Upper Eyelid Swelling After Blepharoplasty

I had one of my upper eye lids lifted just a little, to match my other eye lid. Now after one week, I'm still noticing that the swelling comes and goes after sleeping. I'm wondering if my doctor injected some kind of saline or some kind of filler because if I lay down, it becomes swollen all over again, just on that one side of my face. Half my face is swollen and the swelling seems to move around on that one side of my face only!

Doctor Answers 56

Swelling changes when we lay down

What you are experiencing is, in all likelihood, normal. Swelling that comes with reclining and goes away a while after you get up is usually not a dangerous situation, although it is always helpful to check in with your doctor to be sure.

Particularly in the head and face, when we lie down, we lose the effect that gravity provides in the upright position- gravity pulls any excess fluid down, which is why you might notice that your feet may swell during the day but be better in the morning.

The fluid that gravity causes to flow down to your trunk and to your legs gets re-distributed when you lay down, and all of your body parts, including your head, are at the same vertical level. Areas that have recently had surgery are more susceptible to swelling because the healing process may allow fluid to accumulate more in areas where the blood vessels and other drainage vessels are still regenerating.

This is the reason that we often ask patients to elevate the head of their bed at night- to keep the head and face at a higher level than the rest of the body, so gravity can help us with the swelling.

Everything is normal!

Relax and enjoy your excellent plastic surgery. After one week to have some swelling is absolutely normal. The fact that the swelling comes and goes is normal and supports the fact that it is not permanent and is dependent. This means that if you move to one side, gravity can pull the fluid causing the swelling to that side.
I often tell my blepharoplasty patients to avoid their mirror for at least two weeks.

Robert M. Freund, MD
New York Plastic Surgeon
5.0 out of 5 stars 28 reviews

Your swelling is probably normal, but follow up with your surgeon.

It is quite normal to experience swelling one week out following an upper eyelid tuck (blepharoplasty) procedure. Nevertheless, it is imperative that you follow-up with your surgeon to make sure that there are no other problems going on. We typically advise our patients during the first week to avoid lifting anything weighing more than 10 lbs. and to avoid any strenuous exercises. Because swelling is so common even while sleeping, it is prudent to sleep with the head elevated on one-two pillows.

Thanks for your question.

Stephen A. Goldstein, MD

Stephen A. Goldstein, MD
Englewood Plastic Surgeon

See your doctor

While swelling after any surgery is of course normal, it would be best to see your doctor to make sure you have not developed an infection in the operated area. It is a bit unusual to see significant swelling in the face a week after a simple blepharoplasty.

If there is no evidence of an infection, he may recommend warm or cool compresses and elevation of the head at nighttime. You may also want to discuss with him your activity level (i.e. working out), which can worsen early postoperative swelling.

Brent Moelleken, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 131 reviews

Swelling After Blepharoplasty

Hi Freakin',

No need to keep freaking out. Be patient and the swelling will resolve. I agree with the other docs answers. Sometimes it takes a little time for the lymphatic vessels to re-establish their connections.

Try to continue sleeping with your head elevated on a few pillows so that your eyes are above the level of your heart. You may also try Bromelene (pineapple extract) or daily fresh pineapple, along with other anti-oxidant foods (berries, etc.). Some patients swear by Arnica.

Also limit your alcohol intake and smoking as they both retard healing. Good luck and be well.

Dr. P

Michael A. Persky, MD
Encino Facial Plastic Surgeon
5.0 out of 5 stars 34 reviews

Puffy Eyes, No Surprise

Swelling is normal after upper eyelid surgery, and may last longer than a week in many cases. Most commonly, the swelling is worse when patients awake from sleep, since their heads and faces are at the same level as the heart. Typically, as patients remain upright over the course of the day, the swelling diminishes because the lymphatic tissue fluid that has built up overnight can now drain away from the eyelids with the assistance of gravity, so the swelling is usually at it's minimum just before bedtime.

http://www.plasticsurgery90210.com/facial_cosmetic/blepharoplasty.html

Your doctor would not have injected filler into your face without your consent. As the tissues gradually heal and regain their normal lymphatic connections, the swelling dimishes and your eyelids will no longer appear puffy in the mornings any more than the usual.

Athleo Louis Cambre, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 4 reviews

How to avoid swelling after blepharoplasty

Sleeping with your head elevated compared to your pelvis will help to prevent the edema, as others have said.

In addition, you may naturally roll to one side or turn your head to one side while sleeping - most of us do. The side that you normally lay on will be dependent. Fluid will tend to flow to the dependent side and cause edema or swelling.

Edward S. Lee, MD
Englewood Plastic Surgeon

Swelling is normal

You raise a good question about swelling. Swelling after any surgery is normal. However, swelling after eye surgery can take several days to weeks to resolve. The tissues around the eye are very thin, so any trauma (surgery) can cause significant irritation and accumulation of fluid in the weak tissues. Since you only had surgery on one eyelid, it is expected that only that side would be swollen - as you accurately describe. The best way to help with swelling is to keep your head elevated. When you lay down, you increase the pressure of the fluid in those tissues. When you sit up, you decrease the pressure in the tissues and the fluid starts to leave the tissues. Alternating warm and cold packs also help with swelling in the first few post-operative days. If your doctor injected a filler without out you knowing this is a serious issue and I doubt this is the case. Additionally, if there was a filler injected, it would not come and go as you describe. If saline was injected, it would have resorbed within a few hours of the surgery. Hang in there, the swelling will improve. It just takes time...

David Shafer, MD
New York Plastic Surgeon
5.0 out of 5 stars 72 reviews

Swelling after blepharoplasty can last longer than a week

It is not unusual to have some residual swelling one week after a blepharoplasty. Postoperative swelling can have a dependent nature, meaning that gravity will cause fluid to accumulate when lying flat. This generally subsides within 10 days, but it can be present for a few weeks.

Warm compresses can help to resolve swelling. Sleeping with the head elevated with more than one pillow can also minimize the amount of fluid that bulids up over the night. If there is significant swelling accompanied by redness, warmth, or pain, you should see your surgeon immediately to rule out infection.

Brett S. Kotlus, MD, MS
New York Oculoplastic Surgeon
5.0 out of 5 stars 37 reviews

Healing after eyelid surgery

The reason it is difficult for some people to have eyelid surgery, is the same reason that it is worth doing eyelid surgery.  The eyes are the first thing a person sees when they look at you, and issues with your eyelids tend to be noticeable. 

It is very important to have reasonable expectations about the healing time table after eyelid surgery.  Knowing what to expect avoids having you worry when common things happen.

Eyelids have a fantastic blood supply.  That is great for healing after surgery.  Eyelids heal well and very very rarely get infected after surgery.  However having a great blood supply causing two short term issues as you heal from eyelid surgery.  First, eyelids bruise easily (that's why everyone has heard of a black eye). Second, eyelids swell very easily.  Most of us have experience eyelid swelling in the morning from time to time....even if you haven't had a treatment or surgery.

So here is what to expect after eyelids surgery.  It is not uncommon to get a bruise after surgery.  That can last anywhere from a few days to a few weeks depending on the size of the bruise and your metabolism for getting rid of bruises.  Bruising can be reduced by: avoiding blood thinners before surgery (it approved by your doctor), taking it very easy for several days after surgery, and using lots of cold compresses for the first four days after surgery.  Swelling is very common after eyelid surgery.  Swelling tends to be it's worst when you first wake up in the morning because of gravity and the fact that you move your facial muscles less when you sleep.  Swelling is reduced by avoiding bruising, using cold compresses, controlling ocular allergies and watching your salt intake.

Everyone heals at their own rate.  Many patients look good at a week, however I always tell my patients that if there is a big event, like a wedding coming up, do the surgery at least six weeks before the event.

Bottom line.  Swelling in the morning after eyelid surgery is expected.  You should not worry.  However, these are general recommendations.  You should discuss this with your surgeon. 

Marc Cohen, MD
Philadelphia Oculoplastic Surgeon
5.0 out of 5 stars 22 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.