Visible asymmetry 6 months post upper eyelid surgery - can I just have a minor correction? (photos)

This is Post Upper Blepharoplasty Syndrome. It is characterized by upper eyelid malposition (usually ptosis), crepey upper eyelid platform skin, high upper eyelid sulcus, and compensatory eyebrow elevation. Some of these eyelids also have lateral canthal disinsertion with rounding of the eye shape. It is caused by an overaggressive upper eyelid surgery with the removal of too much upper eyelid skin, muscle and fat. Internal scaring contributes to the deficit. Your problem is not a little more skin on one side. Your problem is that your entire upper eyelid fold was removed which has lead you to this issue. In many of these eyelids there is enough resources left to reposition the upper eyelids, fix the lateral canthus, lower the upper eyelid crease, fluff up the upper eyelid fold fat and reconstruct the upper eyelid fold. That is not a "minor" correction. That entails a very complicated eyelid reconstruction to a achieve. I am attaching a copy of my paper and a graphic video that shows how these are repaired. There is no substitute for a detailed in person assessment.

For unique cases where a variety of modalities could be used to treat the condition, I would suggest an in person or virtual consultation to develop a custom and effective treatment plan. It is difficult to precisely define the best option without collecting the same information. I suggest reaching out to an expert for a consultation with surgical and non-surgical methods to get a comprehensive option. Best, Dr. Emer.

Hello! Thank you for your question.The right eye still have saggy skin above the eye. Also the eye area is downward with only blepharoplasty would not be enough to reach your goal. I suggest you revision upper eyelid blepharoplasty and endoscopic brow lift. After these procedures you will have much elegant, fresh and upside looking in your eye area. If you can provide better photos with better lighting, from side of your face and 1 meter away, I would be able to make a proper evaluation.Best Regards!

Thank you for your question in for including a photo. It is extremely helpful!

First of all, I do recommend contacting your surgeon to voice your concerns and schedule an in person appointment to discuss options. If you do not feel like you’re concerns are being heard, it is well within your rights to seek opinions from another surgeon.

It is possible to only have a revision to the left eye that still leaves you with concerns.

Hello @minnie2023, thank you for your question. Only after the period of time indicated by the surgeon who performed the surgery to reduce inflammation has passed will it be possible to determine whether a subsequent intervention is necessary to improve the results. Best wishes! Alan Gonzalez MD, FACS. American Society of Plastic Surgery Member (ASPS),International Federation for Adipose Therapeutics and Science” Member (IFATS), American Society of Plastic Surgery Member (ASPS), Colombian Society of Plastic Surgery member (SCCP).

You have a deeper superior sulcus on the right than the left. This can be improved with fat grafting or filler. This is a difficult problem to fix and you need to see someone with lots of experience in this area.

You have asymmetry double eyelid. In that case we recommend revision upper blepharoplasty with fat grafting for upper eyelid. It seems to be hard to fix it as you want because you don't have enough extra skin and a deeper superior sulcus on the right than the left. Better to check with expertise plastic surgeon and hope to get better soon:)

Thank you so much for your question! Revision upper eyelid blepharoplasty can be performed 6 month post operation, however in your case we need to do more detailed consultation. Based on your pictures I would recommend you eyebrow lifting surgery. This will help you to raise sagging eyebrows, in your case the left eyebrow will be lifted a little bit more, also, will help to create a more youthful and refreshed appearance. Hope it helped!

The asymmetry that concerns you is not a simple correction. You can consider filler or fat grafting to try to give more symmetry. This will not impact that one eye opens more than the other. If interested you should seek an experienced board certified plastic surgeon.