Is excessive swelling 3 weeks after a lower bleph normal/permanent? This was reconstructive surgery to fix Botox damage. (PhotO)

Thank you for the question and sharing your photos.It is clear that you are swollen still, but this is not unusual 3 weeks post op lower blepharoplasty. On occasion I consider use of a quick taper of oral steroids to hasten recovery. At this point, you should not become stressed. Give the healing process more time (a couple of months) and then make a judgement, because you look like you are on the right path to recovery.Good luck.

Your surgeon is totally incorrect in saying that one injection of Botox would cause irreversible damage to the muscles.  Even years of Botox doesn't cause this.  You have some edema of the lower lids which is not unusual especially if you have a prominent malar fat pad pre-op.  This should all improve with time.

The description of the problem makes no sense.  Botox does not permanently damage muscles.  Most likely you had a preexisting issue.  You are only 3 weeks out from what appears to be a transcutaneous lower blepharoplasty.  Please do not rush from on thing to another.  It is critical that you let these eyelids heal form many months before considering what to do next.  Unfortunately cheek festoons are not corrected with standard blepharoplasty.  You issue is unusually and almost any surgeon you see will lack the surgical tools needed to correct the issue.  Take your time in deciding what might need to be done next.  The swelling can take months to fully resolve.

Thank you for your pictures.  In my opinion it would be unusual to have weakened muscles secondary to BOTOX that cause festoons without causing total weakness and lack of tone to your lower eyelid.  Edema from blepharoplasty (cosmetic or reconstructive) may take months to resolve. The pathways that normally drain swelling need to reestablish themselves and this takes time.  Continue close monitoring for the next 2.5 months.

Your surgeon's diagnosis is incorrect as Botox won't do that. Also, are you sure Dr. Mindin is a Univ. of Michigan faculty? I don't know what you looked like before but I see deep tear trough deformities that could have been addressed with proper fat repositioning during a blepharoplasty. Finally, some edema 3 weeks after subcilliary blepharoplasty with likely significant dissection and muscle tightening or canthopexy/plasty or tarsal sling is not unusual. I'm not sure where Botox was being injected that you thought it contributed to "bags"? were you having Botox injected by a qualified doctor?