How to Avoid Bad Eyelid Surgery Results?

My under eye area is a bit puffy and I was thinking of having something done. I looked at a RealSelf user's review, where her photos showed she had wrinkling under her eyes after upper eyelid surgery and laser resurfacing. Was it caused by the laser since the surgery was for the upper eyelids? How can bad results like this be avoided?

Doctor Answers 9

Eyelids are like snowflakes, no two are exactly the same

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Sometimes the most simple answer is the best. Since eyelids differ from person to person, so also the surgical needs  varies from person to person and technique from doctor to doctor. Your best best is to find a physician you can trust and can customize the surgery for your specific needs. Good luck.

Seattle Oculoplastic Surgeon
4.6 out of 5 stars 12 reviews

Understand goals of eye surgery/procedures to avoid poor outcomes

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The goal for lower eyelid surgery is to reduce puffiness by removing fat bags from underneath the lower lids. If there is excess skin after the fat bags have been removed, a very small conservative amount of skin is removed from the lower lids. The goal for upper eyelid surgery is to remove primarily extra skin and a small amount of fat located on the upper eyelid nearest the nose. Laser resurfacing is done to help smooth out wrinkles on the lower lids.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 158 reviews

Avoiding bad results in eyelid surgery

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Find a physician you trust and state your goals explicitly.  Do not expect perfection or a complete lack of lines.  Do not have anything done if you are afraid that it might not turn out the way you want.

Brian Biesman, MD
Nashville Oculoplastic Surgeon
4.8 out of 5 stars 43 reviews

What may cause the wrinkles after eyelid surgery?

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The wrinkles can be caused by removing the fat, and the area will get hollow as a result. You may want to do fat repositioning. This procedure prevents the under eye area from getting hollow and may possibly prevent more wrinkles. Hope this helps answer your question.

Dr. Nassif

Paul S. Nassif, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 49 reviews

Injectable fillers are wonderful for lower eyelid rejuvenation.

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If your only concern is the appearance of lower eyelid puffiness, you could consider consultation with a specialist experienced in the art of filling lower eyelid grooves. Your lower eyelid bags become more prominent with age since a groove develops between your lower lid bag and your cheek fat. Filling these grooves can lead to satisfying results for you.

I've attached a photo demonstrating this technique.

I hope this is helpful for you.

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon
4.9 out of 5 stars 435 reviews

Bad eyelid surgery results

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The absolute best way to avoid any "bad eyelid surgery results" is to avoid having eyelid surgery because even in the best of hands some complications cannot be prevented. So, to get improvement, we must all take chances.

To minimize the chances of "bad eyelid surgery results" you should have your surgery from a Board Certified Plastic surgeon ( .

Depending on your lower lid, the fat puffiness can be removed through an incision on the inside of the lower lid (transconjunctival) which does not leave a scar on the outside. The fat could be removed or pulled down over the crescent shaped rim of the eye socket making it less obvious. Depending on the looseness of the lid, you may also benefit from a tightening of the lateral lower lid attachment (lateral canthus) to the eye socket (Canthopexy).

Good Luck.

Peter A. Aldea, MD
Memphis Plastic Surgeon

How to avoid bad lower eyelid surgery

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Upper lid surgery is relatively simple compared to lower lid surgery. First I would recommend you choose an ophthalmic plastic surgeon since their training is concentrated around the eyes and they generally get very good at it. The key with lower lid blepharoplasty is 1. how the fat is handled, 2. how the surgeon gets to the fat, 3. how lower lid margin distortion is avoided, and 4. how the excess skin is handled.

Before you decide on the surgeon, interview all of them on these issues. I strongly believe that the best way to handle the fat is to minimize removal and to reposition it instead to plump up the depression under the bulge. The best way to get to the fat is to avoid going through the muscle under the skin. Instead I approach the fat through an incision behind the eyelid which is a bit harder but it minimizes the chance of many complications. Finally, I always strengthen the attachment of the eyelid tendon to the outer rim of the socket bone and remove excess skin conservatively. Laser resurfacing can be used to improve the texture of the eyelid skin but it has to be done carefully.

Peter T. Truong, MD
Fresno Oculoplastic Surgeon
4.9 out of 5 stars 43 reviews

Avoiding bad surgery

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First, you need to define what bad surgery is. Some "bad" results are in the eye of the beholder.The most important thing is to communicate with your surgeon. You need to have a meeting of the minds so he knows what resukt you are looking for and whether that is achievable. Different anatomy demand different approaches and resuts are dependent on the anatomy, the analysis of the surgeon, the skill of the surgeon, and your specific healing. Communicate, communicate, communicate.

Robin T.W. Yuan, MD
Beverly Hills Plastic Surgeon

Bad Results Under Eyelid from Surgery

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Some wrinkles under the eyelid are normal and not necessary bad result from surgery. The worst results happen when you try to take too much skin from under the eyelid and that leads to a scar pulling down the eyelid margin.

The most important thing is COMMUNICATION.

Talk to your surgeon and ask questions, explain in detail what you want and arrive at a common goal that both you and your surgeon feel is realistic and achievable.

Also look at other patient's photographs.

Get at least two opinions.


Tanveer Janjua, MD
Bedminster Facial Plastic Surgeon
5.0 out of 5 stars 126 reviews

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.