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Asymmetrical Eyelids After Blepharoplasty

I think I have asymmetrical eyelids after 8 weeks of upper Blepharoplasty. My right eye crease is a bit higher than the left eye's, and that causes uneven eye shapes. Not sure if swelling still exists on the right eye, but it looks more puffy than the other. I'm not sure if I'll be happy or satisfied, but will I need a revision surgery? Will the swelling eventually go away after 2 months or so? If revision surgery is needed, will that involve correcting the right eyelid only, or both?

Asked 37 months ago by personfromNY in Rochester, NY
asymmetrical eyelids after 8 weeks of upper Blepharoplasty asymmetrical eyelids after 8 weeks of upper Blepharoplasty
Sort 11 expert answers by:
+3

Don't touch a thing: Swelling after upper lid blepharoplasty

This is still too early to draw any long term conclusions about the final result. If this is a double eyelid surgery then occasionally the swelling on the eyelid can persist. However, there are numerous other causes which should be evaluated by your surgeon prior to drawing any conclusions. These can include: edema (swelling) lymphatic obstruction stye/chalazion obstruction of eyelid structures mechanical factors (sleeping with your head towards the right side) previous scars infection dry... more
Otto Joseph Placik, MD
Chicago Plastic Surgeon
+2

Evaluate 4 months after surgery

At eight weeks post blepharoplasty the eyelids are not fully healed and no revisional surgery is required at this point. After three to four months if there is still an asymmetry that is present, revision blepharoplasty surgery can be considered. Sometimes only one eye needs to be corrected, and occasionally both eyes need revision surgery. This decision depends upon the presenting issues and problems that are presenting themselves.
William Portuese, MD
Seattle Facial Plastic Surgeon
+2

Upper lid swelling might stay for a while

Some minor swelling might take 6 months or longer to go away. Most likely, you'll be happy with your final result and will not need revision surgery. I would encourage you to discuss this further with your surgeon as well.
Stella Desyatnikova, MD
Seattle Facial Plastic Surgeon
+2

Wait

It is very common to have asymmetry between the two eyelids after Asian eyelid surgery even after two months. There still may be swelling and definitely healing of the incision. You should wait until the 6 month mark to make a decision on corrective surgery.
Min S. Ahn, MD
Westborough Facial Plastic Surgeon
+1

Eyelid asymmetry after asian eyelid surgery

You should wait about 6mo after surgery to reevaluate. The asymmetry will improve. It appears that you have asymmetric ptosis which most likely was there preoperatively. This usually worsens during the healing process if not addressed at the time of surgery. If at 6mo the asymmetry persists, then the ptosis will need to be corrected - it looks like it's in both eyes, more so on the right eye than the left.
Charles S. Lee, MD
Los Angeles Plastic Surgeon
+1

Asymmetry due to swelling after upper eyelid blepharoplasty.

At a month or two after surgery, asymmetry is not uncommon. However, it would be helpful to see preoperative photos to make sure asymmetry wasn't already present. Either way, waiting 6 months is appropriate until all swelling is decreased. If the eyelids are still uneven at that time then a ptosis repair may be in order. I have attached a link to a video on how a typical ptosis repair is performed. see video
Carlo Rob Bernardino, MD
Monterey Oculoplastic Surgeon
+1

Eyelid asymmetry

You eyes look great. The small amount of asymmetry should resolve with time. Remember what gives us a human appearance are the small amounts of asymmetry we have. This should resolve with time. 
Chris Thiagarajah, MD
Washington DC Oculoplastic Surgeon
+1

Asymetrical eyelids after blepharoplasty can improve for 4-6 months after surgery

Your right eye is still more swollen than the left and should continue to improve for the next few months. The right upper eyelid looks a little lower and the eyelid muscle may still be regaining function after surgery. These asymetries are not uncommon and yours appears to be very slight at this point. I would expect that you will recover. I would not consider revision until at least 6 months and preferably a year.
Brooke R. Seckel, MD
Boston Plastic Surgeon
+1

Eyelid asymmetry

Eyelid asymmetry after an upper eyelid bleph is the norm. However, your asymmetry may be from swelling as well. Two months out is too soon to see the final result. You should give it at least 6 months to a year. I will bet that you probably had asymmetry to begin with as well.
Steven Wallach, MD
Manhattan Plastic Surgeon
+1

You have ptosis of the upper lid more on the right side

There is some swelling but the main reason for the asymmetry is ptosis of the upper eyelid that was not treated. You are compensating with your eye brow lift for the eyelid ptosis and this most probably was camouflaged by the sagging of the upper lid skin before surgery. Please go back to your doctor and let him reexamine you
Kamran Khoobehi, MD
New Orleans Plastic Surgeon
+1

Give your eyelid time

If you have an incision going from side to side on the upper eyelid and if sutures were placed into the muscle under the skin to simulate the crease, then swelling of the eyelid margin is not uncommon and may take a number of months to abate. In any case, the difference in the level of the crease is probably too small to be predictably "corrected" . You might also go back and look at your pre-op photos. Almost everyone has some asymmetry with their eyes and eyelids and often this... more
Robin T.W. Yuan, MD
Beverly Hills Plastic Surgeon
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