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Uneven Eyelids After Blepharoplasty

I am three weeks today post-op from upper/lower blepharoplasty, outside incisions. There has been no change in my eye size difference, one being bigger than the other. It has been this way since day of surgery. My left upper eyelid is noticeably bigger than my right. Is it still swelling at this point, or will I likely need a revision?

Asked 35 months ago by daisy83461 in Jacksonville,AR
Sort 13 expert answers by:
+2

Orbital dystopia

Of course you are quite early arfter surgery and should wait before making any decisions on the final outcome. However, your eyes are asymmetric. Your left eye appears more prominent and higher. This is a result of the eyeball in the eye bone socket, and is not affected at all by surgery. So that asymmetry will always be there, and cannot be corrected by blepharoplasty of any type. There are certain tricks that can be used to camouflage the appearance of orbital dystopia, however the... more
Brent Moelleken, MD
Beverly Hills Plastic Surgeon
+4

You have pre-existing asymmetries, but also looks like asymmetric incision

You have pre-existing asymmetries that are accentuating the post-surgical differences. However, in your eyes-closed post-op view, it appears that that is a distinct asymmetry in the distance between your upper eyelid margin and the incision. The distance is greater in your left eye (right side of the picture). At this point, I think it is best to wait and let all of the tissues settle and swelling resolve for several months before having additional surgery. Good luck with your recovery.... more
David Shafer, MD
New York Plastic Surgeon
+3

Couple points from your photos

There are a couple things in your photo I noticed. 1. Your eyelid crease incision on the left is slightly higher than the right. This difference may be non noticeable after full healing in three months 2. Your brow on the right is a little lower that then left. Obviously nothing was done during surgery which was on your eyelids. However as their irregularities are corrected this brow ptosis can become more noticeable. If you lift your right brow to the level of the left, see if... more
Chris Thiagarajah, MD
Washington DC Oculoplastic Surgeon
+3

What was done?

You look like an attractive woman in her 20's. Preoperatively I see bilateral lower lid, congenital, ectropion but with asymmetry. Upper lids had good position with no excess skin. Brows are in good position. Postoperatively I see bilateral lower lid ectropian but now with upper lid ptosis, sagging which may be due to swelling. Whatever was done to the lower lids wasn't enough. What you needed was a canthopexy with muscle plication. This would have corrected the lower lid issue. I... more
Christopher L. Hess, MD
Fairfax Plastic Surgeon
+2

At 3 weeks blepharoplasty post-op, swelling is definitely still playing a role

At 3 weeks post-op, swelling is definitely still playing a role.  It will be some time before your post-operative results can be carefully assessed for the need for any revision surgery.  I suggest that you keep in close contact with your surgeon so that he/she can walk you through this expected recovery process and address any problems down the road should that become necessary.
Michael R. Macdonald, MD
Bay Area Facial Plastic Surgeon
+2

You see result of Blepharoplasty in 3 months.

Hi. I see what you are talking about.  You may need a revision blepharoplasty in 6 months, but probably not.  Minor asymmetries can be temporary.  I am more concerned about the new lines in your lower lids.
George J. Beraka, MD
Manhattan Plastic Surgeon
+2

Allow full healing to take place

Even though it has been only three weeks postoperative for upper and lower blepharoplasty, there is still some swelling left in the eyelids. A formal decision cannot be made at this point between the asymmetry on the eyelids. Asymmetry on the eyelids is a natural phenomenon, which can be either made better or worse with blepharoplasty surgery. The goal with blepharoplasty is to make the eyelids look more symmetrical, even if they are asymmetrical in the preop condition. No revision... more
William Portuese, MD
Seattle Facial Plastic Surgeon
+2

Lid assymmetric pre op - Blepharoplasty

I agree with those surgeons noting the asymmetry of your eyes preoperatively. This may affect incision placement.  As time goes by this should not be a big factor.  
Richard Gentile, MD
Cleveland Facial Plastic Surgeon
+2

Best to allow yourself to heal after Blepharoplasty

I see that you have a difference in the height of your fold. This could be due to many reasons. Waiting could be helpful to allow yourself to heal. Many times, this can allow your eyes to even out if there is any residual swelling contributing to the difference. If there is a persistence of this difference after 3-6 months you could ask your doctor what he thought could rectify this issue. If there is a difference at this later time, you would have to ask yourself which eyelid you liked... more
Philip Young, MD
Bellevue Facial Plastic Surgeon
+2

Time will help some of these issues but not others

Dear Daisy, We like to say that if you tell the patient before surgery it is an explanation but if you tell them after surgery, its sounds like an excuse. Your photos are helpful but it would be even more interesting to also have the before pictures. I agree with Dr. Moellenken that you have facial asymmetry, almost every one does. In your case the left eye sits higher in the face than the right eye. This is a surprisingly common situation when one looks for this. This asymmetry existed... more
Kenneth D. Steinsapir, MD
Los Angeles Oculoplastic Surgeon
+2

Wait another 3 months after Blepharoplasty before evaluating

Hello Daisy, As someone who has asymmetric eyes himself and who had eyelid surgery, I can tell you that differences in the eyes are there before surgery and remain after surgery. Three weeks is too early to worry. I am not sure what you mean by your left eyelid being noticeably bigger. I do see that the scar is higher on the left, making the distance between the lashes and the scar different. With time, that scar fades and you will not be able to tell much of a difference. Each eye needs to... more
Francisco Canales, MD
Santa Rosa Plastic Surgeon
+2

Eyebrow positions are different and can affect appearance

Your eyebrow is lower than the left, which exposes more of your left upper eyelid than your right. This makes a lot of difference. You are still early in your recovery. Things will probably be more equal in another few weeks. An eyebrow lift for the right side is a possibility, however it is very difficult to get them at exactly the same level. You might also look at your right lower eyelid being a little lower than you left. That will probably correct itself with more time. Revue with... more
E. Anthony Musarra II, MD
Atlanta Plastic Surgeon
+2

Wait

You still have swelling post surgery and result will improve. The other point is the position of your eyebrow. Your right eye brow is lower and this makes the difference between the eyes more prononced. Nobody has a symmetrical face and from what I see you have a good result.
Kamran Khoobehi, MD
New Orleans Plastic Surgeon
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