How long should I wait for revision blepharoplasty? (Photo)

Question

Unhappy blepharoplasty and ptosis repair results. My right eye looks unnaturally pulled up and now my left eye looks droopy. I also don't like how hollow my eyes look now. I just want my eyelids to look naturally opened and refreshed. Will I be able to get this fixed properly?

Kenneth D. Steinsapir, MD · Answer

After ptosis surgery, I am extremely tolerant to an under corrected eyelid.  If the eyelid looked right on the operating room table, generally the heaviness is just related to swelling. Patience is rewarded by the gradual resolution of the swelling. The situation is just the opposite for an over corrected eyelid.  In my book, this must not be allowed to heal like this.  Generally, when I see this, I return the patient immediately to the operating room.  That happens with my patients in less than 1% of cases but it can happen so we talk about it before hand.  In my opinion, it is a mistake to let this permanently heal like this.  It is not going to get better on its own.  This can reasonably be "undone" out o about 2-3 weeks but is best in the first week.  After that time frame, the healing has progressed to the point where I think it is far preferable to wait 6 months before performing revisional surgery. My concern with leaving you like this for the next 6 months is corneal exposure and eye irritation.  Of course your appearance is also affected by this contour abnormality. Speak with your surgeon about immediate revision today.  They are welcome to call me if they need some encouragement to take you back to the operating room.

Thomas A. Mustoe, MD, FACS · Answer

Your eyelid is pulled up with a peaked appearance which is almost certainly due to a stitch used as part of the ptosis repair.  The choices are early correction.. within the next few days to revise the stitch or to wait at least 6 months.  You need to talk to your surgeon.  An early revision would best be done by the original surgeon who knows what was done.

Jacqueline T. Cheng, MD · Answer

Hello and thank you for your question and photos. In cases where an over-correction is performed during surgery, your results can be revised within one to two weeks of your original surgery date. However, if you have had your surgery prior to this period and you have already begun to heal with these symptoms, it is best to complete recovery before seeking a revision surgery. After six to eight months, you can safely undergo a revision blepharoplasty to make the necessary corrections. Schedule an in-person consultation with a board-certified facial plastic surgeon in your area to discuss your revision surgery. Good luck! 
- Jacqueline T. Cheng

Dhaval M. Patel, MD · Answer

Thank you for your question and photos! I would not suggest a revision until at least 8 months post op!  I recommend you speak to your original plastic surgeon and discuss your options!  Best of luck!Dr Dhaval PatelDouble Board CertifiedPlastic Surgeon Hoffman EstatesOakbrookOrland Park Chicago

Mehryar (Ray) Taban, MD, FACS · Answer

Discuss with your surgeon. The peaked right upper eyelid may stay that way so it might be best to release as soon as possible and then let everything heal and re-evaluate in 3 months.

Rohit Seth, MD, MRCS(Ed), PhD · Answer

Thank you for your question. 11 days from surgery is still quite early and you may still find there will some change. However, it does seem at the moment that your right eye is pulled more centrally. Did you have any problems following the surgery?It would be worth going back to the surgeon so he/she can see if there has been any change from the initial post surgery result - I tend to take pictures at the time of completing the surgery and also when I see my patients at their first and all subsequent visits so we can monitor how the area is healing.I also use a stitch that is removed at 1 week and it can depend on what methods were used as to what can develop post-operatively.I hope this is of some help to youBW

Ahad Mahootchi, MD · Answer

Even in great hands that sometimes happens. I think, it's been enough time and a re-operation would be the best chance of fixing that--sooner rather than later.Best of luck to you.

Jordan Spindle, MD · Answer

I usually address an "overcorrection" or "peaking of the eyelid" at the first post op visit around 1 week.  This is more difficult to address if allowed to fully heal, and is pretty easy to fix if it is caught early.  An eyelid that is too low at 1-2 weeks can be allowed to heal fully before making a decision.  At 2-3 months, it is reasonable to assume that it may need further lift as a touch up procedure.

David Azouz, MD, FACS, FRCS(C) · Answer

The results may still improve with massage and time after a blepharoplasty and eyelid surgery.  Normally I would recommend 6-8 months before revision blepharoplasty surgery.  A plastic surgeon can guide what was done in surgery and when they expect the tissues to become less swollen and relaxed.  The unique aspects of blepharoplasty surgery is that swelling and fluid becomes "trapped" between the blepharoplasty incision and the eyelid.  This means that it takes longer than many other surgeries for the swelling to improve and for irregularities to "settle".

How long should I wait for revision blepharoplasty? (Photo)

Answers (9)

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