Is it normal to have one eye more swollen after eyelid surgery?

Why is one eye more swollen than the other?

Each eyelid heals as its own small wound, and the two sides rarely bruise or hold fluid in exactly the same way. The surgeon may also remove a different amount of skin or fat on each side to even out eyes that were not the same before. Differences you already had can look larger while the lids are swollen.

Bruising and swelling are expected and can last a few weeks. After ptosis correction the lid height can also look uneven during that time. After under-eye fat repositioning one side can feel firmer or slightly lumpy, and the white of the eye can look puffy. For each stage, see the recovery tables for double eyelid surgery, ptosis correction, upper blepharoplasty and under-eye fat repositioning.

When is uneven swelling a reason to contact the clinic?

Watch how the swelling changes, not only its size. These signs need action:

• If your sight changes suddenly or the eye becomes very painful, get emergency care first, then tell the clinic. The same goes for an eye that bulges forward or for double vision. Bleeding behind the eye is rare, usually starts within the first 24 hours and can harm sight. If any of these signs comes with one-sided swelling, emergency care still comes first.
• If one side swells quickly and becomes more painful, especially soon after surgery, contact the clinic straight away; if you cannot reach the clinic, get emergency care. This can be a collection of blood under the skin (an eyelid hematoma).
• If a treated area blisters, or you see spreading redness, heat or fever, contact the clinic straight away.
• If one side stays clearly more swollen while the other settles, or a firm lump does not shrink, mention it to the clinic at your follow-up or by message.

When can you judge whether your eyes are even?

Not in the first weeks. Swelling changes how high a crease or lid sits, so an early difference often reflects swelling rather than the final shape. Surgeons usually judge the shape and eyelid asymmetry at about 3 months, once the last swelling has gone down.

A difference between the two eyes that lasts is a known risk of eyelid surgery, and sometimes it needs revision surgery. The surgeon decides that after the lids have settled, not while one side is still swollen. Photos taken in the same light each week help show whether the gap is closing.

Procedures in this article

• Double eyelid surgery
• Ptosis correction
• Upper blepharoplasty
• Under-eye fat repositioning

Sources

1. Eyelid surgery. NHS
2. Retrobulbar Hemorrhage. EyeWiki, American Academy of Ophthalmology