4-6 weeks.

Rod J. Rohrich, MD
Dallas Plastic Surgeon

Lower eyelid position after Blepharoplasty

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Inferior lower eyelid position and swelling after surgery can be normal elements of postoperative blepharoplsty. Massage and administration of opthalmic antibiotics may minimize infection dry eyes resulting from the scleral exposure. In most cases, continuous massage will help eliminate early signs of inferior lower eyelid position. Most of all, speak to your plastic surgeon as early and as frequently as possible.

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
4.8 out of 5 stars 95 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.