Asymmetric eyelid crease - do I need a revision surgery? Can this be corrected with filler? (Photo)

Question

I'm a 44 year old female,had an upper blepharoplasty (11months ago)do to hooded eyelids that where making it hard for me to see. I'm happy with the functional results,as I feel very comfortable opening my eyes now,but can see a difference between the creases of my eyes,the crease seems higher to me in the eye that had most skin/fat removed. My question is,can this be corrected by injecting some kind off filler? Do I need a revision surgery?is it a complicated procedure? Thank you

C. Blake Perry, MD · Answer

You have some hollowness in the right superior sulcus. This can be treated with either filler, fat repositioning, or fat grafting. Best to see an eyelid expert in your area.

Jonathan Kulbersh, MD · Answer

Hello, and thank you for providing images along with your question. Based on your photos, your asymmetry is relatively minor and unlikely to be noticeable to anyone but you. To achieve the symmetry you desire, you may consider filler injections in the right upper eyelid or undergoing blepharoplasty to correct the left upper eyelid. To know for sure, I recommend scheduling an in-person consultation with a reputable board-certified facial plastic surgeon. Your surgeon will assess your profile, evaluate your specific concerns and goals, determine the ideal procedure for you, and ensure the best possible results.

Sheila Barbarino, MD, FACS · Answer

The answer is you can do either! If it's still early in your recovery of your eyelid surgery, I'd wait until at least 3 months sometimes 6 months before doing anything your results could still be taking shape. Both are great options if you are not happy with your results. I hope this helps!

Kenneth D. Steinsapir, MD · Answer

Many would not be bothered by this difference. However, it can be a sources of dissatisfaction with the outcome of your surgery. Fixing this is generally unavailable. I perform this work daily but few other surgeons are in the business of crease lowering surgery. Filler can be used to replace some of the upper eyelid fold. Finding an injector who can reliably address this without creating a new issue is frustratingly challenging. A recommendation for revisional surgery warrants an in person consultation. It can't be make on the basis of a Zoom meeting. Your eyes can be your best feature.

Patrick Flaharty, MD FAACS · Answer

There is a subtle asymmetry to your eyelid creases with slightly more lid plate show on the right upper eyelid than the left. The first question to ask is which eyelid do you prefer? If you prefer the left upper eyelid you could try a small amount of filler with a cannula technique to fill in the the right upper eyelid hollow helping it better match the left upper eyelid. If, alternatively you prefer the right upper eyelid you could then consider a minimal blepharoplasty (additional skin removal) from the left upper eyelid to help it better match the right upper eyelid. Reconsulting with your surgeon to discuss these options would be a good next step.

Robert T. Buchanan, MD (retired) · Answer

Though you do have a slight asymmetry in the upper creases, it is no more than you had before. Personally, since the main thing you were previously concerned about is corrected nicely, I would just ignore it as most observers will never see it. However, if it continues to bother you, I would inject a very small amount of filler on the right just above the pupil. Since this is a complicated and somewhat dangerous area, I would make sure you see a true expert in treating this area.

Asymmetric eyelid crease - do I need a revision surgery? Can this be corrected with filler? (Photo)

Answers (6)

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