Thank you for your question.
You submitted a photo and stated in your question that you had Asian Eyelid surgery with epicanthoplasty
performed approximately 3 months ago.
And you state that everything was healing well and that you noticed that there was a
bump in the lower eyelid and you are seeking some guidance as to what this situation is
all about.
Well, I can certainly give you some opinion.
I’m a board certified cosmetic surgeon and fellowship trained oculofacial plastic and
reconstructive surgeon.
And this means, when I completed first my residency in ophthalmology or eye surgery,
I went on to do advance training in cosmetic and reconstructive surgery of the eyelids.
I’ve been mostly in cosmetic surgery in the past 20 plus years in Manhattan and Long
Island and Asian eyelid surgery has been a big part of my practice.
So I am familiar with the procedure you underwent and certainly the ophthalmology background
can help you with this issue related to the eyelid.
So basically when I look at your photo, of course without physical examination, I can
just make a reasonable attempt to give you some guidance on what I think it is.
But essentially it looks like the procedure of eyelid surgery and the bump and the red
spot you had are not necessarily directly related.
And in other words, incisions are typically made for either upper eyelid surgery or epicanthoplasty.
The location of this bump is pretty far away from those incisions so the thought is maybe
there is a suture that remained or there was a retained dissolving stitch or something
like that.
I think it is relatively likely and I would suggest that essentially what you are dealing
with is an area of inflammation at the base of an eyelash and that typically is related
to a blockage of oil gland called the gland of Zeis.
And like adolescent or teenage acne, the oil secretion as well as the process of exfoliation
could essentially be affecting the drainage of the gland and result of the blockage and
this leads into an inflammation which is typically known as hordeolum or external hordeolum and
commonly referred to as a stye.
Now generally, the treatment for this is pretty conservative, warm compresses.
And if that doesn’t get better then you put on antibiotics.
The reason for the warm compresses is that to essentially liquefy the thicker oily secretions
so that they drain more easily.
Now as far what could have stimulated this to happen which means indirectly related to
the surgery, well I have a couple of thoughts and they apply to you.
One is if the eyes feel dry at all and if you are in an environment where your eyes
are very dry.
The reaction is to secrete more tears and for the glands, it generates the lipid or
the oil layer of the tear film to increase in activity.
This could mean similar to the teenage acne, you are basically blocking the gland because
of the increase in production which means you want to diminish this stimulus for that
production and that would be just lubricating the eyes with artificial tears.
Now if that is not the case, another case scenario could be that some patients will
continue to use antibiotic ointment although the surgery was long behind the fear for potential
infection and because of the moist feeling of the antibiotic ointment of the skin and
surface of the eye.
Now unfortunately, the vehicle or the petrolatum like Vaseline that the antibiotic is in can
also block the opening the gland of Zeis or the sweat glands.
If you are doing that, it is advisable for you to stop.
I would say again that conservative treatment and warm compresses, they’re probably mostly
likely unrelated directly.
You can treat conservatively.
If this does not resolve, bring this to an ophthalmologist but I think that most likely
this would spontaneously improve.
And once again, it is most likely hordeolum or external hordeolum or stye and that it
should respond to warm compresses and of course continue your follow up with your doctor related
to your cosmetic eyelid surgery.
So I hope that was helpful, I wish you the best of luck and thank you for your question!