What Causes Lumps After Blepharoplasty?

How to Treat Lumps After Blepharoplasty (Eyelid Lift Surgery)

The appearance of your eyelids plays a significant role in the overall aesthetics of your eyes. Saggy lower eyelids can create the impression of under-eye hollows and bags, while excessively thick upper eyelids may result in a hooded look. To address these concerns, you may opt for blepharoplasty, also known as eyelid surgery.

Centre for Surgery is a specialist plastic surgery clinic in the UK, specialising in eyelid lift surgery. Our surgeons possess extensive knowledge of facial anatomy and utilise various surgical and non-surgical techniques to help patients achieve their desired appearance.

What Is Blepharoplasty (Eyelid Surgery)?

A blepharoplasty procedure is a cosmetic surgery that removes excess skin from the upper and/or lower eyelids, aiming to rejuvenate the appearance and eliminate a tired look from the eyes. The development of excess, saggy skin is mainly due to the natural ageing process.

As we age, the levels of elastin and collagen in our bodies decrease, leading to a loss of skin structure and elasticity. This effect is particularly pronounced in the delicate skin around the eyes and neck, which are often the first areas to show signs of ageing.

Who is a Suitable Candidate for a Blepharoplasty Procedure?

There are several primary reasons individuals choose to undergo a blepharoplasty procedure, including:

1. Excess skin on the upper eyelids is causing restricted peripheral vision
2. Excess skin on the lower eyelids
3. Under-eye bags

An ideal candidate for a blepharoplasty procedure is someone experiencing one or more of these issues. In addition, there are other criteria that an ideal candidate should meet, such as:

1. Being in good physical and mental health
2. Being a non-smoker, or willing to quit smoking at least four weeks before the surgery
3. Being aware of the potential complications of the procedure
4. Opting for the surgery based on personal reasons and not merely to conform to a trend

Ensuring that you meet these criteria increases the likelihood of a successful blepharoplasty procedure, which can help you achieve a more youthful and refreshed appearance.

Benefits of Blepharoplasty

Blepharoplasty offers numerous medical, aesthetic, and psychological benefits. Individuals who are unhappy with their saggy eyelids or eye bags may experience diminished self-confidence, which can negatively impact their personal lives and social interactions.

Undergoing eyelid surgery can significantly boost self-esteem, helping them feel more confident in their appearance. This newfound confidence often translates to a more active social life and improved personal relationships.

Eye bags typically develop due to a decrease in elastin and collagen levels in the skin, resulting in a loss of elasticity and firmness. This issue is exacerbated by weakened muscles surrounding the eyes, leading to discomfort or even pain.

Additionally, saggy eyelids or eye bags can impair vision, particularly peripheral vision. Obstructed views from the sides can make it challenging to see clearly. Extremely hooded eyelids may also detract from the overall aesthetic appeal of the eyes.

Are Lumps and Bumps Normal After Blepharoplasty?

It is not uncommon to notice lumps and bumps after a blepharoplasty procedure. The skin on the eyelids is relatively thin, making even the smallest irregularities more visible. There are several reasons behind the appearance of these bumps, including:

1. Normal healing process: In some cases, lumps and bumps are a normal part of the healing process after surgery. They may resolve on their own over time as the tissues heal and swelling subsides.
2. Sutures: Lumps may form around the sutures used during surgery. These usually resolve as the sutures dissolve or are removed.
3. Scar tissue: The formation of scar tissue can also lead to bumps, especially if the scarring is more pronounced in some areas than others.
4. Haematoma or seroma: Accumulation of blood or fluid underneath the skin can cause lumps. These may require drainage or other medical intervention.
5. Infection: In rare cases, an infection can cause swelling and bumps at the surgical site.

If you notice a lump or bump on your eyelid after blepharoplasty, it is crucial to consult your plastic surgeon. Do not attempt to pop or poke the bump, as this can exacerbate the issue and, in some cases, negatively impact your surgical results.

Contact your surgeon the same day, or attend A&E, if you develop severe pain, swelling that is increasing quickly on one side, or any change in your vision. Bleeding behind the eye (retrobulbar haematoma) is rare, but in a systematic review of 93 reported cases, mostly after trauma, 22% ended in blindness, while surgical decompression and shorter time to treatment were the factors that predicted full recovery (Christie et al 2018 ↗)^[2].

For eyelid swellings that are not related to surgery, see our guide to eyelid lumps and bumps.

While many bumps may resolve on their own as part of the natural healing process, some may require medical intervention to address underlying issues. Always follow your surgeon’s advice and post-operative care instructions to ensure the best possible outcome from your blepharoplasty procedure.

Our eyelid surgery recovery tips explain how to look after your eyelids while they heal.

What Causes Lumps After Eyelid Surgery?

The primary reason for a bump emerging after a blepharoplasty procedure is the development of scar tissue. It’s crucial to note that the incision scar may initially appear worse, often resembling a raised, red bump before it starts to heal. Such bumps typically do not require any specific care or treatment. Your surgeon will provide you with guidelines for incision care before you leave our Baker Street clinic.

As the scar heals, the bump will also heal. However, the scar might take up to four months to heal entirely. During this period, you can aid the healing process by moisturising daily to help soften the scar. A 2025 evidence review of scar care in upper blepharoplasty found consistent benefit from silicone-based creams, whereas cold compresses, compressive dressings and over-the-counter anti-scar products showed minimal clinical benefit (Aghajani et al 2025 ↗)^[1].

Once the incision has fully healed, a keloid—an excessive growth of scar tissue after the incision—may develop. While these can be unappealing and may necessitate revision surgery for removal, they are a rare complication of eyelid surgery.

Other potential causes for bumps include:

• Sutures utilised during the procedure
• Adverse reactions to the healing gel applied
• Microorganism growth
• Accumulation of foreign substances due to the ointments used

Types of Lumps After Eyelid Surgery: Haematoma, Seroma, Stye and Fat Nodule

The lumps that may develop after a blepharoplasty procedure can be categorised based on their underlying cause. As previously mentioned, there are various reasons for these lumps to form. The different types of lumps include:

Haematoma

This refers to an accumulation of blood, which is a typical reaction after any surgical procedure, not just blepharoplasty.

Seroma

This occurs when fluid accumulates around the incision site and is a common reaction after most surgical procedures.

Milia

These are tiny, pale, pinhead-sized cysts of trapped skin keratin that can appear along the healed incision. They are recognised as a possible scar-related issue after upper blepharoplasty^[1]. They are usually harmless, and your surgeon can remove them if they persist.

Stye or chalazion

A blocked oil gland causes this type of lump. It is prevalent among those who have never had eye surgery. Antibiotic drops are frequently prescribed, but in a review of 2,712 patients, adding an antibiotic to conservative care did not make a stye or chalazion more likely to resolve (Alsoudi et al 2022 ↗)^[3].

Fat nodule

This kind of bump occurs under two circumstances. First, it happens after eyelid surgery only if you have had fat grafted or repositioned in the area. Secondly, it can occur if you have high cholesterol; these kinds of bumps can form even in those who have not undergone eye surgery. A meta-analysis of 4,671 patients who had fat grafting or repositioning in lower eyelid surgery put the pooled rate of unsatisfactory correction or contour irregularity at about 6%, and the overall complication rate at about 11% (Xu et al 2024 ↗)^[4].

Abscess or other forms of bacterial infection

Infection at the incision site is the most common complication of all surgical procedures. When a bacterial infection progresses into an abscess, it typically appears as a bump, often accompanied by pus.

How to Get Rid of Lumps After Blepharoplasty

The treatment for lumps depends on their specific cause. As previously mentioned, if the lump is due to scar tissue, moisturising and massaging the area can be sufficient for proper treatment. A moisturiser will soften the scar tissue, making it easier for the lump to dissolve completely.

Before massaging the scar tissue, wait until the sutures have been removed and the scab has fallen off. Then, massage the area in circular motions using the soft parts of your fingers.

Other treatment options based on the cause of the lumps include:

1. 1. Haematoma: Applying a dissolving gel can help eliminate the haematoma. Massaging the area to improve circulation may also be helpful.
   2. Seroma: Proper massage can help reduce fluid accumulation in a seroma.
   3. Stye or chalazion: Warm compresses and gentle eyelid cleaning come first, and antibiotic drops add little in most cases^[3]. A chalazion that does not settle may need minor drainage. A thickened lump that persists should always be examined by your surgeon, as chalazion-like swellings can occasionally hide something more serious^[5].
   4. Fat nodule: A fat nodule usually needs to be surgically removed. Prompt treatment is necessary to prevent any complications.
   5. Abscess: An abscess should be drained for optimal results, followed by a course of antibiotics to ensure the bacterial infection is completely eradicated. If not drained properly, the infection can recur and lead to further complications.

FAQs about Blepharoplasty Lumps

References

1. Aghajani A, Babaei L, Eshraghi B. From incision to healing: an evidence-based review of scar optimization in upper blepharoplasty. Aesthetic Plast Surg 2025 (published online 5 November);50(2):604–615. doi:10.1007/s00266-025-05414-6 ↗
2. Christie B, Block L, Ma Y, Wick A, Afifi A. Retrobulbar hematoma: a systematic review of factors related to outcomes. J Plast Reconstr Aesthet Surg 2018;71(2):155–161. doi:10.1016/j.bjps.2017.10.025 ↗
3. Alsoudi AF, Ton L, Ashraf DC, et al. Efficacy of care and antibiotic use for chalazia and hordeola. Eye Contact Lens 2022;48(4):162–168. doi:10.1097/ICL.0000000000000859 ↗
4. Xu Z, Zheng F, Zhao X, et al. Complications of fat grafting and repositioning for correction of lower eyelid pouch with tear trough deformity or lid-cheek junction: a systematic review. Ann Plast Surg 2024;93(3):e9–e25. doi:10.1097/SAP.0000000000004022 ↗
5. Weller JM, Messmer EM. Focus on ophthalmopathology: orbital infections from hordeolum to necrotizing fasciitis. Klin Monbl Augenheilkd 2022;239(7):886–893. doi:10.1055/a-1709-6152 ↗

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