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A man had blepharoplasty two days ago. He is worried that the surgeon may have removed too much fat which caused his lower eyelid to sag. He wants to know if he has how hollow eyes or if it just swelling. Dr. Amiya Prasad, a cosmetic oculofacial plastic surgeon, performs a lot of upper eyelid blepharoplasty. He also does a lot of facial cosmetic surgery such as facelifts and he always looks at the eye in the context of the whole face. When someone comes in into his office with bags under the eyes, he sees that the bags under the eyes are the most prominent and dominant feature on their face, but he also discusses with them how it relates to other areas of the face. This means he considers how the whole face looks like when the eye bags are reduced. In Dr. Prasad’s practice, he first explains that if patients have bags under their eyes, there is often adjacent volumetric loss in the eyelid cheek area and the sub malar area. He shows the volume loss in different views of the face so that patients can see how the bags are prominent relative to the eyelid adjacent to it. It’s ironic that when they have puffy bags under the eyes, they have too much fat in one place, and not enough fat in another place. In terms of hollowing and fillers, this depends on what the patient’s desired outcome and what they want look like long term. Dr. Prasad says that this man's doctor is correct in saying that swelling has a tremendous impact in the overall appearance of the eyes, especially in the first month after eyelid surgery. Although Dr. Prasad’s practice is proud of how they do lower eyelid surgery and how they are able to get people back to work within a week, he always explains that swelling after surgery can last anywhere from 6 months to a year, which has to do with a process called wound remodeling. It’s a normal part of wound healing which means there are restorations of blood supply, muscle tone and other factors that contribute to the eyelid healing properly. He follows his patients at 1 week, 3 months, 6 months and until a year. His doors are always open to address any issues and concerns. Hopefully this man will restore faith in his doctor and recall what his pre-surgical consultations were and what were explained. Dr. Prasad thinks he should discuss what his options are, but also allow some time to let the swelling resolve before he draws any conclusions. One cannot make any real judgments when there’s tissue swelling as it’s hard to predict. For Dr. Prasad, the pre-operative evaluation and what the patient look like beforehand and being aware of that helps patients understand what the change is after their surgery. To learn more about the causes of temporary swelling after eye bag surgery and how they can be corrected, please visit our website: http://prasadcosmeticsurgery.com/pras... To learn more about injectible fillers for hollow under eyes, please visit: http://prasadcosmeticsurgery.com/inje... http://prasadcosmeticsurgery.com/inje...