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A lady posted pictures or her upper and lower blepharoplasty 4 weeks after the surgery. Her eyes were even before the surgery and now one of her eyes is larger than the other even when the swelling, tightness and bruising were gone. She asks if she needs a revision. During the initial period of healing after eyelid surgery, Dr. Amiya Prasad emphasizes that it is not that unusual to have some difference between the two eyes. There's a muscle called levator muscle which is responsible for lifting the eyelids. What she is experiencing may be something that is related to swelling affecting that muscle. In oculofacial surgery, when people have trauma, Dr. Prasad calls that traumatic ptosis. He says that there are a couple of things that may cause drooping of the eyelid after cosmetic eyelid surgery where the muscle is not directly operated on. It may be related to swelling where the physical weight can actually push down the eyelid, or it may be due to swelling that caused some temporary stretching. Dr. Prasad suggests that it is important that one communicates with their doctor and discuss the options if there is any need of revision. One should review their pre-operative photos and see if there is a difference between the two eyes. If the difference is more than 1-2 millimeters, then they can accentuate that difference during the early post operative period while healing is ongoing. Dr. Prasad assures that this is a temporary issue and that the symmetry does improve. When a situation like this arises in his practice, he will first observe it for a couple of months to allow swelling to go down. After the healing period, he can see if the levator muscle needs further addressing, then he can do something to correct it. http://prasadcosmeticsurgery.com/ More about blepharoplasty here: http://prasadcosmeticsurgery.com/pras...