Upper bleph left me not feeling like myself - What can be done to bring my eyes close to presurgery 3.5 years post op? (Photos)

Question

I had an insurance covered medical upper blepharoplasty in December of 2022. While the hooding has been removed and upper vision is better, I am left feeling like I have someone else's eyes. This is affecting my confidence and causing me to shy away from social events and photos. What can be done permanently to get me closer to my pre-surgery eyes?

Kenneth D. Steinsapir, MD · Answer

The syndrome is a spectrum but it includes a high or hollow upper eyelid sulcus, a high or absent upper eyelid crease, upper eyelid ptosis, compensatory eyebrow elevation, and creepy eyelid platform skin. To this many also have partial lateral canthal disinsertion with a rounding of the eye shape that is also perceived as a loss of the almond shape of the eye. I pioneered the permanent repair of theses eyes. I am attaching a video of how the surgery is performed ( it is graphic so don’t watch it if you don’t like that sort of thing. I am also providing a link to my paper about PUBS. I have much more information about the surgery on my website on a page about fixing botched upper eyelid surgery.

Chet Mays, MD · Answer

Thank you for your inquiry. After having an upper Bleph surgery the area to the eye gradually over time will start to relax. The eyes should look symmetrical and help with hooding to the upper eyelids. We recommend scheduling a consultation with a Board-Certified Plastic Surgeon to discuss your goals and concerns.

Kadir Berat Oyur, MD · Answer

Based on the photos, there appears to be upper eyelid hollowing and changes in eyelid contour that may contribute to the feeling that your eyes no longer resemble your preoperative appearance. While it is usually not possible to restore the eyelids exactly as they were before surgery, revision procedures such as fat grafting, scar release, crease adjustment, or reconstructive eyelid surgery may help restore a softer, more natural appearance. A consultation with an experienced oculoplastic surgeon specializing in revision eyelid surgery is recommended to determine the most appropriate approach.

Julian De Silva, MD · Answer

Hi Tiffany, thank you for writing so honestly. What you describe, that your vision is better but your eyes no longer feel like yours, is something I hear more often than people expect, and it is real, not vanity.

An upper blepharoplasty for hooding removes skin, and sometimes a little fat. When the eyes feel different afterwards it is usually because the crease now sits higher or sharper than before, or because the lid looks hollower or more open than it used to. Those changes alter the character of an eye even when the surgery itself was done well.

Some of this can be softened. A hollow upper lid can sometimes be improved with careful fat grafting, a crease that sits wrong can occasionally be revised, and brow position plays a larger part than most people realise. What I would be honest about is that the aim is to bring your eyes closer to feeling like yours, not to rewind exactly to how they were.

Please see an oculoplastic surgeon in person and take your pre-surgery photos. Assessing your lids, your brow and the tissue you have left together is the only way to say what is realistic for you.

Best wishes,
Dr Julian De Silva

Upper bleph left me not feeling like myself - What can be done to bring my eyes close to presurgery 3.5 years post op? (Photos)

Answers (4)

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