One eye looks hollow after upper and lower eyelid surgery. If there a chance to fix it? (Photo)

Im 4month post-op after having undergone upper&lower eyelid surgery.The minute I looked in the mirror after surgery my left eye was much more swollen than another one. Now my left eye is hollow looking (though Dr said they weigh the fat when remove it).My eyes are so asymmetric so I am embarrassed to look at people.My surgen said the eyes will look perfect once the swelling is gone.But the swelling had already gone. Pls advise what the surgeon did wrong and if there is a chance to fix it? thanx

Doctor Answers 6

Hollowness after blepharoplasty

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Your photos show what you are describing but also show persistent cheek (malar) edema. A few more months may be helpful but I think you may require a revision procedure or a filler to the area. If you had significant malar edema pre-op that is making things look worse. An in-person exam is absolutely necessary.

Los Angeles Facial Plastic Surgeon
4.4 out of 5 stars 7 reviews

It is difficult to fully assess a set of eyelids from a photograph and a post.

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There is no substitute for a detailed in person consultation.  My revisional eyelid consultations typically run about 2 hours so make sure that whoever you see is carefully listening to you and assess your eyelids not just taking to you from the door of the surgical counselors office.

I agree at 4.5 months there really should not be much swelling left.  Yet in looking at these photos, it really does look like you are still swollen.

So what is going on?  When I study your photos, I notice a significant malar bag under each eye.  It makes you look haggard.  Fat grafting will not fix this but can make it much worse.  It can be due to lymphatic damage associated with surgery, or it can reflect a feature inherent to your face.  There are a few ways to help this but it is certainly something that will need to be addressed.  The left lower eyelid is more hollow than the right but again, the festoon also contributes to what is going on on the left side.

The upper eyelids look rough and not refined.  There seems to be several issues.  First I get the impression that there is left upper eyelid ptosis with a compensatory left eyebrow elevation.  The left upper eyelid looks possibly overreacted with an A frame peak ( asymmetry in the left upper eyelid crease contour can be related to the work of a right handed surgeon.)  There also appears to be excessive skin and orbicularis left in the upper eyelid platform.  With blepharoplasty, the brows have a tendency to come down, this may lead to crowding of the upper eyelid space on the right side.  Also I wonder if your surgeon did some sort of canthal procedure with your surgery with a shortening of the palbepral (eyelid) horizontal aperture (technical speak for making the eyes look smaller).  

You are basically telling us that your surgeon feels he did an awesome job with your eyelid surgery.  At 4.5 months if you are not feeling it with your original surgeon, it is reasonable to consider other opinions.  Generally it is best to wait a full 6 months before having a revisional surgery but getting second opinions now will put you well into that time frame.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Hollow Upper Eyelids

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I know this can be frustrating, but you are still recovering. You appear to have persistent edema below your eyes. Give it a little more time.  After healing is complete, fat grafting could be used to correct hollow areas above or below the eyes. You should be in regular contact with your plastic surgeon's office. 

Michael Law, MD
Raleigh-Durham Plastic Surgeon
4.8 out of 5 stars 123 reviews

One eye hollow after blepharoplasty

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From your photo, I see slight eyelid crease asymmetry and some hollowness in the left lower lid. Wait a couple more months then these issues can be addressed with a filler like Belotero. The alternative is fat grafting but filler injection is much easier and more precise.

Peter T. Truong, MD
Fresno Oculoplastic Surgeon
4.9 out of 5 stars 42 reviews

Eyelid swelling

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Hi elguruono. Eyelids stay swollen for quite a while. Although typically, the swelling is significantly resolved by 3-4 months, sometimes it can persist for a few more months. It appears that you still have some upper eyelid swelling, so it is too early to make any decisions about symmetry at this time. Your left lower eyelid area does look more hollow than the right, however you still have cheek swelling, so the swelling may be asymmetric too. Continue to be patient for a few more months and then discuss your concerns and options with your doctor at that time. Good luck. Best, Dr H. 

Sanaz Harirchian, MD
Houston Facial Plastic Surgeon
5.0 out of 5 stars 26 reviews

Upper eyelid asymmetry

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It appears that your left upper eyelid is somewhat less full and possible has a slightly higher crease. Your appearance still could improve, as it can take at least 6 months for all the swelling to subside. A revision surgery, utilizing judicious structural fat grafting and adjusting the supratarsal crease potential could create more symmetry.

Boris M. Ackerman, MD
Newport Beach Plastic Surgeon
4.8 out of 5 stars 62 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.