Asymmetry
The eyelids or folds on the two eyes are different in height or shape; one eye appears smaller.
CONDITION / FACE
Unsatisfactory result of blepharoplasty.
Unsuccessful blepharoplasty — when asymmetry, excess skin or fat "bags" remained after eyelid surgery, the eyelid drooped or the eyes sunken. Most of these defects can be corrected, but usually when the swelling has passed and the result has stabilized.
CONCEPTUAL VISUALIZATION- What it is
- The result of eyelid surgery is not as expected: asymmetry, "bags", excess skin, drooping eyelid.
- How common
- In a series of 278 patients (533 operations on the upper eyelids), the frequency of repeated corrections was 3.8%, most often due to residual skin.
- When to evaluate
- In a study of 2,134 patients, satisfaction with the outcome did not change significantly between 6 and 12 months after surgery.
- Who treats it
- A surgeon who performs repeated operations on the eyelids; if necessary, together with an ophthalmologist.
01 / WHAT IS ITWhat do they think?
What do they think?
unsuccessful result.
Blepharoplasty is an operation during which excess skin or fat is removed from the eyelids. Dissatisfaction with the result is not always a complication: sometimes the operation went without problems, but it did not turn out the way a person expected. According to the NHS, sometimes the desired effect cannot be achieved and the person feels that another operation is needed.
Most often, different eyelids on two eyes, skin that continues to overhang, fat "bags" that remain, a drooping upper eyelid, sunken eyes, a noticeable scar or an overly high or low eyelid fold are not suitable.
The first weeks are not the result yet. Bruising and redness go away in a few weeks, but scarring can be noticeable and last for months. Therefore, it is too early to make a final judgment about the result, until the swelling has passed.
If years have passed since the operation, the problem may be not only in it, but also in age-related changes. In a series of 100 reoperations on the upper eyelids, 2 to 22 years had passed since the first blepharoplasty, the median was 8.7 years.
A lowered or everted lower eyelid and non-closing eyelids are separate conditions, and there are separate pages about them.
This is general information. The doctor will tell you what will suit you after the examination.
02 / SIGNSMost often
Most often
does not suit
Complaints are aesthetic and functional; often several of them at the same time.
The rest of the skin
The upper eyelid continues to hang down. In a series of 278 patients after blepharoplasty of the upper eyelids, this was the reason why re-correction was most often done.
Fat "bags"
There are protrusions under the eyes or near the inner corner of the upper eyelid.
Lowered upper eyelid
The eyelid covers the eye more than before the operation, and the look seems tired. Doctors call it ptosis.
Eyes lit up
The eyelids look "empty", depressions have appeared above or below the eye, bumps and irregularities are visible.
A scar and a fold
The scar is noticeable or thick, small cysts appeared on it; the eyelid fold is too high, low or double.
Scars after operations on the face03 / REASONSWhy the result?
Why the result?
not like that
Part of the reason is related to the operation itself, part - to healing, age and how everyone sees their desired result.
Ptosis
A drooping upper eyelid is often combined with excess skin: in a series of 278 patients, up to 21% needed ptosis correction in addition to blepharoplasty.
Healing
The eyelid may droop due to swelling, hematoma, scar adhesions inside the eyelid, or damage to the muscle that lifts it.
Fat and skin
The skin or fat has been removed too little or unevenly: excess skin, "bags", bumps or depressions remain.
Scars
The scar healed roughly or small cysts formed on it — in a series of 836 operations, such cysts were the most common minor complication (5.4%).
age
After the first operation, aging continues: most often, over the years, excess skin reappears - in 70% of 100 patients who underwent a repeat operation.
Lower eyelid
If the lower eyelid drooped after the operation and the eyes became "round", this is a separate condition and a separate tactic.
Inversion and retraction of the lower eyelid
04 / SEEK MEDICAL ADVICE
When to seek medical advice?
Dissatisfaction with the way the eyelids look is a planned situation: it does not need urgent help. But in the first days after blepharoplasty, sometimes there is a hemorrhage behind the eye - most often in the first 3 hours, and after the first day the risk is much lower; it usually causes pain and a feeling of pressure in the eye. Then the bill goes for hours.
103 immediately if:
- suddenly stopped seeing in one or both eyes;
- sudden severe pain in or around the eye;
- pain in or around the eye appeared or worsens after eyelid surgery;
- after surgery on the eyelids, the eye protrudes or became tense;
- after eyelid surgery, the eyelids do not open;
- double vision or impaired vision after eyelid surgery.
Do not delay a visit to the doctor:
On the same day: to the operating surgeon if the wound has opened, the eye has turned red, or any unexpected symptoms have appeared. In the coming days: if the eyelids do not close well for weeks, the eye is dry or watery, or small cysts have appeared on the scar, see a surgeon. Planned: asymmetry, remaining skin, "bags", sunken eyes, scars - they are evaluated when the swelling has passed and the result has stabilized; you can see a doctor even earlier.
05 / DIAGNOSTICSAs defined,
As defined,
what to fix
- Conversation and documents
When and what operation was done, what exactly does not suit; statement and photo before the operation, if any.
- Examination of the eyelids
The height and shape of the crease, the rest of the skin, fatty protrusions, depressions, scars, symmetry of the two eyes.
- The position of the eyelids
How much the upper eyelid covers the eye and how the muscle that lifts it works; do the eyelids close completely.
- Eye examination
Dryness, eye movements, double vision; if necessary, consult an ophthalmologist.
- Photo in standard angles
For operation planning and comparison.
06 / TREATMENTHow to fix
How to fix
result
Tactics depend on what exactly is wrong and how much time has passed. According to a systematic review, most of the functional and aesthetic problems after blepharoplasty of the lower eyelids are solved without surgery or by repeated intervention.
01
First, wait
While the swelling passes.
- Swelling and bruising
- Bruising and redness go away in a few weeks, scars can be noticeable and last for several months.
- Lowered eyelid
- Mild or moderate ptosis after blepharoplasty may disappear on its own. If it lasts more than 3 months, surgery may be necessary.
- When to evaluate
- In a study of 2134 patients, satisfaction with the result was assessed after 6 and 12 months - there were no significant changes between these periods.
02
Repeat operation
For a specific reason.
- The rest of the skin
- The skin is removed carefully so that the eyelids close. In a series of 100 reoperations on the upper eyelids, 37% did not remove skin at all, and in the rest - very little: a median of 2 mm.
- Asymmetry and folds
- The fold of the eyelid is reshaped and fixed at the desired height.
- Ptosis
- The drooping upper eyelid is lifted by muscle surgery; the method depends on how that muscle works.
- Fat "bags"
- Remains of fat are removed or moved. In a series of 200 lower eyelid blepharoplasty, 1.0% required reoperation due to residual protrusions.
03
Volume
If the eyes are inflamed.
- Own fat
- Lipofilling evens out the volume and contours of the eyelids; it is also used during repeated operations on the upper eyelids.
- Fillers
- Hyaluronic acid restores volume after blepharoplasty, in most cases for more than 12 months. But there are only 5 studies in the review, so there is not much evidence yet.
- Risks
- In a meta-analysis of 33 studies (4,671 patients), after fat transfer and transplantation in the lower eyelids, insufficient correction or unevenness occurred in 6.2%, reoperation was required in 2.4%.
04
Result of repeated operation
- One more correction
- In a series of 100 repeated blepharoplasty of the upper eyelids, another correction was made in 13% - most often due to asymmetry (5%) or ptosis (4%).
- eye
- There was no persistent non-closing of the eyelids or dry eye in that series.
07 / AT THE VALIKHNOVSKYI INSTITUTE
How
How
we treat it.
The unsatisfactory result of blepharoplasty at Dr. Valikhnovskyi's Institute of Surgery is corrected in the direction of "Complications of aesthetic operations" - in particular, when the first operation was performed in another clinic.
CLINIC SERVICE
Treatment of complications of aesthetic operations
Skin necrosis, dehisced wounds, capsular contracture, liposuction irregularities, and gross scarring.
View service
What we do for this condition
- Repeat blepharoplasty — the remaining skin or fat is removed, the fold of the eyelid is formed, and asymmetry is leveled.
- Lipofilling — the patient's own fat is injected to fill the depressions and soften the scar tissue.
- Excision of scars — a rough scar is cut out and stitched using a different technique.
- Canthopexy and canthoplasty — if the outer corner of the eye has fallen after the operation, it is strengthened or restored.
- Spacers and grafts — if the lower eyelid is pulled by a scar, it is propped up with a cartilage graft or a spacer.
Rostislav Valikhnovskyi
Plastic surgeon, candidate of medical sciences, founder of Dr. Valikhnovskyi Institute of Surgery.
How treatment works with us
- Photo onlineSubmit a photo of the eye straight on and from the side, with the eyes closed and, if available, a pre-surgery photo.
- ConsultationExamination of the eyelids and eye, the position of the eyelids, scars and folds; if necessary, consult an ophthalmologist.
- PlanWhat exactly to correct, whether it is worth waiting and whether it is necessary to combine several methods.
- SurgeryTechniques are selected according to the cause: skin, fat, crease, corner of the eye, volume.
- RecoverySwelling and bruises in the first weeks; the doctor will explain how to care for the eyelids and when to come for an examination.
08 / QUESTIONS AND ANSWERSCommon
Common
questions
Short answers. What is right for you, the doctor will tell you during the consultation.
When can repeat blepharoplasty be done?
Take your time: swelling and scars change over several months, and mild ptosis can go away on its own. In a large study, satisfaction with the outcome did not change significantly between 6 and 12 months. When to operate on you, the doctor will tell after the examination.
One eye is different from the other. Is this being fixed?
Yes, asymmetry is corrected by repeated surgery. But it is one of the most frequent reasons for another correction: in a series of 100 repeated blepharoplasty - 5%.
Can the skin be removed again?
You can, but be careful that the eyelids close. In a series of 100 repeated operations, in 37% the skin was not removed at all — the result was achieved by other methods.
After the operation, the eyes became inflamed. What can be done?
Volume is restored with own fat (lipofilling) or hyaluronic acid fillers. The doctor will tell you what will suit you after the examination.
Why are the eyes double after blepharoplasty?
Blurred vision or diplopia occasionally occurs after surgery. According to the registry of 368,623 patients, strabismus was diagnosed in 2.0% after surgery on the lower eyelids and in 1.5% on the upper eyelids within 3 years. If diplopia appears suddenly after surgery, call 103.
Is it possible to be treated at your place if the operation was performed at another clinic?
Yes. The doctor assesses what is now and makes a plan. Take a statement from that clinic and a photo before the operation, if you have them.
Can I need another operation after a recurrence?
Maybe: in a series of 100 repeated blepharoplasty of the upper eyelids, another correction was made in 13%, mostly due to asymmetry or ptosis.
Sources
16 sources · systematic reviews, cohorts, studies and the NHSshowCollapse
- Secondary upper lid blepharoplasty: a clinical series using the tarsal fixation techniquePlastic and Reconstructive Surgery, 2015doi:10.1097/PRS.0000000000001042 ↗
- Eyelid and Brow Rejuvenation: Technical Pearls and Outcomes of Upper Blepharoplasty with or without Ptosis Correction and Brow LiftPlastic and Reconstructive Surgery, 2024doi:10.1097/PRS.0000000000011324 ↗
- Safety and Efficacy of Resident-Performed Functional Upper Eyelid BlepharoplastyOphthalmic Plastic and Reconstructive Surgery, 2019doi:10.1097/IOP.0000000000001395 ↗
- Long-Term Results with the Extended Transconjunctival Lower Eyelid Blepharoplasty: A Prospective Study of 200 Consecutive CasesPlastic and Reconstructive Surgery, 2026doi:10.1097/PRS.0000000000012545 ↗
- Assessment of Patient Satisfaction With Appearance, Psychological Well-being, and Aging Appraisal After Upper Blepharoplasty: A Multicenter Prospective Cohort StudyAesthetic Surgery Journal, 2022doi:10.1093/asj/sjab389 ↗
- Ptosis after blepharoplastyAnnals of Plastic Surgery, 1995doi:10.1097/00000637-199503000-00007 ↗
- The Incidence of Strabismus After Upper and Lower Blepharoplasty in the United StatesOphthalmic Plastic and Reconstructive Surgery, 2024doi:10.1097/IOP.0000000000002617 ↗
- Complications of Fat Grafting and Repositioning for Correction of Lower Eyelid Pouch With Tear Trough Deformity or Lid-Cheek Junction: A Systematic ReviewAnnals of Plastic Surgery, 2024doi:10.1097/SAP.0000000000004022 ↗
- Revision Upper BlepharoplastySeminars in Plastic Surgery, 2015doi:10.1055/s-0035-1556844 ↗
- Role of Hyaluronic Acid in Post-Blepharoplasty Volume Restoration and Complication Management: A Systematic ReviewJournal of Clinical Medicine, 2025doi:10.3390/jcm14134572 ↗
- Safety and Complications in Lower Eyelid Blepharoplasty: A Systematic ReviewPlastic and Reconstructive Surgery Global Open, 2025doi:10.1097/GOX.0000000000007102 ↗
- Blepharoplasty complicationsPlastic and Reconstructive Surgery, 2010doi:10.1097/PRS.0b013e3181ce17e8 ↗
- Incidence of postblepharoplasty orbital hemorrhage and associated visual lossOphthalmic Plastic and Reconstructive Surgery, 2004doi:10.1097/01.iop.0000143711.48389.c5 ↗
- Visual loss after blepharoplasty: incidence, management, and preventive measuresAesthetic Surgery Journal, 2011doi:10.1177/1090820X10391212 ↗
- Eyelid surgeryNHS, 2023nhs.uk/tests-and-treatments/cosmetic-procedures/cosmetic-surgery/eyelid-surgery ↗
- Vision lossNHS, 2025nhs.uk/conditions/vision-loss ↗
The figures on the page are from these sources.
The result of blepharoplasty
not satisfied?
Send photos of the eyes directly and from the side and, if available, a photo before surgery. The doctor will tell you what can be fixed and when.