Still Droopy Eight Weeks After Upper Blepharoplasty

Question

I had upper blepharoplasty 2 months ago and my left corner eyelid is droopier then before, is it still edema? Should I have the doctor do a revision?

Kenneth D. Steinsapir, MD · Answer

There are two common situations following eyelid surgery that you are potentially describing.  The first is actual upper eyelid ptosis were the upper eyelid margin where the eyelashes live has drooped as a result of the tendon that raises the eyelid having slipped from surgery or swelling from surgery.  The other situation is after having skin removed from the upper eyelid fold, the muscles that support the eyebrow relax allowing the eyebrow to fall increasing lateral hooding.  

	Distinguishing these two situation may require an assessment by your surgeon.  Also be aware that while your surgeon may have been qualified to perform the original cosmetic surgery on the eyelid, fixing whatever problem that you may be experiencing after surgery may require an actual eyelid specialist.

Brent Moelleken, MD · Answer

Upper eyelid drooping after a blepharoplasty is most commonly due to drooping of the outer, or lateral, brow.  It is simply not wise to make a long lateral incision when doing the upper blepharoplasty since the scar would be very visible.

	We often prefer to use a nerve sparing lateral browlift to address this problem.  Endoscopic surgery is also an option.

	The good news is that a lateral browlift can be done later; you haven't burned any bridges by not doing it while you had your eyes done.  However, most patients will choose to do both procedures together.

	Referenced below is a book chapter on the subject.

Malena Amato, MD, FACS · Answer

it can be normal to have asymmetry within the first six months after eyelid surgery that will resolve.  If it has not improved by six months, I recommend that you see your surgeon and discuss options for improvement. Good luck.

Joseph A. Eviatar, MD, FACS · Answer

I recommend waiting at least 3 months before considering a revision after blepharoplasty – as far as droopy lids. Sometimes it takes that long for the swelling to completely go down and for the final result to become evident.

William Portuese, MD · Answer

While it is still too early to make any decisions on revision eyelid surgery, there can be edema in the lateral corners of the eyelids. Wait at least three to four months before making any decisions on tuck eyelid surgery at this point. Full edema and swelling usually subsides by four months after the procedure.

Steven Wallach, MD · Answer

When patients complain of a drooping lateral brow after a bleph, it is most likely that they needed a brow lift to begin with.

Darryl J. Blinski, MD · Answer

NEED a photo!!!! But my guess is lag syndrome after upper lid blepharoplasty. Consult an eye doctor for treatment. Usually self corrects.

	Best of Luck dr. B

Steven Schuster, MD, FACS · Answer

When a patient comes back to me complaining of hooding or lateral eyelid droop I always go back to the pre-op pictures. In almost every case there is drooping of the lateral brow which we have discussed would need a browlift of some kind to correct. Removing more skin is not necessarily the answer and may make things worse. Go back and look at your pre-op pictures and dsicuss with your doctor what can be done.

Kamran Khoobehi, MD · Answer

Without picture it is hard to give you the best answer. You may need to have more skin removed from the upper eyelid or you may need to have brow lift. Please go back to your doctor and discuss your concerns.

Marcus L. Peterson, MD · Answer

After two months almost all of the swelling should be gone in the upper eyelids.  You will need to look at your before and after pictures to see what has changed.  Discuss this with your surgeon and see if a revision is needed but two months should be long enough to tell.

	Best Wishes.

Still Droopy Eight Weeks After Upper Blepharoplasty

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