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Different Eye Size After Blepharoplasty

I am 29 years old, and had upper/lower blepharoplasty 12 days ago, with outside incisions. I cannot put into words how upset I am with myself for doing this. I feel I will never be able to leave the house again without large sunglasses. My left eye is much larger than my right now. My right eye was bigger than it is now before the surgery. My left eye looks like I thought both eyes would look. I have been to my Dr., crying in his office just today. Although he says I still have swelling that needs to go away, he acknowledges the difference in my eye size. I have recently read that Botox can cause your eyelid to droop, and I know he used that. Could that be why my eye looks so much smaller than the other? If so, can I use eye drops so soon after surgery?

Doctor Answers (14)

Almost everything gets better with time

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Dear Daisy

Your anguish is clear in your note.

You are very early after your surgery. At this time, it is common for one eyelid to look a little different than the other. Typically, these differences get better as you heal. This is a good time to put away the magnifying mirror. It is very difficult to be patient after surgery.

Photographs would be very helpful to understand the differences you are describing. It sounds like the two eyes appear different. It may be that this was the case before surgery and now after surgery, the differences seem more exaggerated. Some times more skin and fat is removed from one side that another. However, these differences will often be the most obvious while healing and then get better as the dust settles.

Another very important issue relates to your feelings. You are expressing remorse for having had surgery. I find that it is not uncommon for my patients with a history of depression to become somewhat depressed while they are healing from surgery. However, sometimes there is no history of depression. The reasons for this are not completely clear. We think of surgery as a stressor and we often have a finite capacity to handle stress.

Another factor is simply being out of ones normal work schedule. It is like the normal structure of your life as been taken away during the healing processes that follows cosmetic surgery. Ask yourself if you are feeling depressed, are you having difficulties going through the day, low self esteem, difficulty eating or distrubances in your ability to fall asleep. In extreme cases, there can be thoughts of suicide or feelings that life is not worth living. My experience has been that many of these issues resolve as one heals and returns to a normal routine. However, I have gotten psychotherapists involved for emotional support as needed.

Remember, you need time to heal. Most surgeries can be improved with revision but this may not be necessary. Please share with the Realself community your experiences so others can learn from how this situation resolved or what further actions you took to address your concerns.

Los Angeles Oculoplastic Surgeon
5.0 out of 5 stars 19 reviews


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I am very sorry that you are suffering but the good news is that most likely this asymmetry wil resolve as things heal. This is a very very short time after surgery and I would not be worried at this point. I am not clear why your doctor used botox during your blepharoplasty unless you asked for it but Botox can cause a droopy eyelid so I would wait until the botox wore off....3 months.

Chris Thiagarajah, MD
Washington DC Oculoplastic Surgeon
5.0 out of 5 stars 6 reviews

Different Eyes after Eye Job (Blepharoplasty)

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12 days post-operatively is still WAY early for you to expect complete healing. The healing process will go on for months and the results WILL continue to improve.

Without photographs it is hard to tell if you have surgical complications or are just upset by the swelling we surgeons regard as routine and know will resolve with time,

I HOPE your surgeon is a Board certified Plastic surgeon (check here, ENT or Ophthalmologist. Unfortunately, many other physicians "practice" this surgery without having trained in it. Since very few Plastic surgeons would have operated on a 29 year old without major lid drooping, I suspect your surgeon MAY fall into the latter group.

At this time, you should focus your energies on healing. If a revision surgery is required, it should not be done for at least 6 months to allow the swelling to normalize.

Good Luck.

Dr. P. Aldea

Peter A. Aldea, MD
Memphis Plastic Surgeon
5.0 out of 5 stars 69 reviews

Upper blepharoplasty in young women.

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1) I know this doesn't help you, but other people read these postings. Upper blepharoplasty should almost never be done on a 29 year old.

2) It sounds like you have a bad result. But I am pretty sure you can be improved.

3) Don't do anything for 6 months, and then get 2 or 3 evaluations by board certified plastic surgeons.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon
5.0 out of 5 stars 9 reviews

Too early to determine

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It is still too early to determine, and impossible to know the final healing result since you are only 12 days after the surgery. Corrections can be made after six months’ time (to ensure full healing), however it really depends upon the presenting issues, asymmetry regarding the shape of the eyelid, muscle structure and fat components of the both upper and lower lids before deciding on any corrective surgery.

William Portuese, MD
Seattle Facial Plastic Surgeon
5.0 out of 5 stars 60 reviews

Give the healing time to settle down

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Presently you are in the early postoperative healing phase. There are a lot of factors involved in why the eyes look different. It could be due to a number of factors including how your eyes looked preoperatively, whether the surgeon had to use a different technique on the two upper eyelids, a difference in the amount of postoperative swelling, and even if you sleep on one side versus sleeping on your back.

It's important to keep your follow up appointments with the physician so that he or she can see the progress of the healing. The physician may also have certain exercises or other postoperative instructions that you need to follow in order to improve the results.

Often times, if revisions need to be made, they can be in the office under a local anesthetic.


Joseph M. Perlman, MD
Houston Plastic Surgeon
4.5 out of 5 stars 12 reviews

I refuse to discuss patient results for at least 3 weeks

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You have no idea what your final result will be so relax and wait until at least three weeks post op before you start beating yourself up about your decision to proceed with eyelid surgery. Talk to your doctor about post operative maneuvers to treat eyelid skin retraction.

Richard Gentile, MD
Youngstown Facial Plastic Surgeon
4.5 out of 5 stars 25 reviews


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You are judging the result too early. You have trusted your doctor to operate on you and you trust him for the post operative care too. Wait till your swelling is resolved.

Kamran Khoobehi, MD
New Orleans Plastic Surgeon
4.5 out of 5 stars 66 reviews

You are only 12 days post-op

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You are only 12 days post-op. There is considerable swelling that has to resolve and the tissues have to settle. You should not worry one bit for at least two more months. You really need to be patient to see the final results. Having surgery is not like buying new clothes. There is a recovery phase and you are just at the beginning of it. Good luck.

David Shafer, MD
New York Plastic Surgeon
5.0 out of 5 stars 61 reviews

Wait and be patient

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Without pre and postop photos of you it is hard to tell too much but I agree totally with the advice given by the other doctors about waiting at least 3-4 months until swelling has gone away. Also, don't repeat any Botox for that time to keep this variable out of the equation.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.