Asymmetrical Eyelids After Blepharoplasty

I think I have asymmetrical eyelids after 8 weeks of upper Blepharoplasty. My right eye crease is a bit higher than the left eye's, and that causes uneven eye shapes. Not sure if swelling still exists on the right eye, but it looks more puffy than the other. I'm not sure if I'll be happy or satisfied, but will I need a revision surgery? Will the swelling eventually go away after 2 months or so? If revision surgery is needed, will that involve correcting the right eyelid only, or both?

Doctor Answers 16

Asymetrical eyelids after blepharoplasty can improve for 4-6 months after surgery

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Your right eye is still more swollen than the left and should continue to improve for the next few months. The right upper eyelid looks a little lower and the eyelid muscle may still be regaining function after surgery.

These asymetries are not uncommon and yours appears to be very slight at this point. I would expect that you will recover. I would not consider revision until at least 6 months and preferably a year.

Evaluate 4 months after surgery

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At eight weeks post blepharoplasty the eyelids are not fully healed and no revisional surgery is required at this point. After three to four months if there is still an asymmetry that is present, revision blepharoplasty surgery can be considered. Sometimes only one eye needs to be corrected, and occasionally both eyes need revision surgery. This decision depends upon the presenting issues and problems that are presenting themselves.


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It is very common to have asymmetry between the two eyelids after Asian eyelid surgery even after two months. There still may be swelling and definitely healing of the incision. You should wait until the 6 month mark to make a decision on corrective surgery.

Min S. Ahn, MD, FACS
Westborough Facial Plastic Surgeon
4.6 out of 5 stars 35 reviews

Don't touch a thing: Swelling after upper lid blepharoplasty

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This is still too early to draw any long term conclusions about the final result.

If this is a double eyelid surgery then occasionally the swelling on the eyelid can persist. However, there are numerous other causes which should be evaluated by your surgeon prior to drawing any conclusions.

These can include:

  • edema (swelling)
  • lymphatic obstruction
  • stye/chalazion obstruction of eyelid structures
  • mechanical factors (sleeping with your head towards the right side)
  • previous scars
  • infection
  • dry eye syndrome
  • inflammation
  • chemical irritation
  • numerous other causes

Discuss this with your surgeon but be patient. Occasionally there are some dimple solutions that depend upon the cause. From your pictures it looks mild and is likely to resolve without any additional treatment. I would advise you against seeking any revisions at this point in time and do not feel it will be necessary.

Take care! I hope this hleps

Asian eyelid surgery

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I actually think your result looks quite nice.  Asymmetry is quite common in all eyelid surgery, especially if there is asymmetry preoperatively.  Your asymmetry is minimal and although it may be addressed with a revision, I think at eight weeks it is too soon.  

Asymmetry of eyelids after Asian eyelid surgery is common in healing period.

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As you said, if your right eyelid looks "more puffy" to you then most likely swelling is the cause of the asymmetry at this time and  you should see an improvement soon. 

You may want to look at your picture taken before the surgery to see if there was mild ptosis of your right eyelid. 

At this time, I wouldn't worry much about having revisions as you probably will not need it.


Still some swelling on the right side

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the right eyelid still looks swollen.  i would wait until the swelling completely resolved before making a decision on revision.  if a revision is needed, generally only the right eyelid would need revision.
if this condition persists, you may have ptosis of the right eyelid that was not addressed with your initial surgery.  this means one of your eyelids is lower than the other, a very common finding in most people.  this can be corrected fairly simply using a non-incisional method such as a Muller muscle tuck or an incisional method such as levator plication or levator advancement.  all of the surgical techniques tighten the muscles that determine the position of the eyelid so that the eyelid will be in a higher position.

my preference in cases such as yours is to tighten the muller muscle with a suture, a technique called non-incisional ptosis repair, using the same strand of suture that is used in a non-incisional double eyelid fold creation, to create the fold and lift the eyelid higher.  this technique is uncommon in the US and was developed in Korea, where asian eyelid surgery is the most commonly performed plastic surgical procedure.

Asymmetry after Asian eyelid surgery

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Everyone else is correct.  Just give it a few more months, you'd be quite surprised how things settle.  You still have a little swelling there.  I wouldn't consider any changes until at least 6 months have passed.


Best of luck


Chase Lay, MD

Chase Lay, MD
Bay Area Facial Plastic Surgeon
4.9 out of 5 stars 76 reviews

Asymmetry after Asian blepharoplasty

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I usually always tell people that you get 60% of healing at 6 weeks, and 90% at 6 months. 8 weeks is too early to judge your results.  The right eye is swelling will make the eyelid crease on that side higher. This will come down and you will have more even results. I wouldn't contemplate doing a revision until all the swelling comes down.

Philip Young, MD
Bellevue Facial Plastic Surgeon

Eyelid asymmetry after asian eyelid surgery

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You should wait about 6mo after surgery to reevaluate. The asymmetry will improve. It appears that you have asymmetric ptosis which most likely was there preoperatively. This usually worsens during the healing process if not addressed at the time of surgery. If at 6mo the asymmetry persists, then the ptosis will need to be corrected - it looks like it's in both eyes, more so on the right eye than the left.

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.