Please help me understand why my saggy skin is far worse after bleph than before? (Photos)

Question

I am 13 days post op. Mild inner webbing too. I am devastated. I feel too much skin was taken medially and not enough at the outer side. Scars don’t run past outside of eye. The skin taken has made a hollow that makes the overhang look worse. My eyes were lovely and i fear I’ve ruined them.I think I’m a difficult as my eyes were good before and I wanted just a tweak. I had strange eyes that if tired could look so puffy/saggy but if not they were near perfect (a little excess always present left side).

Kenneth D. Steinsapir, MD · Answer

This is Post Upper Blepharoplasty Syndrome (PUBS). The syndrome consisted of upper eyelid ptosis, high, hollow upper eyelid sulcus, crepey eyelid platform skin, lash ptosis, high or absent upper eyelid crease. It is caused by destabilization of the upper eyelid anatomy by the blepharoplasty surgery. I assure you that your surgeon has no idea what is going on with the eyelid. This eyelid has to heal about 6 months before it should be revised. These are repaired by lowering the crease to a normal height, repairing the internal slippage of the levator aponeurosis tendon so that it supports the upper eyelid height and the upper eyelid platform and the upper eyelid lashes. Hollowing of the upper eyelid sulcus is addressed by repositioning fat and in some cases, placing grafted fat. Unfortunately very few surgeons on the face of the Earth understand this problem and offer surgery to repair the issue. A personal assessment is needed to determine precisely what you will need.

Andrew Campbell, MD · Answer

Overall things appear to be healing quite well. 13 days is not nearly long enough to evaluate the result. Be patient, but continue to have regular follow up visits with your surgeon so your concerns can be discussed.Andrew Campbell, M.D.Facial Rejuvenation SpecialistQuintessa

Charles Nduka, MD · Answer

You are still early in the healing process and what you are experiencing may be due to persistent swelling. The amount of skin removed during a blepharoplasty is carefully determined so as not to remove too much. Having too much of the skin removed will hinder complete closure of the eyelids and may pose more complications than having the ptosis post op. Based on the photo, you are healing well and should expect significant changes over the next few months.

Sara A. Kaltreider, MD (retired) · Answer

A modest brow lift might have created the look you desire, and still might be a good option for you. I don't believe you had ptosis prior to your procedure, so I'm wondering if a slight lift of the brows would be a good option for you. I am happy to see that the skin removal is not excessive - if that were the case, you would not have as many options. First, I would recommend waiting 6 months before any revision. Then - after healing - I would recommend seeking a second, even third opinion. Questions to ask - do you now have ptosis and does that need repair?, do you need to have the brows lifted?, do you still have overhang of the fold in the lateral lid? If you have any reservations, don't jump into more surgery. Get into the details of the lid crease and fold, brow issues, ptosis, scarring, etc. Your consulting physician should offer more than just one option. On the other hand, you may find that your incision lines and folds disappear and flatten out over the next couple of months. Best wishes.

Please help me understand why my saggy skin is far worse after bleph than before? (Photos)

Answers (4)

Answer: You have options for revision of your eyelids

Answer: You have options for revision of your eyelids

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Everything you need to know about Eyelid Surgery

Our mission is to create a world where every investment in modern beauty is Worth It.

Please help me understand why my saggy skin is far worse after bleph than before? (Photos)

Answers (4)

Answer: You have options for revision of your eyelids

Answer: You have options for revision of your eyelids

Browse related questions

Recommended reading

Everything you need to know about Eyelid Surgery

Our mission is to create a world where every investment in modern beauty is Worth It.