Uneven eyelid post incisional blepharoplasty. Any other options in the future to correct this? (photos)

5 months post surgery, I'm convinced that my eyelids are uneven. My surgen keep try to convince me that they are even but its clearly not! I'm really upset with this. Any other options in the future to correct this?

Doctor Answers 3

Agree, not even.

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It is complicated because you have a compensatory brow elevation that is stronger on the right side.  Both upper eyelids are mildly ptotic. I suspect that you have a bilateral levator dehiscence in both upper eyelids.  The challenge for you is that for many surgeons, fixing this is beyond the limit of the accuracy of their surgical results.  I perform a procedure I call microblepharoplasty that addresses small differences like you have. 

Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Skin crease

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Thanks for sending in these photos. You are quite right, there is some assymetry between the eyelids. It would appear that your blepharoplasty simply removed some excess skin, but no measurement of the skin crease was made, or indeed any attempt to ensure that this was symmetrical. The skin crease is made by complex integration between the muscle lifting the eyelid and the orbital septum. Blepharoplasty can be very disappointing is the skin crease is ignored. 

In principle, you would be a candidate for revision blepharoplasty with skin crease reformation,but much wold depend on the examination findings. I would also emphasis the the asymmetry is quite mild and probably within the limits of 'normal assymetry'  If you have had a general plastic surgeon do your procedure, I would get a second opinion from an oculoplastic surgeon who will have a better understanding of the subtleties of aesthetic eyelid surgery and advise on whether redo surgery is worthwhile given the relatively small difference.

Great result

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I don't think your incisions look uneven at all in the picture with your eyes closed, and your eyelids look terrific when open. Your mild asymmetry is from a little more skin on the left upper eyelid leading to more "fullness" above the crease. This could also be from the left eyelid crease being lower but it does not appear that way in the picture with your eyes closed. No two sides of the face are exactly identical. I think this is a good result. A pre-op photo would be helpful. Good luck!

Katherine Zamecki, MD, FACS
Danbury Oculoplastic Surgeon

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