Asymmetrical eyelids after upper and lower blepharoplasty/eyelid surgery. Do you think I need a revision? What kind?

I am 26 days post upper & lower eyelid surgery. Before surgery, my left upper eyelid was slightly more hooded than the other, which the dr admits he may have over corrected.One incision is higher than the other resulting in a larger lid and A-frame deformity.Everyone each eye heals independently, one needs to wait 3 months before making any decisions, but based on my photos and surgery, I am not optimistic it will change that much. Does it look like I'll need a revision? What kind and which eye?

Doctor Answers 8

Eyelid asymmetry.

You do have slight upper eyelid asymmetry and I would recommend waiting 4-6 months to allow your tissues to fully heal and soften.  As lowering a crease can be difficult surgically, consideration should be given to a careful resection of additional skin from your right upper eyelid skin to gain as much symmetry as possible, with the understanding being that there is no perfect symmetry.  Your left upper lid may benefit from addition of volume, either by fillers or fat grafting.  Speak with your surgeon about your concerns.  Best wishes.  

Blepharoplasty revision

I certainly see the difference between the eyes, and you will most likely need a revision, but I would recommend waiting until you are a full six months out from surgery before considering it. At that time, a personal evaluation would determine whether to retreat the left, right or both eyes.

Andrew Campbell, M.D.

Facial Rejuvenation Specialist

Quintessa Aesthetic Centers

Andrew Campbell, MD
Milwaukee Facial Plastic Surgeon
4.7 out of 5 stars 26 reviews

Assymetry after blepharoplasty

You are correct in that you likely could benefit from a revision.  Deeper crease probably results from a scar attachment of the skin to the underlying structures.  Waiting a few months is advisable.

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

Asymmetry 26 days post op

I definitely agree you need to wait so full healing can occur but I also believe you will need a revision. If there is extra skin on the right upper lid then you may consider surgery on the right side. It is difficult to lower a crease so left upper lid surgery would be trickier, but filler can be placed to help with the "A frame deformity". I hope this helps and best of luck.

Katrinka L. Heher, MD
Boston Oculoplastic Surgeon
5.0 out of 5 stars 8 reviews

Too early to determine revision surgery

While I know that looking at your eyes you think that you need immediate surgery, I would hold off.  Upper and lower eyelid surgery is actually four entirely different operations. Because of this reason,you may have a symmetric healing for sometime.. I would not consider doing a revision surgery of your eyes until at least six months have passed. At that point you can be reevaluated and see if there's a need for it. 

Carlos Wolf, MD
Miami Facial Plastic Surgeon
4.9 out of 5 stars 60 reviews

Asymmetry following blepharoplasty

One month following a blepharoplasty there is still postoperative  swelling. It is better to wait 3-6 months before considering any revision surgery. 

It is good to be conservative with eyelid surgery and as plastic surgeons we can always remove more skin later (right upper lid). 

I would allow more time to heal and visit your surgeon for follow up. 

Andrew Turk, MD
Naples Plastic Surgeon
4.8 out of 5 stars 29 reviews

Eyelids

It would be nice to see preop photos. There is some asymmetry( but one can not expect perfect symmetry as no one has that to begin with). You are still early post-op and this may change as well.

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

Before deciding on the course of revision surgery, try to be patient and let the eyelid heal more.

It is amazing that more helping is very beneficial.  At 4 to 6 months, you will have a much more accurate idea of what is going on here.  Sometimes the differences settle down to the point where they are acceptable and not worth having more surgery for.    The left upper eyelid does not have a true A frame deformity so don't let the internet poison your thinking.  You left upper eyelid crease was made a bit high than the right.  It could be lowered or the right fold could be raised.  This is best done with an anchor blepharoplasty to support the upper eyelid lashes.

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

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