Asymmetry After Upper Blepharoplasty (Asian Male)

I did the surgery to achieve double upper eyelids...

I did the surgery to achieve double upper eyelids and bring appearance of both eyes as symmetrical as possible due to one having more fatty tissue than the other.

I am an Asian male and had upper blepharoplasty performed in October of 2009. It has been approximately 11 weeks and the asymmetry that was discernibly apparent from the beginning after post-op is still present albeit to a lesser degree. I understand that there is always going to be some minor asymmetry, however, I believe my situation is quite conspicious from a glance. I have orbital dystopia and, pre-op, my right upper eyelid had more fat/skin so my eyes were never symmetric.

The goal of the surgery was to create the double upper eyelids as well as to get the eyes closer to size for the best symmetry possible and this was all discussed with my doctor. He stated that he performed a slightly different incision on the right upper eyelid versus the left one so I can only suspect this has partly to do with the post-op asymmetry .

I'm looking for a second opinion on how my progress is and if I will need a revision or if it's still too early to tell. I understand 6-12 months is the preferred healing duration but most, if not all, of the swelling has subsided with minor soreness in the muscles still remaining. As you will see, my right eyelid is turning out very well but the left one still has a higher crease and even the eyelashes sprout up higher. Every time I look in the mirror I think of those cars with the pop-up headlights and one of them is broken.

Both my doctor and I were dissatisfied with the...

Both my doctor and I were dissatisfied with the outcome of the surgery after letting a year pass for full recovery. The incision on my left eyelid was made too high compared to the right resulting in larger looking fold on the left and 2 distinct looking eyelids. We agreed to perform a revision where he would loosen the incision on the left eyelid to allow more skin to fold down. A month and a half has passed since the revision and the asymmetry is even worse than before. I am displeased with the level of experience and expertise with this doctor. Although he is very professional and courteous, he seems to have trouble with correcting existing asymmetries by compensating accordingly with surgical technique.

In response to another member I am writing another...

In response to another member I am writing another update.

End of July 2012, I consulted with Dr. Allen Putterman in Chicago. The entire consultation process was so impressive and a night and day difference in attention to detail compared to my initial surgeon's visits. Dr Putterman's assistant took careful measurements in millimeters, I repeat in millimeters, and documented everything down on a postcard. Then Dr Putterman evaluated my eyelids in more detail taking photos with 3 different cameras. He commented that sometimes he gets different results depending on the camera/lens thus likes to make sure he gets all perspectives.

He stated there is a clear and definite disparity between the left and right eyelids. Unfortunately, he also told me what I didn't want to hear. That attempts to make my left, larger folded eye similar to the right would be very tricky (using fat grafting or other methods) with hit or miss results and that it would be safer and with higher positive results to make the right eyelid the same as the left. If I wanted to try to correct the left eyelid, he suggested first using a filler to see what the result might be as it is temporary.

At this time I have not made a decision yet. I am unhappy with my left, larger eyelid and to have the right just as large would not be the permanent result I wish to have. I plan on speaking with Dr. Putterman again early next year to discuss further as I believe both eyelids need revisions since they are so different from one another now.

I wish I had the positive outcomes that many Asians seems to have with this type of surgery but if you ever run into a surgeon who says "trust me, you're going to like the results, or, you're going to feel much better"...take it with skepticism and keep consulting with other doctors until you are 100% confident.
Chicago Plastic Surgeon

Very easy to get along with, professional, and wants to make sure you're happy with this work, however, expertise and experience for corrective surgery is questionable.

3 out of 5 stars Overall rating
4 out of 5 stars Doctor's bedside manner
2 out of 5 stars Answered my questions
4 out of 5 stars After care follow-up
2 out of 5 stars Time spent with me
3 out of 5 stars Phone or email responsiveness
4 out of 5 stars Staff professionalism & courtesy
4 out of 5 stars Payment process
3 out of 5 stars Wait tmes
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Comments (21)

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Did you ever decide on a revision? I am in the process of looking for a doctor and any input helps!
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Hi, at this time any revision attempts I'd like to do will be postponed indefinitely. I now have a child on the way!
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CONGRATS!!!!

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Did he say why he chose to do two different types of incisions? Did he offer you a significant discount to correct it in a 2nd surgery?
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The doctor stated one eyelid had much higher fat tissue than the other. It was not 2 different incisions, they were the same, but rather reattaching the muscle back to the ligament. The surgery fee was all inclusive of any revisions needed so technically I could have gone for a 3rd revision also but that option would have been to make the other eye larger and it was at that time I decided to get other opinions.
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Well at least I feel comforted in knowing he was honorable by including revisions as another patient I read abou did not get that benefit from Bloch who is the only other guy in the area with a notable reputation. Was this including of revion surgery in the quote he gave you? That would help me a great deal to know that
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Yes, one time fee for the surgery and if additional revisions are required.
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Well, it sounds like you have some big decisions to make. I wish you the best with it.
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I'm not sure which way you decided to sway but I think your eyes look great. I'm a perfectionist too but I think they look very natural and it's not very off at all. I hope you're happy either way & that everything worked out :) --- I'm currently going through my own woes of Asian eyelid surgery.
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Thank you for your kind words. I have not proceeded with any further action yet but still plan to do so. I understood very well prior to jumping into this that plastic surgery would not achieve perfection so after both a 2nd and 3rd professional opinion agreed on the clearly discernible asymmetry, I don't believe i'm being a perfectionist. Best of luck to you and thank you again.
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I do not at all think you are being a perfectionist. I was just trying to see if he explained why he chose two diff cut styles and if he was whimsical in his approach or was just distracted or something and if that choice he made Was the reason for the results. Why not pursue your goal? I think you are doing a great job of advocating for yourself
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Hey DP101, how is your eyes right now? I have same problem with you, it has been 2 months but my left eye is smaller than right one, although there is still some swelling in the right eye. I want to know do I need some revision or not, please share about your condition right now. Thanks :)
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Hey! Just wanted to say that your eyes look good. I do notice the apparent asymmetry but it is not that bad, plus our eyes are naturally slightly different in shape and size. I understand your purpose of getting the surgery was to correct the asymmetry and that you are upset, but I want to console you by saying your eyes honestly do not look bad at all. Your left eye might seem big now because it is still in the healing process and swelled up compared to your right eye. I'd say give it some time, and in 6-12 months, if you are still not satisfied, consider flying to Korea to get a revision, the doctors there are truly fantastic and skilled in revision surgeries. I find doctors in the US are only good at primary surgeries, esp. on Asian eyes, and they suck at revisions...
Try massaging your left eye with oil (such as emu or rose hip, both are great at healing scars) as massaging lessens scar tissue and can help loose the tightness in the eye! Good luck!
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Updated photo 2012.07.19, 8 months after revision. The distinct asymmetry still exists and at times is even more pronounced depending on time of day, weather, and how I'm feeling. I've also noticed that my left eyelid (larger of the two) feels like its pulling up tighter than before and constantly find myself pulling down on it to loosen the skin. I feel that I've become even more self-conscious; often I catch my reflection and immediately notice the asymmetry and how awkward I look. Suffice to say, I am disheartened.

I initially searched for second opinions back in January with most of the surgeons advising to give it a little bit more time, however, one stated that it did appear that too much might have been cut out and if I wanted it to to match the other eyelid I might want to consider fat grafting. I am scheduling a visit with another surgeon who seems to have extensive occulofasical and blepharoplasty experience. I may also see Dr. Byun again just to hear what he has to say. I truly wished I had seen Dr. Meronk before he tired as everything I've read on him was exactly the kind of experience I needed to correct this.
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Hi DP, thank you for your post. How are eyes doing now (June 2012)?
I completely understand your disappointment. Like you I had an upper blepharoplasty performed in April 2012. From the start, my left eye was a lot more swollen than my left eye. Two months after my surgery, my left eye was still swollen and the asymmetry became more and more apparent. I had several discussions with my doctor and there is a possibility that I might need to have a minor procedure done. But first I have to wait until the six months after the surgery date.

I am now few days shy of 3 months after my surgery and looking at your pictures, they look like how your eyes were in November 2009. That means, my eyes are healing in a much slower pace than yours. As of now, my left eye has a higher crease and the left eye incision is a lot more noticeable than my right eye. However, this was not done by my doctor on purpose like yours did. So basically, my procedure left me with a slight ptosis in my left eye, which is correctable but I now must wait. I wish I can time travel to October 2012 to see how my left eye will turn out so I can stop worrying about my current condition. It is definitely hard not to since we have to see it daily. I hope you are much happier now.
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I know how you are feeling, I am a perfectionist and when it comes to the face, eyes in particular, I am very very nit picky. Just ask my doctor lol. I drive him crazy I am sure when I point out a tiny difference I may see in one eye all the time. He likes to tell me they are sisters, not twins lol. I hate hearing that, that's what boob doctors like remind you too. Anyways, I only took about 4 months for my creases to completely settle. I had some minor modifications as well but it was upon my request (bc of my always trying to reach perfection) and my doctor has been great doing as little trauma to my eyes to keep them healthy and natural looking. Asian eye lids are tricky and not all doctors are experienced enough to do it. I had extreme assymmetry w my double lids and he took off a lot of skin and fat. You can view my eyelid surgery review for more details but I would recommend going to a specialist like I did if you put your eyes through anymore surgery.
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I think it looks great! Trust me, it does.
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by the way don't get revision dude your eyelids are not that asymmetrical at all, my eyes look almost exactly like yours but a little bit more asymmetrical. dude its the crease there that matters, your eyes look much better than before thats all I have to say. symmetry is not really important dude- you have a good looking crease yo, and trust me dude, people will look at you only because of your eyelid creases, not because of the asymmetry
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do your eyes feel tight, stiff and something is pulling down on it? Mines do, and look exactly like yours, but it might be because of my ptosis..
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yup, your eyes are good. I personally would have preferred it a biy higher though but their great
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I think your eyes look great!
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