Nine months on and one crease still sits higher than the other. At what point is it fair to raise revision?

Everyone here is very good at telling the two week people to be patient, and rightly so, I have said it myself on this board. So what does the advice become when you have been patient and it has not evened out?

My uppers were done last November. Nine months. The result overall is one I am pleased with, I look rested, nobody has guessed, all of that. But the left crease sits noticeably higher than the right and shows more when my eyes are open. It has not moved since about month four. At six months I told myself it was still settling. It is not still settling, it is just how my face is now.

I feel awkward even typing the word revision because it sounds ungrateful and because my surgeon was lovely. Is this a real thing people get adjusted, or is a slightly uneven crease simply the normal outcome of cutting two separate lids and I should live with it? And how do you raise it without sounding like you are accusing someone of botching you?

Nobody has two identical eyelids to start with, that is the bit people forget. Have you got a photo of yourself from before? Mine showed my left lid was always a bit different and the surgery had not created that, it had just moved it somewhere I now stare at.

Please do not feel ungrateful. You are allowed to be pleased with the result and also want one part looked at, those are not in conflict and any decent surgeon deals with both sentences at once. I would just book the appointment and say exactly what you said here.

MargueriteP said:

It has not moved since about month four.

That is the part that makes your question a fair one rather than an impatient one. Mine kept quietly changing until about month five, then stopped, and where it stopped is where it still is now.

From the double eyelid side of things, an uneven crease height is the single commonest thing people go back for, and yes it is adjusted, though usually with a good deal of caution because there is only so much lid to work with. What I was told, for what it is worth on a different operation to yours, is that the higher side is the harder one to change, since making a crease lower is a different job to making one higher.

This is such a fair question and I want to give it a proper answer rather than the reflexive be-patient one, because you have already done the patient part.

Nine months is past the point where the tissues and the scars have settled, so what you see now is broadly what you have, and asymmetry that persists once everything has settled is one of the recognised reasons a second, usually small, operation gets discussed. It is not an accusation and it is not rare. Our piece on revision blepharoplasty sets out what genuinely revises well and what does not, and the short version is that residual skin on an upper lid and a crease that needs refining sit at the easier end, while anything caused by too much having been taken sits at the harder end. It also explains why surgeons want you at roughly this distance from the first operation before they will consider it, which you now are.

On raising it, my honest advice is to say it as plainly as you have said it here. When I went back with a question about my own result I had rehearsed an apologetic speech and did not need a word of it. A good surgeon would far rather you brought it to them than sat at home resenting it, and they have the one piece of information nobody here has, which is how much skin and support is left on that lid. Take your pre-operative photographs with you, as hoodedat52 suggested, because the answer may be that the asymmetry predates the surgery, and that is worth knowing before anyone talks about operating again. Blepharoplasty scars and the eyelid crease covers what a settled crease normally looks like at this stage, which is a useful yardstick to take to the conversation.

The one thing I would go in braced for is being told that the improvement available is partial rather than complete, and that living with it is a legitimate option rather than a failure of nerve.

Appointment is booked for next month and I dug out the old photographs, which was an experience. My left brow sits lower than my right and always has. Whether that is the whole explanation for the crease or only part of it, I have no idea, but I am glad I looked before I walked in with a complaint.

Will post what she says. I am now genuinely unsure whether I want anything done or whether I just wanted to be told it was real and not me being obsessive. Possibly the second one.