Post Upper Eyelid Surgery Asymmetry? (photo)

I had upper eyelid bleph a week ago. I am sending a picture of the day after surgery and one a week later (the day after stitches came out) and pre op. My left eye has been more swollen and smaller since immediately after the surgery and even though swelling and bruising have improved, the asymmetry hasn't. My PS says in time it will improve. Is this much asymmetry in the first week normal? I'm trying to relax and give it time, but I am feeling uncomfortable with the results so far.

Doctor Answers 6

Post Upper Eyelid Surgery Asymmetry?

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A before posted photo would help! It might demonstrate you had a mild ptosis of the left upper lid? Or you may have a post operative lid lag on the left or iatrogenic ptosis. This "should" self correct in time but you can always obtain a second opinion. 


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Looking at your preoperative photo, it seems that your eyelids are quite symmetrical. The asymmetry that you have now is likely due to asymmetric swelling which is not uncommon. Most of the swelling should be gone by about 4 weeks after surgery, but we generally don't consider a result "final" till about 3 months in most cases.

If the asymmetry has not resolved in 3 months, it is possible that the muscle that elevates the left upper eyelid [levator palpebrae], was damaged during surgery. If that is the case,  I would recommend consultation with an ASOPRS trained Oculoplastics surgeon. You can find one close to you on the ASOPRS dot org website.

A.J. Amadi, MD
Seattle Oculoplastic Surgeon
5.0 out of 5 stars 42 reviews

One Week After Blepharoplasty

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I agree with my colleagues that 1 week after surgery is not the time to make a final judgment on results.  However, the one comment I would make is that the left upper eyelid appears to be ptotic (droopy).  If this finding was present pre-operatively and was not addressed in the procedure, this asymmetry may become more obvious in the months to come.

Stephen Prendiville, MD
Fort Myers Facial Plastic Surgeon
4.9 out of 5 stars 103 reviews

Eyelid asymmetry

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Always one eye will be slightly different from the other.  After surgery there is always more swelling on one side and often some muscle weakness may be more pronounced.  This should resolve gradually.  Elevation and warm compresses to the eyelids several times a day will help. The most difficult thing to to is have patience and let nature take its course particularly when you see yourself in the mirror many times a day.  Give this several more weeks.

Glenn M. Davis, MD, FACS
Raleigh-Durham Plastic Surgeon
4.9 out of 5 stars 77 reviews

Asymmetry after upper blepharoplasty

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First of all, I will say that the look of your eyes will definitely still change with time.  At one week after upper eyelid surgery, there is still going to be swelling and in some cases, there may still be bruising.  It would be helpful to see a picture of you before your surgery.  In the current pictures, it does appear that there is a ptosis of your left upper eyelid.  This means that the bottom of the lid falls a little lower over the eye than normal.  I don't know if this was present before the surgery or not.  There are surgical procedures to correct this problem, and if it persists, I would look in to that option.  

Michael I. Echavez, MD
San Francisco Facial Plastic Surgeon
4.5 out of 5 stars 18 reviews

Swelling after blepharoplasty

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I would reassure you at this point, so early out from surgery. Particularly if there was some asymmetric swelling right after the surgery, the two eyes can take different amounts of time to become more equal. 

Give it a few more weeks, and I am sure that the result from your eyelid surgery will be much more equal as time goes on.

Best wishes,

-Dr. Jamil Asaria

FACE Toronto

Jamil Asaria, MD
Toronto Facial Plastic Surgeon
4.8 out of 5 stars 139 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.