35 days post op upper eyelid surgery, eyelid swelling like sausage. operation considered failure? Do I need a revision? (photo)

Many, many eyelid surgeons perform these procedures under local anesthesia.  With patience on the part of the surgeon, it is possible to put in sufficient local anesthetic so that these procedures are very comfortable.  Your discomfort was avoidable.  Unfortunately, it can happen and no matter what the surgeon might say, it can sometimes lead to an impression that something went wrong.  Almost always, that is not the case.  However, it can be the case that a rough anesthesia and a rough surgical outcome can go hand in hand.You had surgery almost 5 weeks ago.  Your skin looks irritated.  I wonder if you are using an ointment or cream prescribe by your surgeon that is causing the rash.  Regarding swelling, it is very common for double fold surgery for swelling to persist for months.  Even small amounts of swelling can push the fold up creating the impression that the crease was made too high.  The right upper eyelid is also very heavy.  The swelling can cause this put sometimes, the heaviness or ptosis was present before surgery, sometimes the ptosis was actually caused by the surgery.  Do to the uncertainty, a large measure of patience is needed to know what these eyelids will need.  How is the left side?  Is this perfect?  That can make it very tough to be patient with an eyelid that is not healing as fast as the other side.  My guess is that in 2-3 months the right upper will be much better but you may still have issues.  Honestly, at this point it is too early to know if you will have any long term issues.

Prolonged swelling after Asian blepharoplasty is not unheard of especially in patients with thicker skin. Local care with heat and anti-inflammatories may help you in this period. Have your eyes evaluated by your surgeon who should be able to assist you in this matter.