Lump developed 8 months after eyelid surgery. Can this be fixed easily? (Photos)

Question

I had eyelid surgery about 8 months ago. Things were healing okay but I suddenly developed this bulge/lump about a month ago. The lump is not hard at all, it’s very soft but it’s gradually getting worse and worse to the point where I have to do something about it. Is this easy to fix? Does it have to be fixed surgically?

C. Blake Perry, MD · Answer

Lumps can often appear that be be related or unrelated to surgery. Some common causes of bumps include the following: chalazion (blocked oil gland), prolapsed lacrimal gland, lacrimal gland cysts, and hypertrophic scarring. I would recommend seeing an eyelid specialist to determine the cause.

Kenneth D. Steinsapir, MD · Answer

This is not normal. Your eyelid surgeon likely barely has a grip on routine blepharoplasty. Asking them to fix something they have never seen before is like asking Christopher Columbus to navigate to the moon. At a minimum, an in person physical exam is needed to even adequately make an informed list of what it might be. Sometimes it is not clear until the eyelid is opened at surgery. It could be a trapped bit of fat, the herniated tail of the lacrimal gland, or something else. Whatever it is, it is not inflammatory. That means it is not likely to be a cyst and it looks soft not a hard mass. A reconstructive blepharoplasty is needed to open the eyelid at the crease where this mass is located. What happens after than will very much depend on what it turns out to be. You need to decide if you have confidence in your current surgeon to let them perform this revisional surgery. If not, you will need to find a surgeon you are confident in for this work.

Zoran Potparic, MD · Answer

Occasionally a small inclusion cyst may develop on the eyelid scar. This can be treated with a simple excision in local anesthesia. You should discuss this issue with your surgeon. Good luck.

A.J. Amadi, MD · Answer

This far out from surgery, its unlikely related. The swelling is in the area of the lacrimal gland. 
Hard to give a diagnosis without an examination, but if it is worsening, then you should see an Oculofacial Plastic Surgeon (Oculoplastics). Since you are in Vancouver, the Casey Eye Institute at OHSU would be a good place to start.

Kenneth R. Francis, MD, FACS · Answer

Dear penguinplush,
Your issue is very interesting and could be one of several things.  The best advice would be to return to your operating surgeon.  He/she has the full information on your surgery and what the bulge may be due to.  Good luck!

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