Post-Chalazion Surgery: Persistent Swelling and Concerns About Scarring

Q: Post-Chalazion Surgery: Persistent Swelling and Concerns About Scarring

Hello： You can go for another eye examination to see if medication is needed. <br>Also, have the physician evaluate whether further surgery is necessary.

After the chalazion surgery, there is still some swelling that has not completely resolved?

Hello doctor, I had a chalazion surgery on the upper part of my left eye at the end of last month, and it has now been three weeks.
The doctor at the clinic diagnosed that my chalazion was located on the outer side and needed to be excised from the outside.
A few years ago, I had a similar procedure done from the inside, and I was worried that an external incision would leave a scar.
However, the doctor assured me that the scar would not be very noticeable, so they proceeded with the external incision to remove it.

After the surgery, I initially had some bruising around my eye, but now, three weeks later, the incision site is still "red and swollen," and there is still noticeable swelling.
Additionally, the scar from the incision has resulted in a double eyelid appearance, and my eyelid is slightly drooping.
Upon observation, it seems that the redness and swelling from the incision are causing the eyelid droop.
Currently, the chalazion has reduced by about two-thirds, but there is still one-third that remains swollen.

Is there a possibility that the chalazion was not completely excised, or could this be a case of hypertrophic scarring? What should I do? Thank you.

HC, 20~29 year old female. Ask Date: 2023/01/12

Dr. Gao Pilin reply Ophthalmology

Hello: You can go for another eye examination to see if medication is needed.
Also, have the physician evaluate whether further surgery is necessary.

Reply Date: 2023/01/12

More Info

Post-surgery concerns, especially regarding cosmetic outcomes and healing, are quite common among patients who undergo procedures like chalazion excision. Based on your description, it seems you are experiencing some persistent swelling and changes in your eyelid appearance three weeks after the surgery. Let's break down your concerns and provide some insights.

Understanding Chalazion Surgery and Healing
Chalazion surgery typically involves the excision of a blocked meibomian gland, which can cause a cyst-like swelling in the eyelid. The procedure is generally straightforward, but as with any surgery, individual healing responses can vary significantly.
1. Swelling and Redness: It is not uncommon for the surgical site to remain swollen and red for several weeks post-operation. This can be due to the body's natural inflammatory response to surgery. However, if the swelling persists beyond what is typical (usually a few weeks), it may warrant further evaluation.
2. Scarring: Scarring is a concern for many patients, especially with external incisions. The appearance of scars can depend on various factors, including the surgical technique, your skin type, and how well you follow post-operative care instructions. The fact that you are noticing a change in your eyelid, such as a double eyelid formation or slight drooping, could be related to the swelling or the way the skin has healed.
3. Incomplete Excision: You mentioned that about one-third of the chalazion remains swollen. This could indicate that the chalazion was not completely excised, or it may be a residual effect of the inflammation. In some cases, if the chalazion is not fully removed, it can lead to recurrence or prolonged swelling.

4. Keloids and Hypertrophic Scars: If the scar tissue is raised or thickened, you might be developing a keloid or hypertrophic scar. These types of scars can occur when the body produces too much collagen during the healing process. Keloids can be more common in individuals with darker skin tones or a family history of keloid formation.

Recommendations for Management
1. Follow-Up Consultation: It is crucial to return to your ophthalmologist or the surgeon who performed the procedure. They can assess the surgical site, evaluate the swelling, and determine if any additional treatment is necessary. They may recommend a gentle massage of the area, steroid injections, or other interventions to reduce inflammation and improve the appearance of the scar.

2. Cold Compresses: Applying cold compresses to the area can help reduce swelling and discomfort. Be sure to do this gently and avoid direct pressure on the eyelid.

3. Avoid Irritants: Keep the area clean and avoid any products that could irritate the skin around your eyes, such as makeup or harsh cleansers, until the area has fully healed.

4. Scar Management: If scarring becomes a concern, there are various treatments available, including silicone gel sheets, topical treatments, or laser therapy, which can help improve the appearance of scars over time.

5. Patience: Healing can take time, and it’s essential to give your body the opportunity to recover fully. Monitor the area for any changes, and keep your healthcare provider informed of your progress.

Conclusion
In summary, while it is normal to experience some swelling and redness after chalazion surgery, persistent symptoms warrant further evaluation. Scarring can be a concern, but with appropriate management and follow-up care, many patients find that their scars improve over time. Always consult with your healthcare provider for personalized advice and treatment options tailored to your specific situation.

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