To make an assessment regarding the outcome of the procedure, we first inform most need equality set of before and after pictures. If you don’t have a set up before and after pictures to ask your surgeon to forward the pictures they took. Your surgeon is also with the correct person to follow up with regarding the concerns. It would also be helpful if you can tell us exactly what your surgeon attempted to do with the lower eyelid blepharoplasty. There are a few different things that can be done with this operation. First, the incision can either remade through the skin or in the back of the eyelid through the conjuring. Skin can be removed if the incision is at the last line Orbicularis muscle can also be removed. Plastic surgeons may do this if they wish to tighten the skin of the lower eyelid. Doing this can Cause the lower eyelid to be pulled down creating an ectropion. After the primary goal of a lower island blepharoplasty is to remove fat from the three separate individual fat pads deep to the lower eyelid. Sometimes the fat is not removed, but rather repositioned. Some individuals also have a loss of volume in the upper midface that benefits from volume restoration. Some plastic surgeons will try to move the fat from the lower eyelid to fill in the lack of volume in this area. My best guess is that your surgeon attempted some version of this. It looks like the fat pads of your lower eyelid are bulging more after the procedure repaired. If you’re not getting the care or explanation you need from your provider then I suggest you get an in person second opinion consultation. I highly recommend patients Avoid virtual consultations. For second opinion, consultations come prepared. Bring with you the best set of before and after pictures you can obtain and a copy of your previous operative report. These are all part of your medical record that you can request from your current providers office. They have a legal obligation to forward Copies of any or all aspects of your medical record. Bring the operative report and before and after pictures to the second opinion consultation. The report should explain exactly what was done during surgery and this will help shed some light on why your results looks the way it does. From the information provided we can give you a quality assessment. This response was dictated. I apologize about any grammatical errors. Best, Mats Hagstrom MD