Are my eyes asymmetrical after upper blepharoplasty? (photos)

I am noticing a significant asymmetry my eyes 3 months post upper, lower bleparoplasty with fat reposition & brow lift. It seems to me that right eye is smaller & fishtailed in the corner. What went wrong? What are the recommendations to correct it?

Doctor Answers 3

Are my eyes asymmetrical after upper blepharoplasty?

If you are complaining about dropping of the eyelids or lower eyelid bagginess then you might be a good candidate for the Laser Blepharoplasty operation. Although the plastic surgery era is highly developed and there are new treatment models for several other procedures; there is still no efficient alternative of blepharoplasty operation. If you are not comfortable with the look of your eyelids blepharoplasty operation may be a solution for you.

Asymmetrical Eyes.

Looking at your left picture (assumed preoperative) and comparing to the right, you do have asymmetry of the eyes and eyebrows.  Your left photo showed asymmetry as well, so I don't think the surgery caused your asymmetry.  Asymmetry of the eyes and brows is often from underlying bony orbits-facial asymmetry.  Soft tissue surgery on the eyelids/brows can improve this some, but not usually totally overcome it.  Also you with the there surgeries you had that is a lot to recover from and you may not be to your final results for another 3 months or possibly longer.  I don't think you had too much surgery as when the upper/lower eyelids and brows need to be addressed I think it is best to do them simultaneously.  A non-surgical option for your eyebrows would be to do some botulinum toxin on the right brow depressor muscles to raise it and on the left forehead (frontalis) muscles to lower it.  An experienced injector would know how to do this.  Your right outer corner of your eye is perhaps a bit higher than the left, but your provided photos are small and not zoomed in on your eyes.  A canthoplasty could improve this aspect, but your right eye from your photos I think will remain smaller than your left likely from what I suspect is your smaller right orbit.  Your original surgeon knows your situation best, so I would speak to him/her and voice your concerns and go over options if there are felt to be any.  Sometimes we will do one-side brow lifts to help with marked asymmetry.  I hope this information is informative and helpful.  I wish you the best. 

John R. Burroughs, MD
Colorado Springs Oculoplastic Surgeon
5.0 out of 5 stars 14 reviews

Asymmetry after blepharoplasty

We all have a little natural facial asymmetry prior to surgery. Preoperative photographs would show if you had some asymmetry prior to having blepharoplasty. Also, it is very common to see asymmetry after blepharoplasty. I think what you are noticing is the slight difference in contour of the lower lid margin. The left lower lid dips down slightly at the lateral corner compared to the right. Mild residual swelling may be present at 3 months (pushing the right lateral corner up). This may resolve spontaneously over time. The eyelid tissues are very distensible and edema/ swelling/ bruising may be quite different on one side compared to the other even with the same procedure performed on each side. Mention your concerns to your doctor and set up an appointment at 12 months if you are still concerned. 

Sara A. Kaltreider, MD
Charlottesville Oculoplastic Surgeon
5.0 out of 5 stars 3 reviews

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