Revision Eyelid Surgery Suggestions? (Photos)

2 mths ago upper/lower bleph w/ptosis repair both eyes/endotine direct brow lift on left. Before eyes were same size and almond shape, eye brows/ lids had become uneven, left side drooped more than right. Reasons for surgery; to even my eyebrows/eyelids and make eyes open,brighter, refreshed. Now they are completely uneven, I have a lump on outside corner, and look more tired/older than before. Dr wants to do a revision ptsosis repair left only. Is that all I need to repair this? Please help

Doctor Answers 8

Revisions

Several more months will allow the edema and inflammation of the first surgery to subside. Then you have some options. If you were my patient, I would recommend lifting the brows a bit more to get them off of the lid platform (pretarsal area), and addressing the lid curve (right and left), level (left), and crease/ pretarsal area where the skin is bunched below the crease. There is enough skin to do this as your crease in the first photo appears high. I believe that if these items are addressed with meticulous attention to the details, then your eyes will be beautiful and symmetric. Meticulous attention to fine details are required. Some or even all of these surgical revisions could be addressed in an office setting with sedation and local anesthetic.


Charlottesville Oculoplastic Surgeon
5.0 out of 5 stars 3 reviews

Assymetry post op

It is difficult from just photos, but it appears they didn't correct the pre op Ptosis on the left eyelid and you have residual brow ptosis on the left. The lump on the lower eyelid is probably residual fat. I would wait at least 6 months post op , but you will at a minimum require an eyelid muscle tightening on the left eyelid(at the same time they can remove the residual fat on the lower eyelid). I would get a second opinion with an oculoplastic surgeon in your area.

Byron A. Long, MD
Marietta Oculoplastic Surgeon
5.0 out of 5 stars 3 reviews

Eyelid asymmetry post op browlift

What happens when you elevate the left brow to a "normal" position with your finger?  Is the eye opening (palpebral fissure) symmetrical?  If so the it is more a brow problem.  If that doesn't change the opening then probably a revision of the eyelid ptosis correction plus a brow correction is necessary.  In any case I recommend waiting 3 more months to see if there is any change as additional healing takes place before any further surgery.

Richard O. Gregory, MD
Orlando Plastic Surgeon
5.0 out of 5 stars 11 reviews

Both upper eyelids are now more droopy then before surgery.

The two sides are asymmetric, and the eye lashes are droopy (lash ptosis). The surgeon did not control the upper eyelid platform so they are disorganized and bulky.  It is hard to recommend that you let the original surgeon do any more work on these eyelids.  First you need to heal more.  I recommend waiting at least another 4 months before having the eyelid revised.  It is unrealistic to think your issues will resolve in this time.  This time allows the tissues to settle down.  Not every surgeon can perform this type of revisional work.  You need to find surgeons with a track record of doing these type of revisional work.

Kenneth D. Steinsapir, MD
Los Angeles Oculoplastic Surgeon
4.9 out of 5 stars 23 reviews

Revision eyelid surgery

The main issue appears to be the contour and height of the upper eyelids being asymmetry. The lump is likely residual fat. See an oculoplastic surgeon.

Mehryar (Ray) Taban, MD, FACS
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 62 reviews

Eyes

Your upper lids have a tiny asymmetry. Both brows still appear a bit low though within normal range - depends on your goals. If your surgeon can predictable improve the lid position for you it may be a reasonable option however I would suggest considering waiting 6-12 months for the tissue to soften and stabilize before trying to further alter it.

Robert H. Hunsaker, MD
Miami Plastic Surgeon
4.4 out of 5 stars 72 reviews

Post op bleph

I think you look better then before.  You do have some residual ptosis on the left.  You need to wait at least 6 months to give yourself time for all the swelling to resolve.  If you have an endotine on the left, the left brow and lid will take longer to heal.  The lid may come up a bit more over the next couple of months.  If at 6 months it is still low can probably lift with an internal approach.  You have very heavy brows with a full brow fat pad.  This can also take a long time for the edema to resolve.  

John J. Martin, Jr., MD
Coral Gables Oculoplastic Surgeon
5.0 out of 5 stars 25 reviews

Swelling

You are likely swollen. The bump you feel is likely the endotine. You need to give it 6 months to a year to settle down. Best of luck.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 24 reviews

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