What should I do next if I still have droopy eyelids after an upper eyelid blepharoplasty? (photo)

Doctor's Answers 2

Photo of Dr Samuel Ho
Dr Samuel Ho

Plastic Surgeon

I am sorry to hear about your unhappy surgical experience.

Eyelid surgery is a complex subject and requires a meticulous assessment as droopy eyelids has a variety of causes, needing different treatment options. In your case, based on your before photograph, it would appear that you have excess outer eyelid skin (lateral hooding), which is very common.

Your eye opening size appears unaffected, which indicates you do not have true blepharoptosis (true drooping of the upper eyelid). The treatment for this is ideally an infrabrow lift, which I do for many of my patients with very satisfying results.

What you have gone through is a conventional upper blepharoplasty (cutting eyelid), which solves part of the problem but often leaves the skin beyond the outer corner of the eye still droopy. To address this through the same surgery (cutting eyelid) often requires a very long scar leading out beyond the outer corner of the eye, which is cosmetically displeasing. For this reason, I often prefer an infrabrow lift.

I would need a closer assessment to comment further. It is also quite soon after your eyelid surgery and I usually reserve any revision surgery for about 1 month after the original surgery.

Best Regards,

Dr Samuel Ho

After upper eyelid surgery, the patient’s appearance can be difficult to assess adequately because of swelling. But if after 1 week, there is gross asymmetry then it is best to go back to your doctor and seek an explanation or reassurance. If you are still dissatisfied, then a second opinion should be sought.

In your case, the right upper eyelid fold appears to have a come down slightly and hence it looks swollen and bulging, making the eye look smaller than the other side. Your original doctor can reassess the situation and decide whether it was due to stitch loosening or inadequate skin excision, and then proceed to revise the upper eyelid.

A second surgeon, would have to wait a bit longer till most of the swelling has resolved before deciding the best option to take. This is because he/she did not perform the first surgery and cannot troubleshoot the problem on the spot.

I would advise you to wait for 1 to 2 months if you are considering to go for a revision by a second surgeon. I hope my reply helps.

Regards,

Dr Por Yong Chen

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I would agree with Dr Chua’s answer. Hypopigmentation is far harder to treat than hyper pigmentation. Fractional laser is considered one possible treatment. But it does not guarantee results that will be satisfactory to you.

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Thank you for your question. This is certainly an important consideration for anyone considering ptosis repair for droopy eyelids. Depending on the severity of the ptosis and the technique used, eyelid swelling can be quite variable, with some patients having little while other patients having more. Speak with your surgeon before your surgery to have an estimate of what your recovery will be like. Nonetheless, let me share with you what I tell most of my patients who come in for ptosis correction surgery with levator advancement technique.

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