Almost one week after lower blepharoplasty, ectroption from too tight stitches. Just swelling? (photo)

Question

I got a lower blepharoplasty 5 days ago. The doctors method is to cut from the sides and pull up, which is unusual I think but is supposed to prevent the eyelid from falling. Anyway, on one side it looks great and is healing well, but the other side has a good millimeter of space between the eyeball and the eyelid and I feel is clearly being pulled too hard by the stitches. It is dry and painful and difficult to close. Doctor says it's normal swelling, but that seems wrong. Help!

Kenneth D. Steinsapir, MD · Answer

The left eyelid malposition does not appear to be related to tapping.  You have a very aggressive four eyelid surgery.  This needs time to heal.  It is too early to know if you will need to have revisional surgery for these issues.  If your eyes are uncomfortable that is from drying because the surgery weakens the blink function of the eyelids.  Use artificial tears frequently and ointment at bedtime.  See your ophthalmologist for a independent assessment and professional advise regarding the dry eye.  Please let us know how you do.

Houtan Chaboki, MD · Answer

Swelling after eyelid surgery (upper or lower) lasts several weeks, if not longer, especially when combined with other surgery such as rhinoplasty or brow lift surgery. 5 days is very early in the healing process after any facial cosmetic surgery. Keep in close communication with your plastic surgeon.Best,Dr. Chaboki

Philip S. Schoenfeld, MD, FACS · Answer

From the photos that you have provided, it appears that the combination of rhinoplasty and lower eyelid blepharoplasty that you have recently undergone has resulted in some significant swelling.  Although it would be comforting to see both eyelids heal symmetrically, in the first couple of weeks this is not always the case.  Once the swelling subsides I think you will be pleased with the surgical outcome of your lower eyelids.  Absolutely stay in touch with your surgeon during this healing period.

C. Coleman Brown, MD, FACS · Answer

Hello,You are very early in your recovery so significant swelling is expected. There could be some tightness and pulling and this should be addressed with your surgeon through close follow-up visits.Your taping could be contributing as well. Keep following up with your surgeon to make sure you are on track. Good Luck

Sahar Nadimi, MD · Answer

it is normal to have swelling for a week or more after eyelid surgery. Based on these photos, it looks like you also had a rhinoplasty which will only add to the swelling. It is not uncommon to have dry eye symptoms after eyelid surgery, particularly if you are unable to fully close your eyes. You may want to use eye drops more frequently to help with the dry eye symptoms. Be sure to follow up with your doctor and let them know about any eye complaints.

Mark L. Mazow, MD, FACS · Answer

Thank you for your question and for submitting your photos. The lateral tightening that you describe is actually a fairly common procedure. Your photo does show the slight lateral ectropion that you describe. It does appear that you have had a Rhinoplasty at the same time so the swelling in the face and the splint may play some role. It is also possible that the suture that's used to tighten the lid has loosened in the corner rather than being too tight. Your are still very early in the healing process. I would follow your surgeon's advice and see how this progresses as the splint comes off and the edema resolves. If it persists then this can be corrected with a simple office procedure.

Robert Brueck, MD · Answer

It looks like you also had a rhinoplasty so since you are only 5 days you will have more swelling so I would take eye drops and maybe tape your outer part of your lower lids up to close the gap.

Robert L. Kraft, MD, FACS · Answer

GIven that your blepharoplasty was combined with nasal surgery (have not used one of those splints in over 30 years so you are taking me back in time!) the swelling could be related to whatever was done to your nose.  You will have a better perspective once the splint has been removed.  Swelling is not symmetrical and can be influenced by a variety of factors.

Almost one week after lower blepharoplasty, ectroption from too tight stitches. Just swelling? (photo)

Answers (8)

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