What could be causing my upper eyelid discoloration?
After Asian double eyelid surgery( itís been more than a month since then, both my eyes are purple-blackish discolored, right eye slightly less. My surgeon says itís edema thatís causing some slight swelling, but this doesnít account for the blackish-purple color (he says it will return to normal skin texture/color in a few months, but by now it should be a somewhat normal color, which I consider it is not) Anyways I have done a ton of research on it and the edema only accounts for the puffiness/hardness of the eyelid but not the purplish/blackish/bluish mix color of the eyelid. If I'm not wrong I believe this is the bruising but the bruising should have been gone at least already by 2nd/3rd week. Iím wondering whether it could be post-inflammatory hyperpigmentation, which makes sense considering the eyelids are still somewhat inflamed (swollen) and they are hyperpigmented (a different color). My other considerations are hemosiderin staining, but the color of the eyelids are not consistent, its not brown, (as hemosiderin staining tinges the skin slight red, brownish) Or perhaps the veins are showing through now? But I don't think this is likely because before I had this surgery, my eyelid skin did not show even a tiny bit of vein or blood (in other words the eyeskin was yellow, same as the rest of the skin, which is thick) I am thinking more along excess melanoma but I doubt it). Anyways check out the picture and tell me what you think it is? Any advice would be helpful.
Here are the pictures (2 of them have flash, the other one has no flash and was taken in a bright white light setting. Color is consistent, and when the eyes are open, the eyelid creases look even darker than they are in the picture, probably because of dark skin piling on top of each other in the eyelid crease when the eye is opened)
ImageShack Album - 3 images
Oh, and to add some information, my skin does not bruise easily. I can bump into a table, running, and not get a bruise. My surgeon said I did not bruise much at all after the surgery. Consistent here.
This picture is how my left eye was RIGHT AFTER the surgery
ImageShack Album - 2 images [its the first image on the left]
and THIS picture is how my right eye was right after the surgery (notice it was already less darker than the left eyelid and it was done a week later too. Right now, it's the same; the right eyelid crease is still less dark than the left eyelid crease.)
ImageShack Album - 2 images [its the second image on the right]
My skin is olive color and my eyelid skin is somewhat thick. Also, in the picture maybe you don't see it, but my left eye is a little more black-colored than my right eye, and it feels more "lumpy" (hard) When I attempt to move the right eye, some of the skin moves (in a ripple motion) but with the left eye, none of it moves, its completely lumpy and feels hard.
The left eye had a minor ptosis correction along with the double eyelid surgery. The right eye was operated on a week after the left eye.
Welcome to the forum!!!:)
I see a great deal of swelling. If you run your finger over your eyelids does it feel like you feel fluid inside? If so, that is the edema your surgeon is speaking of.
Was the swelling worse when you originally had surgery?
Yes, it feels like there is fluid inside. But I have doubts as whether the edema is why
the eyelids are light purple in color, because as far as I know, tissue fluid is not light purple,
and is clear. And it's not blood- or is it?
Yeah, the swelling was worse the days after surgery. It's worse in the morning too,
and at night, most of it (80-90%) of it is gone. It has been a little more than a month
after the surgery.
Well a month after surgery is a long time to still be experiencing that, but it's not totally unheard of. I have heard of bruising and discoloration up to 2 to 3 months after facial plastic surgery. Yes, it's rare but it does happen once in a while. I don't think it matters if you naturally bruise or not, because surgery isn't natural LOL :p It sounds like it is improving though, right?
for all of you reading this and having similar problems
According to some second opinions from a few surgeons here and there, there is residual edema/ post-inflamatory hyperpigmentation
This is because
1) the eyelid incision is "very far" [the incision was longer than it should have been] (from a very blunt surgeon i was told, i was told "poorly done surgery" which did NOT make my day), so the lympathic drainage may have been compromised. Lymphatic drainage is what controls the swelling and moves the tissue fluid in the eyelid back and forth in the eye, and it is what finally gets all the swelling down. If it is compromised it takes a while to go back to normal. This also causes some post-surgery inflammation. But not much of it. It is more of residual edema that slowly goes down.
2) the inflammation cuases mild hyperpigmentation. i was recommended to get some Cortizone cream and apply it to the eyelids. or, rather, cortisone cream. I don't think I need it at the moment as I can cover up the eye with light make-up (scar concealer) for a few months. I'd rather have the scar heal quicker than the swelling/discoloration for obvious reasons. the scar is more noticable when blinking and the swelling/discoloration nobody notices that at all. so for this reason i am applying silicone gel + silicone gel sheet at night which should tremendously accelerate the time for the eyelid scar to lose redness.
my mistake. there was little bruising immediately after surgery. there was [inflammation] along with [edema/swelling]. inflammation causes [discoloration] in mostly asian skin types and the discoloration is due to [pigmentation]. according to one surgeon this is common in Asian skins but probably not in Caucasian skin, which is probably why you don't see it that often, but I do notice that yeah, in lots of asian before and after photos, there is a lot of pigmentation in the eyleid crease after the surgery.
I had no idea that happens with Asian skin but not Caucasian. That's great to know because I'm sure others in your same situation will come to this forum with the exact same question in the future. Now I know the answer :)
Unfortunately, no. Hyperpigmentation of the eyelid crease never resolves. It is the "natural" color of the thin eyelid skin. Bruising is purple; it goes away within a week. You will know that your eyelids will be BROWN if about 2 weeks after surgery the eyelid crease is a muddy brown color still, unfortunately. To be more explicit, this happens in many Japanese/Chinese type of people, and almost never Koreans. If you notice Korean their creases are white, same color as the rest of the skin, but on Chinese, their creases are almost never usually the same color. So you should consider this before you decide to get the surgery done. If you're olive-medium dark YOU PROBABLY WILL GET EYELID HYPERPIGMENTATION and your eyelid creases will look dark after surgery, for some reason surgeons don't stress this at all.
And right now, I am considering revision as my eyelids are fatiguing from holding the crease up. Unfortunately for me I did not know this beforehand
Any updates regarding your situation, coolbeans64?
Wow that is interesting to know, I had no idea discoloration was such a common problem for certain skin types. You are absolutely right, surgeons *should* be stressing that more to patients! Do they ever list it as a potential side effect on the papers they give you?
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