Asymmetric eyes after blepharoplasty

This is a question that I answered for someone who had a procedure by another physician.

Asymmetry can occur very commonly after upper and lower null or eyelifts. I may see that the left eye is slightly larger in the bottom part of it where the white is showing. This is sometimes due to the skin being taken which can cause contraction of the skin downwards making the eye larger appearing. The bags can be due to a number of things. When it is located right under the eyelid margin it is likely coming from the fat within your orbit of the eye. This fat can be easily removed. When it is lower it is likely due to the eye muscle that surrounds your eye socket and that helps you close your eyes that is causing the bag. This is called the malar crest and it usually is due to the eye muscle hanging over the smiling muscles.

Midface lifts can improve these malar crests but volumizing this whole area can improve the appearance of this cheek region. The larger appearing left eye can also be due to ptosis of the right eye or swelling. Ptosis is when the eyelid margin becomes droopy in relation to the iris. Ptosis can be temporary and can last months if caused by the procedure. Other times, the ptosis can be due to an actual injury to the muscle that opens up the eye (the muscle that pulls up the eyelid margin). This can require a more formal repair and is very difficult.

Dr Young’s office is in Bellevue near Seattle, Washington.

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