Doctor's Column

Swelling after double eyelid surgery is one of the aspects that patients are most curious about during the recovery process. Dr. Kim Sung-hoon of Face Designer Plastic Surgery explains the anatomical causes of swelling and specific management methods that patients and the clinic should undertake together. From daily care—such as cold compresses, sleeping posture, exercise, alcohol consumption, and smoking—to clinical treatments performed at the hospital, including hyaluronidase, steroids, LLLT (low-level light therapy), and taping therapy, this is a practical guide to minimizing postoperative swelling and speeding up recovery. Moving beyond the simple question of "When will it go down?", this article covers the physiological principles of swelling and the progression of recovery, providing both "peace of mind" and "evidence" to all patients anticipating double eyelid surgery.

Face Designer, Dr. Sung-Hoon Kim, Director of SH Plastic Surgery

Hello. I am Dr. Seong-hoon Kim, facial designer and director of SH Plastic Surgery.

Today, we will learn about swelling after double eyelid surgery.

Actually, the word "butgi" (swelling) is an incorrect expression, and "bugi" is the correct term.

From now on, I will explain using the correct spelling, *bugi* (swelling) ^^

When will the facial swelling go down?

This is a question I hear multiple times a day in the consultation room.

"Doctor, how long does the swelling last?"

"Around when will it be okay to meet people?"

Whenever that happens, I answer like this:

"Swelling is not a matter of time, but a result of management."

Swelling is not just simple puffiness.

It is a physiological response that occurs during tissue recovery.

After surgery, inflammation occurs, blood vessels dilate,

and it is a natural phenomenon that takes place as the tissue settles into its new position.

The Reason for "Swelling" from an Anatomical Perspective

The eyelid has the thinnest skin on the face, densely packed with blood vessels and fat layers.

When microvessels are damaged through incisional or non-incisional (suture) methods,

plasma components seep into the interstitial tissues, causing temporary edema.

The reasons swelling lasts longer in this area are as follows:

The skin around the eyes is thin, making edema easily visible;

It is less affected by gravity, allowing body fluids to linger longer;

And because there are many microvessels, the inflammatory response is very active.

In other words, swelling is not "abnormal," but a "sign of recovery."

The key is how quickly and evenly it can be reduced.

"How long does the swelling last?"

I will explain the progressive flow of recovery through the table below.

Conclusion

If there are no special side effects:

① In 1 week, most of the swelling decreases

② In 2 weeks, it looks natural in appearance

③ Complete recovery takes 2 months.

Swelling management that patients can do themselves

Then, is there any swelling management that patients can do themselves?

Yes, while you cannot make the swelling disappear immediately,

you can prevent the swelling from getting worse,

or relatively accelerate the time it takes for the swelling to subside.

I can do it.

1. Compresses — Cold compress → Warm compress

Immediately after surgery: Cold compresses suppress inflammation and prevent blood vessel dilation.

After 3 days: Switch to warm compresses to promote circulation and help discharge waste products.

💧 Summary table of cold compress vs warm compress management

The recovery speed of those who apply compresses meticulously and those who do not is distinctly different.

2. Sleeping posture

Keeping your head higher than your heart reduces swelling with the help of gravity.

Pillows that are too low cause blood to pool, making swelling last longer.

3. Exercise

Avoid strenuous exercise for 2 weeks.

Squatting or lifting heavy objects increases abdominal pressure, worsening swelling.

After 2 weeks, light walks and brisk walking help promote recovery.

4. Drinking and smoking

Alcohol causes peripheral vasodilation + increased inflammation,

while smoking worsens swelling through decreased blood flow + reduced oxygen supply to tissues.

As a rule, abstain from drinking and smoking for at least 2 to 3 weeks.

5. Posture

Habits such as frequently bowing your head or looking at a smartphone for a long time

also increase facial blood flow and worsen swelling.

Professional care provided by the hospital

From now on, this is about the professional aftercare provided by the hospital.

How professionally, quickly, and effectively it is managed is important.

The care included in professional management is as follows.

1. Hyaluronidase

An enzyme that reduces water retention by regulating hyaluronic acid binding within tissues.

In other words, it is used not as a "filler-dissolving injection," but as an enzyme to control swelling.

2. Dexamethasone

A corticosteroid that suppresses inflammation and stabilizes blood vessels.

3. Aminophylline

Although it is a bronchodilator, it helps eliminate fluids from the body through its diuretic effect.

4. Oral Medications

Medications such as Venoruton and Traumeel help stabilize capillaries and improve microcirculation.

5. LLLT (Low-Level Light Therapy)

Uses LED light to promote blood flow, cell regeneration, and bruise relief.

6. Taping Therapy

Physically suppresses subcutaneous edema by gently compressing the area above the incision.

Applying light compression taping for just 3 to 5 days after surgery makes a significant difference in swelling.

Reflections by Facial Designer Dr. Kim Seong-hoon

“It is completely natural to worry about swelling after double eyelid surgery.

However, what matters is not 'how quickly it goes down,'

but 'how healthily you recover.'

Swelling is not just puffiness; it is a sign of healing.

Understanding that process and supporting its natural rhythm

is ultimately what determines the quality of the final result.

Double eyelid surgery is not a procedure to 'make eyes bigger,'

but one to 'restore the impression of the eyes.'

A natural recovery process is what creates the most definitive aesthetic results.”

FAQ

Q1. Are some body types naturally prone to prolonged swelling?

Swelling may last relatively longer in people with thin skin, many blood vessels, or allergic skin conditions.

Q2. Is there a big difference in swelling between the non-incisional (suture) and incisional methods?

The incisional method causes more initial swelling due to greater tissue manipulation, but the stability of the result after recovery is high.

Q3. How often should cold compresses be applied?

For the first 48 hours after surgery, it is recommended to apply them for 10–15 minutes every hour, at least 5 times a day.

Q4. When is the right time to switch to warm compresses?

It is good to switch after 3 to 4 days post-surgery, when bruising appears or the stiff feeling subsides.

Q5. Are there any nutritional supplements or foods that help reduce swelling?

Intake of vitamin C, protein, and water is important, while salt and caffeine should be avoided.

Q6. What should I do if I have both swelling and bruising?

Bruises are absorbed quickly with light therapy (LLLT) or warm compresses. It is possible to manage them concurrently with swelling.

SH Plastic Surgery Clinic

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