Should I go for a blepharoplasty revision? Eyes are looking asymmetrical. (photos)

Question

My eyes are looking weird after surgery and. I had my blepharoplasty done 2 months ago. It was the second time and I had the first back in 2014. The surgeon told me the the will make my eyelid opened up more, therefore he made a new cut for the crease. But I noticed a few weeks after the surgery that the incisions are or even and my eyes look very different. Should I go for another surgeon to do a revision blepharoplasty and when is the safest time to do it? I will highly appreciate your answer.

Richard Nadal, MD, FACS · Answer

Hi and welcome to our forum!
From your photos, there is asymmetry noted. However, as you are just 8 weeks out from surgery, asymmetric swelling could play a role. The scars are slightly asymmetric but the redness of inflammation accentuates the difference. This will fade with time. It is for this reason that we wait 6 months before considering revision to allow dissipation of  postoperative swelling and inflammation of healing. 
Continue followup with your plastic surgeon. It is still too early to assess the final result.
Best wishes...

Kenneth D. Steinsapir, MD · Answer

The left eyelid has slight upper eyelid retraction and that appears to be there in the before photos. You may have mild thyroid eye disease. There are issues with the design of your blepharoplasty that contribute to an unhappy result. Generally it is best to let the eyelids heal for at least 6 months before considering revision. I would recommend getting assessed by an oculoplastic surgeon regarding the upper eyelid retraction and eye prominence. The American Society for Ophthalmic Plastic and Reconstructive Surgery maintains a regional directory on their website that will help you find a highly qualified eyelid surgeon close to home.

Dan Landmann, MD · Answer

Thank you for your question and photos. I always tell my patients that the majority of swelling subsides around six weeks postop, but that full healing occurs over the course of a year. For that reason, I would tell a patient who had surgery two months ago to allow more time for healing to take place before assessing the final results and moving forward with a revision. I would suggest going to see your surgeon so that he can examine you and talk about your concerns. If for some reason you are not comfortable returning to your surgeon, then I would suggest seeing an oculoplastic surgeon for an evaluation. Hope this helps. 
Dan Landmann, MD, MSEE

Katrinka L. Heher, MD · Answer

You definitely need to wait for at least 6 months before considering a revision. Either side can heal more slowly and edema is still present so it is impossible to determine if you will need further surgery. If you do it will be a very small touch up so try not to worry. Good luck!

Should I go for a blepharoplasty revision? Eyes are looking asymmetrical. (photos)

Answers (4)