Does damage to the levator muscle become immediately visible after a blepharoplasty? (photos)

You had ptosis before surgery and your recent surgery made things much worse. The problem was not the prior surgery. The problem is that like many surgeons performing eyelid surgery, she does not understand eyelids and does not understand eyelid anatomy. With the preoperative appearance you had, it is completely unsurprising that you developed ptosis after blepharoplasty. Your preoperative appearance show you to have a compensatory eyebrow elevation. You had bilateral central partial anterior levator disinsertion. Was this caused by your prior surgery. It might have been exacerbated to a degree by the original surgery. Certainly The original blepharoplasty surgeon had the opportunity to stablize the upper eyelid by repairing the partial central levator disinsertion which very likely was present at the original surgery, However that exceeds the understanding of eyelid surgery of 99.5% of
blepharoplasty surgeons out there. You did okay with that first surgery. This second surgery is something of a problem. Obviously your second surgeon also completely ignored the preexisting ptosis-did she even examine your eyes? On top of this, I question the design of the revisional blepharoplasty--things look pretty rough. I most definitely would not let this surgeon "fix" the eyelids at this point. You need real help.

You must be seen by an expert Oculoplastic surgeon. Only an expert will fix this issue.
Be encouraged!!
Dr. Cardenas

I think it’s going to be difficult to get an answer to your question.
Providers are often reluctant to take ownership, and will find any excuse to blame someone other than themselves.
At this point, I think you need expert care to address the outcome, imperative
Look for senior oculoplastic surgeons in your community, who have experience successfully treating unilateral ptosis in terms of both assessment and treatment.
You’ll probably need surgical exploration, and an oculoplastic surgeon should be able to determine if the levator muscle has lost its attachment and put it back together.
It would be fairly important to differentiate if there is a potential neurological explanation.
Get into the hands of the right provider for both assessment and treatment.
This may require having multiple in person consultations before finding the right provider to help you.
Best,
Matt Hagstrom, MD