Assymetry, Higher Scar After Upper Blepharoplasty

Plus one eye looks round and one has retained a semi-almond shape...My surgeon says he did both the same and admits no fault...What can I do now? I am embarassed by the differences and am trying to camouflage with makeup but this is very depressing...

Doctor Answers 5

Asymmetric scars of eyes

Asymmetry of the eys is normal and slight differences between the scars may be the result possibly of misplaced incisions or more likely differential removal of skin and differential pulling on the scar.

New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Asymmetry after blepharoplasty

It is quite possible that your asymmetry will improve with time. I would hope that your surgeon would follow your healing after surgery. If there is a persistent deformity that is amenable to revision, this can be addressed by your initial surgeon, often in the office. If you are not getting the postoperative care and attention that you deserve, I would seek a second opinion. However, I agree that you should allow time for your eyelids to heal before pursuing any revision surgery.

Best wishes,

Stephen Weber MD, FACS

Stephen Weber, MD, FACS
Denver Facial Plastic Surgeon
4.9 out of 5 stars 129 reviews

Asymmetry in scar position and eye shape 4 months after blepharoplasty.

Once swelling has settled and scars have matured, comparing preoperative and postoperative photographs will take emotion out of the discussion. At 4 months, you are mostly there, but additional subtle changes can occur.

So at 6 months, get post-op photos and compare them with your doctor's pre-op photos. He made the incisions; he has to own the scars since nothing you did or didn't do can change that. Same thing for eye shape. So if you approach this as your surgeon's "fault" and his "responsibility to fix" that might cause some defensiveness on your surgeon's part. Do you think he wanted to make you unhappy? Do you think he intentionally made one side different from the other? Perhaps you chose to have your surgery at a teaching hospital for "reduced" cost and had a resident or fellow surgeon do the work. Perhaps you chose an inexperienced surgeon who did his best and just fell short of perfection. Perhaps your surgeon is the best there is and just had a less than perfect outcome. Only my mother thinks I'm perfect--I wait every day for my perfection badge to show up in the mail; still not here!

What I'm saying is that you need to not be depressed or at least not be "blaming" or "looking to assign fault" for your result. You should already know your surgeon's revision surgery policy; there is no free touch-up surgery but most surgeons charge no surgeon's fee for additional surgery, only operating room and anesthesia costs. This is fair and reasonable, though of course, aggrieved and unhappy patients often feel that they have paid for a specific result, and think they should pay nothing more to achieve it! That is part of the risk you assume when you asked your surgeon to do the procedure.

Go see your doctor, let him know you are distressed by your result, let him know you don't blame him for being a "bad surgeon" since anyone can have an undesirable outcome, and ask "How can we make this better?" Don't ask him to FIX it, and don't expect it to be FREE! He will do his best to make it as good as possible, but if you feel that he is not capable of doing that, then you have to see another surgeon and pay the freight to try to make a better choice this time.

BTW, I'm not being harsh with you, I'm just trying to give you perspective on this unfortunate outcome. No one wants an upset patient, and most of us will move heaven and earth to try to make our patients as happy as possible. But perfect we're not. Good luck!

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
4.9 out of 5 stars 255 reviews

Post-blepharoplasty asymmetry

Eyelids are usually asymmetric, even if minimally so. Post-surgery eyelids can often be asymmetric. I would wait six months or longer until things are stable and then re-assess. Asymmetry can be simple or complex and so can the surgery. You may also have to decide on what and how much asymmetry to accept.

Robin T.W. Yuan, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 11 reviews

Post blepharoplasty asymmetries

I agree with the previous response.  Pre and post op pictures compared several months after the procedure should allow you to discuss things clearly with your surgeon.  There is no feature on anyones face that is exactly symmetric and often overscrutinizing certain rfeatures can lead people to assign importance to the trivial.  There may also be significant asymmetries that can easily be corrected with an office procedure like a zplasty or superficial canthal support.  Try to reingage with pictures and neutral emotion and you will likely achieve your goal.


All the best,


Rian A. Maercks M.D.

Rian A. Maercks, MD
Miami Physician
4.9 out of 5 stars 73 reviews

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.