Uneven eyelids after upper blepharoplasty - 3 months post-op. (Photos)

Question

After 3 months What do I do and what is my problem My doctor specifically does not tell me and only asks to wait until 6 months Do I find a response to my problem

Mehryar (Ray) Taban, MD, FACS · Answer

Your left lower eyelid appears lower (retracted) compared to right eye. There could be also other cause for the asymmetry. See an oculoplastic specialist.

Robert Deeb, MD · Answer

Hello and thanks for the question.  From the photos, it does appear that you have some mild asymmetry.  It is nearly impossible to have get eyelids look exactly the same after surgery, in fact a little bit of asymmetry is normal and probably existed before the surgery.
With that being said, if this is something that is bothersome to you, I would recommend waiting at least 6-8 months for the swelling to fully subside. Often things smooth out with time. If it is still an issue after waiting then sometimes a small revision procedure is necessary to even things out.  I would recommend discussing your concerns with your surgeon.  
Hope that helps and good luck

Jeffrey Joseph, MD, FACS · Answer

Although it's too early to judge your results, your left eye may have a weakness in the muscle that lifts the eye.  Sometimes it is not obvious in mild cases such as yours to see it preoperatively.  Give it some time before evaluating and keep your follow ups with your surgeon.

Kenneth D. Steinsapir, MD · Answer

Of course perfect would be better.  However, persistent swelling can make a difference. I totally agree that you need to give this time.  So long as this is improving, I would give this time before trying to jump in with more surgery.  That patience should extend out even a full year if necessary.

Mark Beaty, MD · Answer

Asymmetry after eyelid surgery can be the result of swelling.  I agree with your surgeon that waiting 6 to 8 months to insure all swelling is resolved is appropriate before deciding whether any revision is necessary.

Ann Jayaram, MD · Answer

Thanks for reaching out, great question! While swelling does play a role, I'd recommend reassessing for yourself if you feel the asymmetry is coming from the upper or the lower eyelids. Because your left lower eyelid is lower than your right, it may be giving the illusion of "asymmetric eyes" in general, when really this has not too much to do with your upper eyelid. Your eyelid plastic surgeon can help you in making this determination! Hope this helps!

Shoib Myint, DO, FAOCO · Answer

Hello aly attia,Seems like you are healing well. Sometimes it does take 3-6 months for people to heal. It is very difficult to determine what is the cause of the appearance before edema and wound healing has resolved. However, sometimes it is possible for the levator muscle (which elevates the eyelid) to be affected after skin removal. Even in ptosis surgery where the muscle is lifted and tightened, it is possible for a reoperation to address that muscle again due to its intrinsic weakness. My suggestion is to have patience and follow up with the surgeon in the next few months. It is better not to rush this with another surgery too early. Hope this helps.Cheers

Jason Lichtenberger, MD · Answer

You do appear to have some asymmetry.  The left upper eyelid appears somewhat ptotic (droopy) which can be a result of blepharoplasty when the levator muscle is injured or stretched in surgery.  Revision surgery may be necessary but I would recommend waiting to see how things look at 6-9 months unless it is causing you great discomfort, dry eye, or vision problems.

Sara A. Kaltreider, MD (retired) · Answer

At 6 months after surgery, you will have a more accurate answer to your questions about the uneven eyelids. Your photographs show that the brows are very low and potentially pushing the lid margins down. It is difficult to assess from your photographs - 3 months post-op photo taken in slight upgaze - but it appears that you may have an element of ptosis (levator dehiscence). Some measurements at 6 months will be very helpful prior to your next decisions. Best wishes.

Donald Nunn, MD (retired) · Answer

Yes, you do have some asymmetry of your upper eyelids.  Your surgeon is right to want to wait at least 6 months before a final decision is to made about any revision surgery.    You may still have some swelling which is contributing to the asymmetry of your upper eyes.  Most of the swelling will be resolved by 6 months post operatively.  At that time, simple excision may be all that is needed to improve the asymmetry.   Good luck.  Donald R Nunn, M.D. Atlanta plastic surgeon

Uneven eyelids after upper blepharoplasty - 3 months post-op. (Photos)

Answers (10)

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