Asymmetry After Lower Blepharoplasy - What Can Be Done?

I am in my late 20s. Two years ago, I had a lower transconjunctival bleph on both eyes (not laser). Afterward, one eye was still puffy. My doctor agreed and in 6 months I had an unsuccessful revision on the puffy eye. After a full year, it is still puffy and the other looks like too much fat was removed. Would it be possible to try again in the future (w a different doctor)? Also, can I get a bit of fat back in the other? I would like a bit of fat put back to support my lower lid.

Doctor Answers 4

Post photos

Fat grafting is possible. However if the asymmetry is subtle, it may not be possible to guarantee perfect results.

Without photos, it is impossible for us to give you a good evaluation on the concerns that are specific to you and your anatomy. Please post high quality photos of the eyes AND the face to give us a better perspective.

Seattle Oculoplastic Surgeon
5.0 out of 5 stars 37 reviews

Lower Eyelid Asymmetry after Blepharoplasty

Asymmetry is present in everyone's face to a certain degree, which is normal. However, asymmetry between sides of the face should not be so great that it draws attention. There are many reasons why one eye bag is puffier than another, which also includes medical conditions such as allergies or thyroid condition.

Only after a comprehensive evaluation can an eyelid plastic surgeon help determine appropriate options for you. Further surgery is unlikely to be the best option. One may consider injectable filler with hyaluronic acid (Restylane) to help reduce lower eyelid asymmetry. Best of luck.


Dr. Chaboki


Houtan Chaboki, MD
Washington DC Facial Plastic Surgeon
4.9 out of 5 stars 85 reviews

Fillers are likely your safest option.

I am so sorry that you have had this experience.  Photographs are really essential to understand your concerns.  It is likely that your surgeon did not correctly understand the basis for your puffy eyes.  At your age, it was improbable that you actually needed lower eyelid surgery although it is possible.  I would be very careful about looking for more surgical solutions.  Can fat be put back into the lower eyelid?  Yes and many surgeons will be more than happy to offer you this service.  However graft fat can also be very problematic.  In my office, I would first consider whether Restylane treatment might be able to address your concerns.  These treatment tend to last well over a year and can easily be adjusted if there is an issue.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Revision of lower lid bleph

Photos would be very helpful. I would like to understand the reason for the bleph in your 20s and what you categorize as puffy/too much fat removed. Fat grafting may be an option but the more you try to correct a perceived problem, more problems may results I'd recommend a lot of research and consultation with board certified plastic or oculoplastic surgeons.

Robert L. Kraft, MD, FACS
New York Plastic Surgeon
5.0 out of 5 stars 40 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.