Is bruising spreading down my cheek normal after blepharoplasty?

What's normal

AAO states that bruising and swelling typically last 10 to 14 days after upper eyelid blepharoplasty, and StatPearls says all patients will have some degree of bruising and swelling, which may last up to 2 weeks. Eyelid tissue is loose and thin, so blood that collects there is not held in place. It moves down into the cheek over the first several days.

Bruising after lower eyelid surgery tends to be more visible on the cheek than bruising after upper lid surgery, simply because it starts lower. Bruises also change color as they clear, moving from red and purple through green and then brown or yellow before disappearing.

ASOPRS notes that aspirin, non-steroidal anti-inflammatory medications like ibuprofen, and other blood thinners may increase the risk of bruising and bleeding, so more dramatic bruising is common in people who were on those medications recently. Cold compresses and keeping the head elevated are the standard measures to limit it.

Darkest around days 2 to 3, changing color through days 4 to 7, mostly a faint yellow shadow by days 10 to 14.

When it stops being normal

A bruise that is spreading and getting bigger day after day, especially with increasing pain and pressure, is different from one that is simply moving downward as it fades. AAO states severe pain, decreased vision, and progressive swelling may represent retrobulbar hemorrhage and should be brought to immediate medical attention.

Also call your surgeon for bleeding from the incision that will not stop with gentle pressure, or for a firm, tense, rapidly enlarging lump under the skin.