One Eye Looks Different After Upper Blepharoplasty

Question

I just had my upper eyelids lifted a week ago. Although still red, most of the swelling has gone down. I am noticing that one eye is smaller and 'different' than the other. I went to a well-known and respected surgeon. Is it too soon to worry? Should I wait the full two weeks to really appreciate results?

Theda C. Kontis, MD · Answer

One week after any cosmetic surgery is too soon to make any decisions about final outcomes. You will need to wait at least 2 months, not weeks, to see how you are healing. The differences you are noticing now are most likely due to swelling...even if you sleep with your head turned to the side, you can develop more swelling on the side that is down.
Sometimes after surgery, people notice asymmetries that they never noticed before. You might want to look at some old photos of yourself and see if both eyes were symmetric before your surgery.
On the outside chance that your surgical results are asymmetric, it is very easy to remove a little more skin to even things up. So be patient, give it more time to heal, and don't worry.

Steven H. Williams, MD · Answer

Thanks for the question -
It is too early to tell smaller differences in symmetry.  Things that can be of concern at this point would include inability to close your eyes and protect your cornea, wound healing problems, infection or major asymmetry.
As always, it is vital that you stay in touch with your surgeon as your post-op course progresses.  Self photography to document your progress can be helpful as well.
I hope this helps.

William Portuese, MD · Answer

Since it has only been a week from your surgery, swelling still has not subsided. It can take upwards of two months for the swelling to subside. Also look at your preoperative pictures to make sure that there was not preexisting asymmetry with regards to the eyelids.

Christopher L. Hess, MD · Answer

First, take a serious look at your preoperative pictures.  Everyone is asymmetric and I'm sure you are no different.  We all have one eye that is more open than the other.  In addition even though it seems like you're healed in 2 weeks, you're not.  Tissues really take 6 weeks to finish the initial phase of healing after which scars take up to a year to mature.
So I would suggest being patient and if you still have concerns 6 month after surgery then you can discuss it with your surgeon.

Scott E. Kasden, MD, FACS · Answer

Each eye will heal a little differently, and I would say that two weeks is still way too early to make a judgement.  I would advise you to have a great weekend without worry.
Although there may be some asymmetry, have your surgeon give you his honest opinion next visit.
sek

Philip Young, MD · Answer

There are many reasons why one eye would be smaller than the other. Swelling can be the most likely reason.  No matter how well you do the surgery, you cannot control swelling sometimes. The body is a complex thing and many reasons could account for why one side is more swollen than the other.  
Another probablr cause is sometimes, manipulation of the muscle that opens the eye could have caused it to be temporarily tired.  This could take months to resolve.  Sometimes, if your surgeon has attempted to recreate your crease, there could by many more reasons for your eyes to look differently.  This would depend on just what was done.  
Sometimes, when you create the crease too high on the muscle, it could tether it coming up and effect the movement of the muscle. You would really have to be seen by your physician to determine just what is going on.  But wait it out for now and I wouldn't worry about it until at least a month.
Consulting a Board Certified Facial Plastic Surgeon would be something that I recommend. We specialize in the face and are highly qualified to help you with this.
or so.

Jeffrey Zwiren, MD · Answer

It is just part of human nature to compare one side to the other. There will always be differences in the way each eye heals after surgery. It never ceases to amaze me that you can perform the exact surgery on each lid yet they can heal differently. At this point it is way to early to worry. Your swelling is most likely normal. Give it more time and your symmetry will likely return.

S. Randolph Waldman, MD · Answer

It is much too early to judge the outcome of the procedure especially as it relates to symmetry. In fact the final result may not be apparent for several months. I also agree with the previous poster that no one starts with perfectly identical eyes.

Francisco Canales, MD · Answer

Any two sided procedure heals at different rates. So having one eye look different at a week is no big deal. Chances are, your eyes were different before surgery, as they are in nearly 100% of patients.  Surgery just makes you look in the mirror and notice the differences that had been there all your life.
As someone who had his own eyes done, I was guilty of not appreciating how different my eyes were before surgery.  After surgery, I looked in the mirrror a lot more than I ever had before surgery and noticed all these differences. My wife kindly pointed out how different my eyes were ahead of time and I had been blissfully unaware.
Let the healing proceed and keep your surgeon advised of any concerns.  After all, he was highly recommended and is highly respected so use his experience as a guide to your questions. Best of luck.

Brooke R. Seckel, MD, FACS (retired) · Answer

The eyes are the most delicate tissues on the surface of the body. Thus, they are more sensitive to bruising and swelling associated with surgery.
It is very common to see asymmetries between the eyes after blepharoplasty during the first 3 weeks.
By six weeks, the swelling should have subsided enough so that you can accurately evaluate your results.

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