Upper blephorplasty uneven incisions and eyelids. Any suggestions? (photos)

Question

I had upper blephorplasty and today is 5 days post op. I noticed my incisions are not even and I'm starting to get worried. Is it too soon to notice or am I right?

John Bitner, MD · Answer

I can see what you are noticing.  Asymmetry after surgery is very common and can sometimes be exaggerated by the swelling and bruising that you have immediately after the operation.  I would recommend that you sit tight for now.  Point it out to your surgeon when you go in for your postoperative visit.  I wouldn't recommend doing anything (revision surgery or otherwise) until the scar has settled down and most of the pinkness has faded.  It may be that with time the asymmetry essentially disappears.  If obvious asymmetry persists after the healing process is more complete, there are some things you can do to fix it.  I know it is hard to wait as every time you look in the mirror you can see it.  But, jumping in and having another operation too early can sometimes cause more harm than good.

John J. Martin, Jr., MD · Answer

You are correct that the left incision is higher than on the right.   In the first couple of weeks after the surgery this may be more noticeable due to the swelling.  With time it will often look better. Also, with your eyes open you don't usually see the difference.  So give it time.

John A. Standefer Jr., MD, FACS · Answer

The skin of the upper eyelid is the thinnest skin of the entire body. It is also the easiest to stretch and hardest to measure exactly the same. It swells and stretches just from the local anesthesia injections required for the surgery. The lids swell differently and therefore stretch the skin differently, especially in the early post-operative period. Rest assured, when the swelling subsides, the incisions will appear much closer to the same, if not the same. When the eyes are open, no one will ever see exactly where they are because they will be in the crease. If they are noticeable after they heal completely, I would discuss your concerns with your surgeon.John Standefer MD

Vasdev Rai, MD · Answer

Upper eyelids are never toally symmetrical before surgery. Skin excess is also uneven on two sides. Slight variation in incision is needed to accomodate those differences.

Stacey Folk, MD · Answer

Dear KaseyR,You are healing beautifully and there is nothing wrong with the placement of your incisions. We all have facial asymmetry (and I will spare you pointing out yours so you don't obsess) and each eye has it's own unique features. It is perfectly normal for the incision placement to look a little different from side to side. Enjoy your blepharoplasty!

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