Possible Levator Muscle Injury from Eyelid Surgery?

You are now 2 weeks out from the surgery and by this time, you eyelids should have accomodated to each other. If you still have signficant ptosis at this point, it is likely that the levator muscle or attachment to the tarsus is not functioning fully and will likely not resolve with further waiting. In other words, the transient effects of medication, brusing, swelling, etc, should have mainly dissipated.
There are a number of possibilities that are causing your eyelid asymmetry at this time, but removing too much fat is likely not one of them. My advice is for your to wait and be patient a while longer (minimum of 3-4 weeks). If you require further treatment, the levator may be explored, tightened, or "advanced." By this time, you will also see that the scars on the lateral incision will have healed much further.

Hi,
Thank you for your question!
It is possible that your muscle was damaged during the surgery. It is difficult to say without examining you. It could be several things. It would be a good idea to go back to your doctor or consult a plastic surgeon that specializes in this area.
As for your scars, they should heal up over the next few weeks and not be as raised.
Best regards,
Dr. Speron

Dear Anonymous
You are relatively early from you surgery. It is quite possible that heaviness in the eyelid that you are describing is due to swelling and will resolve with time. On the other hand, it is possible for the tendon of the upper eyelid to become disinserted or loose. This can be the direct but unintended result of the eyelid surgery or in someone who is predisposed, swelling in the eyelid associated with the surgery can contribute to this. It is my impression that the levator aponeurosis, the tendon that connects the upper eyelid to the muscle that opens the eye, gets injured during eyelid surgery much more commonly than we realize.
It is appropriate to address your concerns to your surgeon and hear what that person has to say. Recognize that not all sugeons who do eyelid surgery are formally trained in oculoplastic surgery. They may only know how to perform a basic cosmetic blepharoplasty and not much else. If your eye does not open and the lid margin blocks the pupil, this might prompt your surgeon to explore the involved eyelid under local anesthetic in the office or in an operating room. If your surgeon does not provide a response that makes you comfortable, you might consider a consultation with an eye plastic surgeon. If you have a good relationship with your surgeon, you might ask them to recommend and eye plastic surgeon for a second opinion. It can be very helpful to have such an opinion.