Question:
I had upper eyelid surgery a week ago. The swelling has faded a lot but it seems really bad after sleeping or whenever I lay down. Is this normal?

Answer:
It is certainly normal to have some swelling remaining after a week from an upper lid blepharoplasty and it is not uncommon to have it become worse if you have been lying flat due to the increased venous pressure that occurs in that position. Keeping your head elevated while you sleep can make you look better in the morning but usually that small amount of additional swelling does go away in the first hour or so after waking. Eventually the additional swelling will not occur and this usually is within the first month or two of the surgery.

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Question:
Can fat injections improve tear troughs?

Answer:
Fat grafting can definitely improve tear troughs and, in fact, is the most common area that I personally place fat.  I most commonly perform this in conjunction with a lower lid blepharoplasty and oftentimes I am also performing other procedures, such as facelifts and brow lifts.  The overall effect is very natural appearing and very rejuvenating.

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Question:
I feel like my eyes make me look tired and old and I really hate my dark circles. What can I do to make my eyes look young again?

Answer:
Many patients come and see us due to the fact that they are accused of being tired or angry when they are not and this typically is due to the fact that their eyes have changed over time and giving them this appearance.  A blepharoplasty on the upper and lower eyelids plus or minus a possible brow lift can completely reverse this look and give a patient a very refreshed and alert appearance.  Most dark circles under the eyes are caused by the excess fat in the lower eyelids and this is contoured during a lower lid blepharoplasty, which improves this significantly.

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Question:
What should I expect once I return home after my blepharoplasty?

Answer:
After a blepharoplasty we recommend that patients ice their eyes as much as possible for the first two hours and then once an hour for 15 minutes until they go to bed at which point I recommend that that they sleep relatively upright.  The discomfort is quite minimal and essentially completely relieved by the iced gauze or frozen peas that are placed on the eyes.  The following morning there will be a small amount of swelling and bruising, but most patients look relatively good.  Three days after the procedure is typically when we remove the sutures and at that point with a little bit of cover makeup most patients look acceptable and by the time one week rolls around they look quite good.  A small amount of swelling can persist for up to a couple of months, but it is quite minimal.

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Question:
What would cause continued drooping of the upper eyelids even after eyelid surgery?

Answer:
Continued drooping of the lower eyelids even after an upper eyelid blepharoplasty can be caused from a few different reasons.  One would be that the patient had low-set brows and this was either ignored, not noticed, or purposefully not treated and this still gives the patient the appearance of heavy upper eyelids.  Another possibility is that the surgeon simply did not take out enough of the excess upper eyelid skin and there still is a significant amount that is visible.  I would simply discuss this with the surgeon and then if need be obtain a second opinion.

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