What Problems Could Result from Performing Blepharoplasty on Only 1 Eyelid?

Both of my eyelids droop. But the insurer only authorized surgery on one (the left). They said the right wasnt bad enough. What problems could result if surgery is only performed on one of the eyelids?

Doctor Answers 9

In blepharoplasty lid asymmetry common, but do both lids

Lid asymmetry in blepharoplasty is so common and almost expected. Each of us has a dominant eye and one eye is always slightly larger that the other. The asymmetry is noted in the shape of the eye and also the upper lid. It should not come as a surprise that one lid droops more than the other. Despite what your insurance company says however, we recommend correction of both lids to keep the lids in balance and complementary to one another. Perhaps for a small out of pocket expense you can complete your procedure on both.

Best of luck,


Chicago Plastic Surgeon
4.0 out of 5 stars 42 reviews

Why unilateral blepharoplasty is not a good idea

It sounds as though you have very asymmetrical eyelids now. It is best to have both eyelids done so that they both match. Asymmetrical surgery will remove more skin off the droopier eyelid and less off the opposite side. This will make the eyelids symmetrical even though only half of it is paid for by insurance.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 143 reviews

Treating one eyelid

I would refrain from just treating one eyelid for eyelid droop.  It is better to achieve symmetry by treating both of them at the same time. 

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Unilateral bleharoplasty

As you can tell most doctors are advising surgery on both eyes to improve or retain symmetry. Unilateral blepharoplasty is rare and not the standard of practice in most communities. I hope you will listen to your doctors and not medical advise from your insurance company. Your insurance company will claim that they are only rendering coverage boundaries but as we can all tell in your case they are defacto influncing your medical care decisions and make you believe that it is OK to perform a unilateral blepharoplasty.

In your case the insurance coverage of one eye may lead you to problems in the future if you pursue such path, in other patients medically atypical coverage decisions may lead to real health problems.

Julian Henley, MD
Greeley Facial Plastic Surgeon

Right eyelid will remain droopy

The obvious answer is that the right eyelid will remain droopy. There is a chance of the improved eyelid will open up more than normal to compensate for the droopy eyelid (herrings law of equal innervation)

Performing blepharoplasty on just one eye could end in asymmetry

 That is why the insurers are in business - to save $. Therefore you will have to pay for the other eyelid or do not do the operation. To many risks for a symmetrical result.

From MIAM Dr. B

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.6 out of 5 stars 173 reviews

Unilateral Blepharolplasty Best Only in Cyclops

Hi 2524,

A problem that could result if surgery (blepharoplasty) is only performed on one of your eyelids is that you may end up walking in circles endlessly. Ask a silly question, get a silly answer. Insurance companies are ridiculous, and now Obamacare won't be much help either.

Performing eyelid surgery on one lid is ludicrous unless you have a marked asymmetry to begin with. Save your money and have the surgery when you can toss a surgeon a few extra shekels to complete the job. Otherwise an eye patch (pirate) or a Phantom of the Opera mask may be options.

Good luck and be well.

Dr. P

Michael A. Persky, MD
Encino Facial Plastic Surgeon
4.8 out of 5 stars 36 reviews

Blepharoplasty on one eyelid

There would not be any problems so to speak if you only had blepharoplasty on the eyelid approved by insurance. The issue would be the difference in the asymmetry of the eyes which may be minor or could be significant. You mention that both eyes are droopy - is this due to excess eyelid skin or ptosis (loss of muscle tone in the lid) or both? If it is due to ptosis, then removing excess skin alone will not change the position of the eyelid and you may still have a droopy appearance in that eye.

My suggestion is to have the surgeon who will perform your surgery to show you a picture of yourself that gives you a concept of how you will look only doing one eyelid vs. both.

Arnold Zweig, MD (retired)
Atlanta Facial Plastic Surgeon
5.0 out of 5 stars 5 reviews

Upper eyelid surgery

Hello - Performing surgery on only one eyelid may give you asymmetry afterward.  It's difficult to say without actually seeing a photo, but it may be to your benefit to pay for the side that insurance is denying.

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.