Thank you for your question.
You submitted two photos with your question and you state that you have had Asian eyelid
surgery done 2 weeks prior.
And that currently, you’re concerned about itchiness, redness and swelling.
And you’re asking if Tobradex can be used to help alleviate these symptoms.
Well, I can certainly give you my opinion based on just the photos alone.
A little bit of background, I’m a Board-certified cosmetic surgeon and Fellowship-trained oculofacial
plastic and reconstructive surgeon.
I have been in practice in Manhattan and Long Island for over 20 years.
Asian eyelid surgery is a significant part of my practice.
I treat patients from around the world both for primary surgeries or I should say, first
time having the surgery as well as revision surgeries for complications or undesirable
results after Asian eyelid surgery.
So I’ll tell you first that the main person you should ask this question is your doctor.
If you have been doing follow-ups with your doctor, then your doctor naturally has an
experience from practice as well as experience from treating you as to what looks right and
what doesn’t look right and I’ll explain further.
Asian eyelid surgery is like other eyelid surgeries in some ways and very specific in
other ways.
What we’re doing with Asian eyelid surgery is creating a connection between the skin
and the muscle called the levator muscle and that’s to create the crease.
Now with Asian eyelid surgery, there is a natural progression where swelling can be
significant from the incision in the crease area all the way to the margin basically,
typically someone applying eyeshadow.
Now that area can be swollen and it can normally be swollen for several months after surgery.
Now as far as redness and itching is concerned, two weeks after surgery, it’s not unusual
to have redness.
But when it comes to the degree of itching, this is where we have to differentiate what
the cause of the itching is.
It’s normal to have a certain amount of, let’s say, low grade itching, an awareness
that the skin is essentially healing.
Now that’s different from itching related to allergies.
That’s what I want to differentiate.
When I tell my patients to apply antibiotic ointment to the upper eyelids, I actually
have them do the antibiotic ointment for several days after surgery.
I have them stop the antibiotic ointment after a few days because I have a concern about
the development of something called contact dermatitis or an allergy to the antibiotic.
Now very often, people think that when they have, let’s say redness which is a typical
sign of contact dermatitis, they may think that they have an infection.
And so, what do they do?
They apply more antibiotic ointment.
Unfortunately, that further aggravates the condition of contact dermatitis.
So very often, what I tell people is or typically I would say, after several days of antibiotic,
stop the antibiotic ointment.
But to help the skin heal which is optimal for a moist environment for a skin to heal,
I’ll have them use something in the petrolatum family such as Aquaphor.
It’s also very important that I also advise people to not use anything else.
Very often, people are very eager to have their incisions heal, heal well and to avoid
scarring.
So they may find different remedies, over-the-counter skin treatments that are used to prevent scarring.
And a lot of those can be irritating.
So I tell them, “Don’t put anything other than Aquaphor.”
Beyond that, I would say that just by the photos alone, it’s very difficult to tell
whether you’re having allergies versus some normal itching.
It’s just part of the normal healing process to have some itching.
Now, short-term symptomatic relief, there may be a role to use something with a topical
steroid.
But I think it’s very important that you speak to your doctor about this, or better,
see your doctor because your doctor will be able to tell pretty quickly.
Photos are helpful but photos are not as accurate as we would like them to be.
Sometimes, the intensity of the colors and the details can be either exaggerated or not
as well defined.
So nothing beats a personal examination and evaluation.
So to answer your question, it may be helpful to use Tobradex but I would still be careful
about whether that same Tobradex was used after the surgery or whether you might be
causing more problems by continuing using it.
So again, meet with your doctor and discuss these concerns and issues.
I have my patients, after Asian eyelid surgery, I see them more frequently than I do non-Asian
eyelid surgery.
In the first month, I’ll see them at 1 week then 2 weeks later and then 2 weeks after
that just to watch them during this initial period where swelling can be concerning and
incision healing can be concerning.
So I’d rather see them in person rather than just tell them to come back after a month
and that’s just my personal approach.
So I hope that was helpful, I wish you the best of luck and thank you for your question.