Plastic Surgeon Dr. Dean Kane of Baltimore Answers Question Regarding Post Surgery Swelling

Q. Puffy and swollen 2 months post procedure. Upper and lower lids. Fat pad adjustment and filler to improve facial volume. 2 months post surgery. Upper and lower eyelid , fat pad adjust and voluma filler. I’m super swollen/puffy around eyes, bridge of nose and cheeks. Generally puffy round face. Doc prescribed medrol pack and everything got better, as soon as I stopped taking the puffiness returned. Took another medrol pack and symptoms resolved. Now off and symptoms returned. I think it is water retention of filler. Not sure what to do next.

A. Thanks for sharing your photos, they are helpful. So sorry for your troubles.

Based on your history, there are 2 main issues I suspect are going on:

  1. Prolonged swelling from 4 lid surgery due to obstruction of lymphatic and venous drainage. I believe the 2 trials and improvement with the Medrol Tapered dose packs points to this problem. It will improve with time but may be exacerbated by reason #2.
  2. Added hydrophilic (water attraction) to the injured surgical area and adjacent festoon regions of the lateral-anterior cheek from filler injection. Healing goes through “4 phases” of which phase #2 includes swelling which is expanded by adding a volumizing filler. Hyaluronidase, an enzyme to dissolve the filler may help but may also unmask any underlying irregularities from the eyelid surgery and fat “adjustments”.

I recommend that you return to your surgeon and review these or other concerns. He may suggest:

  1. Higher, longer dosing of steroids,
  2. Self-massage techniques,
  3. Referral to a Head and Neck Physical Therapist (knowledgeable in post-surgical and post-radiation head and neck cancer swelling and lymphatic therapies).[ “Please do not mistake my statement.” I did not say you have cancer.] These specialist are knowledgeable in similar prolonged swelling of the face and may be very helpful to you.

If you have any further concerns, please consult another experienced and Board Certified Plastic Surgeon or ENT Surgeon who has seen and assisted in this difficult recovery. I wish you all the best!

Read more about similar topics:

Lid Swelling

This information is not meant as medical advice. It is provided solely for education. Our practice would be pleased to discuss your unique circumstances and needs as they relate to these topics.

Give us a call at  410.602.3322  or email Lauri@DrDeanKane.com and make an appointment soon. We’re located on Reservoir Circle just a block off the Baltimore beltway, convenient to greater Baltimore, Annapolis, the Eastern Shore, Southern Pennsylvania, Delaware and Carroll County.

This information is not meant as medical advice. It is provided solely for education. Our practice would be pleased to discuss your unique circumstances and needs as they relate to these topics.

Give us a call at  410.602.3322  or email Lauri@DrDeanKane.com and make an appointment soon. We’re located on Reservoir Circle just a block off the Baltimore beltway, convenient to greater Baltimore, Annapolis, the Eastern Shore, Southern Pennsylvania, Delaware and Carroll County.

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