Asymmetry after blepharoplasty/double eyelid surgery - One eye droops, vision is blurred.
Is it normal?
(Photo)
The surgery was on April 8, 2014.
The plastic surgeon tightened the muscles involved in opening/closing of upper eyelids,
in addition to blepharoplasty and forming Asian double-eyelids (inward folding type).
10 days after the surgery, the two eyes are uneven.
My right eye seems over-done - lashes are pushed way up and there seems ectropion.
My 'weaker' left eye does not close all the way, making it very dry.
The surgeon said all will be fine in time.
Should I have my right eye corrected ASAP?
Thank you for your question!
You submitted a question about asymmetry after asian eyelid surgery and concerns about issues
related to difficulty with closure and possible ectropion where the inside of the eyelid is
turning out.
And you want to know if you need to have a revision as soon as possible.
Well, as a cosmetic oculofacial plastic surgeon who specializes in revision surgery for cosmetic
eyelid surgery, I can certainly give you some insight about what kind of timing is appropriate
if a revision is necessary.
We have patients who come from all over the world who have difficulty with eye closure
from too much skin from the upper eyelids being removed.
More commonly, we see a lot of patients who have had lower eyelids pulled down or eyelid
retraction or ectropion where it’s everted and turned away resulting in severe exposure
or irritation and ultimately, aesthetic revision who just don’t like the way their eyelids
looks because they don’t feel like they look like themselves.
When someone gets rounding of the lower eyelids and used to have an almond shape, they can
be very distressed about it and this something that we do a lot of work with.
Now that being said, it has been 10 days since your surgery and you’re having these symptoms.
Now predicting how much they’ll resolve is dependent on factors such as some degree
of swelling, the nerves that innervate these muscles, working and coming back as well as
absolute amount of the skin for the eyelid to be in proper position.
I think it’s reasonable in a situation such as yours, as long as there’s no significant
eye exposure.
At the core of the issue in terms of urgency is the health and integrity of the eye itself
in danger even with conservative management.
When I say conservative management, I’m usually talking about topical lubrication.
In other words, if someone has an issue that would most likely need revision, if they can
keep the eyes moist with artificial tears, ointment at night, wearing of goggles or keeping
a humidifier in their room, whatever it takes to keep that eye moist so that we can time
the surgery where the tissue is less swollen is very beneficial.
Swelling, like I describe to my patients, is like working on a moving target when you’re
doing surgery.
it distorts the anatomy and makes it challenging to able to do predicatively consistent results.
So, at 10 days, as long as your doctor is advising you about how to keep your eyes lubricated
and managing in terms of the procedure itself then you do have some time.
We make these decisions based how much we think that there will be scar tissue that
will hinder any type of revision surgery.
A lot of times, it is advisable before a lot of scar tissue forms to do the procedure to
revise the surgery and that can be within the first couple of months.
So we’re talking about a couple of months rather than days.
And if there is a situation where it’s we call plus minus or just slight, then we may
wait 6 months to a year to allow for full healing and softening of scar tissue and settling
out.
And as long as things don’t move in the wrong direction or undesirable direction,
you do have some time.
So, to summarize, I want to stress, do everything to protect the integrity and quality of the
health of the eyes and addition, work with the doctor as far as the management.
Sometimes, just massaging when the lower eyelid is reverted slightly, people will sometimes
successfully massage the eyelid up and get enough of improvement.
If there is skin shortage then usually that doesn’t work.
But these conservative methods are appropriate early in the healing phase.
So continue working with your doctor and hopefully things will resolve as times goes on.
So, I wish you the best of luck, I hope that was helpful and thank you for your question!