One Eye Bigger Than the Other After Upper/lower Bleph with Skin Removal? (photo)

Question

Hello, I had an upper/lower bleph 4 weeks ago. My eye were very even before the surgery and now one eye is MUCH larger than the other. Swelling, tightness, and bruising seem to be gone. What now? Do I need a revision? I don't want to even leave the house. Is there a chance my eyes will even out? Concerned

Amir Nakhdjevani, MBBS, MRCS, FRCS(Plast) · Answer

Thanks for your question and sorry about your concern. The eyes look quite swollen and will still change over the next 8 weeks. Your final result can be expected around 12 weeks from surgery so there is still some time for the eyelid to pull back some more. Worse case - if it doesnt, you might need a minor revision to address the asymmetry but I would not contemplate doing this before 3-6 months - allow everything to settle down fully before attempting a revision.I hope this is of helpBW

Mark Beaty, MD · Answer

It appears that you had more swelling in the right eyelid post-operatively and that this has persisted, causing some ptosis of the upper lid. This will probably resolve with a bit more time as the swelling decreases. A follow up with your surgeon would be helpful for further assessment.

Michael A. Persky, MD · Answer

Hi Dunraven,

	It appears that your right upper eyelid has persistent swelling that is resulting in the difference between your two eyes.  With time, this should resolve.  In some cases it may take a few weeks.  You should discuss your concerns with your blepharoplasty surgeon.  Good luck and be well.

	Dr. P

Kenneth Hughes, MD · Answer

You have a little bit of right upper eyelid ptosis or droop that is improving over the two week period between the second and the first photo. This may have been due to hemorrhage or swelling in a deeper layer of the eyelid, and this may resolve. I would recommend giving the issue more time as it has improved.

Amiya Prasad, MD - Account Suspended · Answer

During the initial period of healing after eyelid surgery, it is not that unusual to have some difference between the two eyes. There’s a muscle called the levator muscle that is responsible for lifting the eyelids. What you’re experiencing may be something that is related to swelling that affects that muscle.

	In oculofacial surgery, when people have trauma we call that traumatic ptosis. There are a couple of things that may cause drooping of the eyelid after cosmetic eyelid surgery where the muscle is not directly any way operated on. It may be related to swelling where the physical weight can actually push down the eyelid. Or may be related to swelling that caused some temporary stretching.

	It is important that you communicate with your doctor and discuss the options should there be any need for any revision. Review your pre-operative photos and look and see if there is difference between the two eyes. If there was a certain amount of difference that is more than 1-2 millimeters, then you can accentuate that difference during the early post operative period while there is an ongoing healing process.

	I could tell you that this is a temporary issue and that the symmetry does improve. When a situation like this arises in my practice, I will observe for a couple of months and allow swelling to resolve so that if we need to do anything about the muscle, we can do something. I hope this was helpful and thank you again for your question.

One Eye Bigger Than the Other After Upper/lower Bleph with Skin Removal? (photo)

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