Revisional Blepharoplasty

Last updated date: 14-May-2023

Originally Written in English

Revisional Blepharoplasty

The main features of our faces are the upper eyelids and our eyes. When we look at someone, we direct our attention to this area of the face, and because of this, our eyes can detect asymmetries or variations in the eyelids with ease. Plastic surgery's sensitive, harsh field of eyelid surgery has many potential failure aspects. Eyelid surgeon has specialized in eyelid surgery and has extensive knowledge in revision surgery. Speak with a specialist who specializes in eyelid surgery if you want to avoid revision surgery.

A highly skilled surgical operation called eyelid revision surgery is used to fix earlier eyelid surgery performed by other physicians. The removal of extra skin, fat, and fat from the upper and lower eyelids is known as blepharoplasty, which is one of the most popular surgeries in the world.

If a patient has had any eyelid cancer or injuries, they can additionally require surgery around their eyes. While many patients experience positive results, some suffer scarring, asymmetry, disfigurement, or other issues with their eyelids that may necessitate revision surgery. Oculoplastic surgeons are needed for eyelid revision surgery.


What is Revisional Blepharoplasty?

Revisional Blepharoplasty Definition

Revisional blepharoplasty, commonly referred to as eyelid revision surgery, is a second surgical treatment used to address issues that have developed or enhance the outcomes of a prior eyelid procedure. A revision operation may be suggested if a patient feels unsatisfied with the results of a prior blepharoplasty, perhaps because of a distressing defect or deformity that resulted from the procedure.

Depending on the complexity of the issue, revisional blepharoplasty is more difficult to do than the initial treatment. The most frequent issues addressed by revision blepharoplasty include lower eyelid retraction, scarring, rounding of the eye corners, hollowing of the upper or lower eyelids, or lingering bags and bulges.

The very typical blepharoplasty side effects include lateral eyelid sagging and, in more extreme cases, loss of intercanthal tilt and ectropion. These modifications may result in severe eye pain, discomfort, and vision loss in addition to being visually catastrophic.


Revisional Blepharoplasty Indications

Revisional Blepharoplasty Indications

There are several reasons why a patient could require blepharoplasty revision surgery, however the majority of the time, patients are dissatisfied with the outcomes of an initial eyelid procedure. Blepharoplasty treats a very delicate area of the face; thus, complications can happen if the treatment is not performed by a highly trained oculoplastic surgeon.

From mild scarring to severe eyelid malposition that compromises the integrity of the eye and its ability to function properly, the severity of the issue can vary greatly from person to person. The following are the most typical causes of blepharoplasty revision:

  • Scarring. Although the skin on the eyelids usually heals quite well, there are times when it can be too quick. As a result, there may be visible scars and lumps near the incision sites, which some patients may not have anticipated before having eyelid surgery. If scarring is the cause of your desire to have your eyelids reshaped, scar revision procedures can typically treat it successfully.
  • Under-corrected eye surgery. When the initial eyelid surgery under-corrected the primary problems or concerns, another issue could develop. In this case, an initial blepharoplasty operation or ptosis surgery did not remove enough skin, and/or the muscle that raises the eyelid was not tightened enough. When this happens, the face seems heavier and older. The upper field of vision can be blurred, and the eyelids frequently appear swollen and tired.
  • Excessive removal of fat or skin. An initial eyelid treatment that removes too much skin might be quite problematic for the patient. Changes in the lower eyelid's contour that cause retraction and increased eye exposure are the most serious consequences. For instance, if the lower eyelid's soft tissue and skin are removed excessively, the colored iris and more of the white sclera (the eyeball's outer layer) may be exposed. This is because the lower eyelid hangs below the sclera.
  • Lower lid retraction changes are complex. They can have disastrous effects on an individual's appearance and cause agonizing soreness and dryness. Lower eyelids sag, exposing more of your eye's white (sclera show) than usual. A lower blepharoplasty revision can restore the eye contour and give it a more natural shape, even though this kind of issue is likely the most difficult to resolve.
  • The incorrect alignment of the eyelids is another common issue when too much skin or fat is removed. The result may be an unnatural, imbalanced, and asymmetrical appearance. To realign everything and regain the previous symmetry, blepharoplasty revision might be done.

If too much fat has been removed from the area, the area under the eyes may also appear sunken and hollow. The lower and/or upper eyelids can gain volume for a more youthful appearance by receiving filler injections or fat transfer.


Problems Treated with Revisional Blepharoplasty

Revisional Blepharoplasty Treatment

Revision blepharoplasty is frequently done to address one of the following issues:

  • Under-correction. By removing less tissue than is required, a second surgery may be performed to better improve the eyes that were previously under-corrected.
  • Over-correction. Too much tissue removal might overdo the eyes. A dry eye can result from overcorrection that prevents the eyes from completely closing. A deformed look is sometimes caused by excessive tissue removal.
  • Ptosis. The upper eyelid may droop as a result of aging or an anatomical problem. Ptosis can be treated with blepharoplasty by some surgeons, although the procedure is different for this issue than it is for cosmetic eyelid rejuvenation. The levator muscle may still pull on the upper eyelid after blepharoplasty, causing it to droop. Ptosis can sometimes be brought on by blepharoplasty and unintentional damage to the levator muscle in the upper eyelid.
  • When incisions are performed on the upper eyelid too high, visible scarring may result. Usually, scars from incisions are effectively concealed since they are made in the eye's natural crease.
  • Entropion. A disease known as entropion causes the tissue of the eyelid to turn inward.
  • Ectropion. Ectropion is a condition where the eyelid's tissue bulges outward.

When one or more of these side effects manifest, a revision blepharoplasty might enhance the eyes' appearance. A complete correction might not be achievable, though, depending on the severity of the issue. Your board-certified surgeon should be honest with you about the expected results of your treatment.


Revisional Blepharoplasty Consultation

Revisional Blepharoplasty Consultation

You will be required to provide a medical history when you arrive for your consultation since your doctor needs to be aware of any serious conditions including heart disease and hypertension. Your team must understand the details of your previous facial surgery. It can be especially beneficial to include old photos from before your initial surgery.

Since your first operation, what feature of your eyelids and face has been bothering you? Your team will explore possible solutions with you. An ideal result requires a shared understanding of the objectives, expectations, and results.

Any eye disorders, such as dry eye, that can affect or change the surgical plan or be a concern after your treatment are also reviewed during your appointment. Depending on the results of your study and consultation, doctors can suggest a completely different procedure to produce the desired results. Sometimes a technique like a brow lift, mid-facelift, or fat transfer is the ideal way to address the facial structure and initial surgical results. Your team should be knowledgeable about eye conditions and problems.


Revisional Blepharoplasty Preparation

Patients who have been planned for revisional blepharoplasty will receive direct preparation advice from the surgical team. Patients may receive advice to stop smoking, if applicable, and to switch to another drug or supplement, as well as to avoid others that may increase the risk of bleeding, in the weeks leading up to this surgery.


Revisional Blepharoplasty Procedure

Revisional Blepharoplasty Procedure



Local anesthetic or light sedation are typically used to do revision eyelid surgery. The sedative will make it possible for the patient to relax throughout the process. If the revision eyelid surgery is being done in conjunction with another treatment or if the patient is really worried and anxious, the surgeon might recommend general anesthesia.

The general anesthesia will be administered by a qualified anesthesiologist or anesthetic nurse, who will also supervise the entire process to monitor the patient's reaction to the anesthesia. A knowledgeable and qualified anesthesiologist can identify an adverse anesthesia reaction early and take precautions to lower the risks.


Revision Lower Blepharoplasty

The surgeon will do minor incisions after the patient has passed out to ensure that any scarring that develops afterward is hidden.

Small, unnoticeable incisions can be made in the skin's natural creases beneath the lower eyelids. Through these incisions, the surgeon will remove extra fat and skin; he or she may also tighten loose underneath muscles.

The surgeon may utilize soft tissue fillers or fat transfer if the area under the lower eyelids looks depressed. The surgeon will carefully close the wounds with sutures after the procedure is finished.


Revision Upper Blepharoplasty

After the patient has been given general anesthesia, the surgeon will make the incisions in the upper eyelid's natural creases. This lessens the procedure's visible scars.

To treat the sagging effect of the upper eyelids and any partial vision blockage, the surgeon will carefully excise any extra skin. Additionally, they will tighten the underlying weak muscles.

The surgeon will raise and reattach the remaining skin to provide a more refreshed and youthful appearance once the drooping skin has been removed. After the operation is finished, the surgeon will use sutures to close the wounds.


Revision Transconjunctival Blepharoplasty

Even though there are excessive fatty pockets surrounding the eyelids, the surgeon could advise the patient to have a revision transconjunctival blepharoplasty treatment if the skin in the eyelids is not sufficiently lax. For patients with less obvious under-eye bags, this procedure is less invasive and more suitable.

After administering an anesthetic, the surgeon performs this revision eyelid surgery by making several small incisions inside the lower eyelid. Through these incisions, the extra fat pockets will be cut out. This operation does not involve the removal of skin or the tightening of muscles. There won't be any external scarring because the incisions are made inside the eyelids.


Revisional Blepharoplasty Recovery

Revisional Blepharoplasty Recovery

Recovery times vary greatly from person to person and frequently depend on the kind of corrective surgery that was done. For instance, the procedure required to fix an overly-corrected eyelid may take longer in the operating room, resulting in a longer recovery. On the other hand, revision surgery for under-correction is less difficult and typically has a quicker recovery time.

You should anticipate some degree of swelling and bruises around your eyes, regardless of how your eyelids are fixed during your revision treatment. Over a few weeks, these adverse effects progressively go away. It is typical to have some hazy vision, tears, and light sensitivity in the first few days following surgery. The majority of the time, discomfort is manageable and minimal with over-the-counter painkillers. Painkillers on prescription can be obtained if needed.


Revisional Blepharoplasty Risks

Revisional Blepharoplasty Risks

Following a blepharoplasty, there is a chance of both short- and long-term problems and adverse effects. Because the surgeon must work around the scar tissue that had developed after the initial treatment, these risks can be enhanced for patients having revision surgeries. This demands considerable thought regarding the person doing a revision blepharoplasty.

Revisional blepharoplasty adverse effects frequently resemble those that can develop following primary eyelid surgery. These include the potential for scarring and infection. After their revision surgery, patients should anticipate mild to moderate swelling, bruises, and pain. The best healing can be accelerated with regular follow-up and communication with your team.


Is Revisional Blepharoplasty Dangerous?

Even while patients seeking revisional blepharoplasty may be at higher risk for complications, these risks can be effectively handled by a skilled surgeon. When a patient is unhappy with the results of eyelid rejuvenation surgery, they should carefully assess their expectations for a revision and compare them with the prognostications offered by a qualified, board-certified plastic surgeon.

Revisional blepharoplasty has risks, although these don't always mean the treatment is dangerous. The main issue is quickly performing a surgical operation with a doctor who is underprepared to address poor surgical results. This can make the initial issue worse or cause unintended problems.


How Much Blepharoplasty?

Depending on the details of each patient, revision eyelid surgery will include varying degrees of correction. Surgery has several expenses, including anesthesia, surgical facility charges, medical supplies, and the surgeon's experience, which is represented in their rates. You can anticipate a full cost breakdown and discussion about the details of your treatment and how it will enhance your appearance if you choose a good office for your revision surgery.



A popular surgery carried out by several surgical specialties is revisional blepharoplasty. Primary care doctors and specialists who conduct surgeries on the face and orbit should be knowledgeable about the anatomy, technique, and risks associated with eyelid surgery. The results of revisional blepharoplasty are mostly positive, however, over the years, several problems have been documented. Anyone who does blepharoplasty must be qualified to handle any complications that may arise. When done correctly, it can greatly boost patients' confidence and self-worth.