Revision Eyelid Surgery in Salt Lake City

Smiling woman with light skin and blue eyes, touching her face gently. Her expression conveys warmth and calmness. Neutral background.
A young woman with clear skin gently touches her cheek, smiling softly. The close-up conveys a sense of freshness and skincare.

Restored Results for Full Satisfaction

Eyelid surgery can deliver transformative results. However, Dr. Patel often has patients come to him due to dissatisfaction with another surgeon’s procedure. Their results either do not match their expectations or may even cause functional issues. As the top facial plastic surgeon for revision eyelid surgery in Salt Lake City and Saint George, Dr. Patel helps patients overcome imperfections or issues caused by their initial blepharoplasty.

What Is Revision Eyelid Surgery?

Following eyelid surgery, patients may be dissatisfied for a range of reasons, both functional and cosmetic. For some, this may entail a procedure that failed to create the results the patient wanted, or the results simply have faded. For others, it might mean functional issues directly caused by the procedure. Regardless of the issue type, revision blepharoplasty is the best way to reverse these issues and restore a satisfying outcome.

Upper Eyelid Revision

Patients dissatisfied with a previous upper blepharoplasty can address issues such as:

  • Residual excess upper eyelid skin
  • Uneven or asymmetrical eyelid creases
  • Irregular eyelid contours
  • Excessive tissue removal
  • Hollowing or a sunken appearance
  • Persistent upper eyelid fullness
  • Eyelid or eyelash position changes
  • Scarring or poorly positioned scars
  • Eyelid drooping or ptosis that was not adequately addressed
  • Difficulty fully closing the eyes
  • Changes that make the eyes appear overly operated on
natural-looking upper

An example of a natural-looking upper and lower blepharoplasty without any of the complications sometimes seen with upper and lower blepharoplasty. In a man, we try to leave no scars that can be seen.

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anatomy
One must understand the anatomy and the physiology of the eyelids and the face to choose the correct procedure and the site of the incisions. This is a problem we often see and we have termed this “the pink eyelid syndrome” (our paper will be published soon). The incision is placed too high centrally and too low medially and laterally which affects the nerve supply and the blood supply to the upper eyelids resulting in atrophy of the upper eyelid with a pink appearance. These are very difficult to improve and the best approach is to avoid them in the first instance.
Incision Tattoo: Although uncommon, some patients can develop incision tattoos. The exact cause is unknown but these can be improved with appropriate lasers
Upper Blepharoplasty was performed but the underlying ptosis was not recognized or corrected: Correction of the ptosis improved her upper blepharoplasty result. We always examine the position of the upper eyelid for any subtle or overt ptosis so that it may be corrected during a blepharoplasty
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5 Stars

The most beautiful upper and lower blepharoplasty by Dr. Bhupendra Patel: thank you!

Salt Lake City, UT

Beautiful upper and lower eyelid blepharoplasty: I couldn’t afford to also get my brows lifted but Dr. Bhupendra Patel MD operated upon my upper and lower eyelids and transferred some fat into my frown lines and even my brows look better! People now take a double take when I tell them I am 75 years old! My eyes look like those of someone much younger! I wish I could have Dr. Patel perform a facelift on me but maybe next!! Right now, I am very happy with my upper and lower blepharoplasty results. I look very good and feel happy and confident. Happy, happy, happy.

Multiple problems with lower blepharoplasty: too much skin removal, too much orbicularis muscle removal, too much fat removal, no correction of lower eyelid canthal laxity, too thin a skin flap, overuse of cautery, cheeks not addressed. These are difficult to correct but we are able to sequentially improve such patients
Correction of lower eyelid retraction: Lower interpositional graft and lateral canthoplasty together with cheek elevation
Over-resection of lower eyelid skin during blepharoplasty resulting in ectropion and retraction with dryness as well as tearing. Correction with recruitment of skin with cheek lifts and lower eyelid repositioning which allows us to avoid using skin grafts in some patients.
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Lower Eyelid Revision

For lower eyelid revision, Dr. Patel will address issues that remain after prior lower blepharoplasty such as:

  • Persistent or recurrent under-eye bags
  • Residual lower eyelid fat
  • Over-removal of fat causing a hollow appearance
  • Tear trough or nasojugal groove irregularities
  • Lower eyelid retraction
  • Eyelid malposition
  • Ectropion or outward turning of the lower eyelid
  • Excess lower eyelid skin
  • Asymmetry
  • Excessive visible sclera (white) showing beneath the iris
  • Contour irregularities
  • Visible scarring from previous surgery
  • Changes in the relationship between the lower eyelid and cheek
Excessive removal of lower eyelid skin and orbicularis muscle, without adequate cheek elevation and support resulting in lower eyelid retraction with inferior scleral show.
Severe lagophthalmos (inability to close the eyelids) results in dryness, tearing and vision changes. Reconstruction can require one or more of a number of techniques, including skin grafts, tarsal grafts, alloderm grafts, palate grafts, cheek elevation, canthoplasty, etc. The exact procedures are determined by clinically examining the dynamic and static changes present. This is why it is important to establish the exact extent of any eyelid surgery prior to surgery and after examining for orbicularis weakness, lower eyelid laxity, cheek ptosis, negative malar angle, skin condition (cicatrizing changes, prior surgery, etc), existing dryness of the eyes, upper eyelid tone and position, among other important aspects. I have often lectured that well-done lower cosmetic blepharoplasty is one of the most difficult operations in plastic surgery because of the innumerable variations
Surgeons will often concentrate on just the lower eyelids when a lower blepharoplasty is requested. This is a mistake. This sketch shows all the areas that must be carefully assessed to allow one to perform a safe and effective procedure on the lower eyelids. The lower eyelids are connected to the cheeks which are connected to the jowls. Sometimes one needs to address these structures to improve the lower eyelids. “Choose and perform the correct procedures to obtain the best results, or don’t operate at all”

63 Yrs Old with Fat Droopy Eyes

Salt Lake City, UT

Well, the last time I had a picture taken I could hardly see my eyes because of the weight of heavy eyelid. Then I paid attention to how I was actually using my eyes and I really noticed when I was looking at anything especially the computer I was straining my forehead to see better. Since I have had it done I no longer have to lift the forehead and tilt my head to see. It is amazing! I love…

D. Rock ​

Quad Revision

In some cases, patients may need revision on both of their upper and lower eyelids. Such instances are often complex, and they may involve different issues even from one eyelid to the next. Dr. Patel carefully builds a revision plan based on individual anatomy and concerns.

Extensive problems after quad blepharoplasty and several attempts at revision elsewhere: Methodical assessment and planning are needed to reconstruct not just the eyelids but also the cheeks and mid-facial and lower facial tissues
Quad Correction: Upper eyelid cicatrizing scar tissue was released from the orbital rim to allow free movement of the upper eyelids, the lower eyelids were elevated with alloderm grafts, cheek lifts and lateral canthoplasty. Skin grafts were avoided in this case, but that is not always possible. Even with excellent correction, some lagophthalmos and dryness will remain
An example of accurate assessment of the patient: by improving the brow position and performing the appropriate procedures on the upper and lower lids (together with correcting the zygomatic groove and cheek ptosis), and the use of nano fat grafts and stem cells with the fractionated CO2 laser, we get very pleasing results.
Lower eyelid retraction worsened by unrecognized relative proptosis: careful analysis and measurements allows us to reposition the globes and correct the upper and lower eyelid positions to improve the overall appearance and the protection of the corneas
Correction of complications of upper and lower blepharoplasty: the brows were repositions, the volume loss in the upper eyelids corrected with fat grafts, the ptosis of the upper eyelids repaired, the lower eyelid retraction corrected and the texture and tone of the skin was improved. Changes a tired-looking gentleman into a handsome and vibrant gentleman
Another example of accurate diagnosis and planning: a youthful, soft appearance to the brows, lids, cheeks and the skin.
Quad blepharoplasty with brow lifts and cheek lifts (Hammock Lift) and use of stem cells and fractionated CO2 laser: gives a soft, pleasing result.
The power of proper planning and assessment of the skin: this lady presented for an upper and lower blepharoplasty. We re-volumized her cheeks with nano fat grafts, performed an upper and lower blepharoplasty and improved her skin with stem cells and fractionated CO2 laser. The cheeks were lifted, essentially performing our signature “Hammock Lift” to give a fresh and soft face

Expert Advice

Revision surgery should be approached conservatively. When too much skin or fat has already been removed, simply removing more tissue may worsen the issue.

Brilliant Surgeon

PARK City, UT

My Hammock Lift is exactly what I needed, but did not know!! Dr. Patel explained to me how the Hammock Lift improves the upper two-thirds of the face, including brows, upper lids, forehead, lower lids and cheeks. I also got an improvement along my jawline which I am thrilled with as I plan on having a lower face and necklift later but this already gets me a great improvement. I have sent my two sisters to him! Brilliant surgeon. Cannot speak highly enough about him and his team.

J. Stevenson

Revision Blepharoplasty: At a Glance

  • Procedure Type: Revision / reconstructive
  • Anesthesia: Local anesthesia with sedation (sometimes general anesthesia when clinically appropriate)
  • Procedure Time: 1–2+ hours (depending on complexity)
  • Downtime: 7 to 10 days away from work and social activities
  • Results Duration: 7+ years for upper eyelids, 10+ years for lower (on average)
  • Your Surgeon: World-renowned surgeon who has researched and published extensively on cosmetic and reconstructive procedures, and in particular on Upper and Lower Blepharoplasty (see references below)

Procedure Day & Techniques Used

Anesthesia: Most patients will only need local anesthesia, possibly with light sedation. Together, these facilitate a comfortable, low-stress experience.

Incisions: Incisions are strategically placed to access target tissues. When possible, previous incision locations are used to minimize novel scarring.

Adjustments: Dr. Patel will adjust tissues and support structures to achieve optimal results.

Conclusion: Dr. Patel closes all incisions before you are taken to a room to rest. Afterward, you can return home the same day.

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Revision Blepharoplasty: Full Overview

Individualized Patient Assessment

The assessment for revision eyelid surgery often must be even more thorough than for standard blepharoplasty. In addition to examining your unique eye/eyelid structures, Dr. Patel must evaluate your previous procedure’s results. Scarring, tissue adjustments, and more can all create a complex clinical picture.

Evaluation can include:

  • Reviewing your medical history
  • Examining scars from the previous procedure
  • Evaluating the eyelid creases and symmetry
  • Checking eyelid closure/strength
  • Assessing brow position
  • Evaluating lower eyelid laxity and support
  • Assessing the transition between the lower eyelid and cheek
  • Looking for eyelid retraction, malposition, or scleral show
  • Evaluating tear production, dryness, and other factors affecting ocular comfort
  • Reviewing previous photographs

Downtime, Recovery, & Results

Downtime: About 7 to 10 days away from work is typical. Patients will spend this time resting at home and focusing on caring for surgical sites.

Recovery: Swelling and bruising typically show dramatic improvement after 1 to 2 weeks. Residual swelling will continue to resolve over several months.

Results: Initial results should be visible around 2 weeks (once most swelling has resolved). Final, refined results appear over 3 to 6 months with the fading of residual swelling.

Frequently Asked Questions

What are the common complications of eyelid surgery?

While complications are rare, eyelid surgery does have some risks. Working with a skilled, experienced surgeon is the best way to minimize these risks. Still, some of the patients who come to Dr. Patel for revision surgery can report:

  • Dry eyes
  • Blurred or double vision
  • Eyelid tightness
  • Eyelid malposition
  • Inability to close the eyes completely
  • Eyelid asymmetry

Not always. In many cases, Dr. Patel can use the previous incision point for a revision procedure. If the previous incision was placed poorly, he may or may not use it. It largely depends on the adjustments that need to be made and what will benefit the patient most.

When done properly, eyelid scars should not be visible. When making incisions, the surgeon must carefully plan, place, and minimize each incision. While some scarring is inevitable, a healthy scar should also improve over time. When making incisions, Dr. Patel always places them in the least conspicuous place appropriate for the procedure.

Most patients will need 10 to 14 days before they can safely resume wearing makeup. Regarding applying makeup, remember that:

  • Always wait until Dr. Patel confirms it is safe
  • Apply makeup with care to avoid harming the incision sites
  • Never apply makeup over incisions that are not yet closed

Aging continues even after revision eyelid surgery. While the bags should not return in the same way as before surgery, skin laxity changes can continue. As such, we recommend an attentive skincare routine to keep the under-eye area healthy.

Rather than age, health is a more important factor for qualifying for revision blepharoplasty. Dr. Patel has successfully worked with eyelid patients from 70 years on up, providing optimal outcomes regardless of age.

Schedule a Revision Blepharoplasty Consultation in Salt Lake City

Revising or restoring eyelid surgery results starts with a consultation with Dr. Patel. As the area’s leading oculofacial surgeon, he is the premier provider of revision eyelid surgery in Salt Lake City. Schedule your visit using our online form or by calling Dr. Patel’s office at (801) 823-6443 for Salt Lake City patients or (435) 900-4550 for Saint George patients.

References:

Transconjunctival blepharoplasty. Patel B.C.K., Anderson R.L. Plast Reconstr Surg  1996;97:1514.

Management of postblepharoplasty lower eyelid retraction with hard palate grafts and lateral tarsal strip. Patel B.C.K., Patipa M., Anderson R.L., McLeish W. Plast Reconstr Surg 1997;99:1251-1260.

Upper Blepharoplasty: advances, techniques and tips. Joos Z, Patel BC. Journal of the Tamil Nadu Ophthalmic Association (JTNOA), 2017 55(2); 961-971

Blepharoplasty. Kwitko GM, Patel BCK. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; PMID:29493921

Transconjunctival blepharoplasty. Patel BCK, Malhotra R. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing;2020 Aug 24. PMID: 30844179

Upper Eyelid Blepharoplasty. Patel BCK, Malhotra R. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing;2020 Jul 31. PMID: 30725763

Blepharoplasty: a systematic approach. Patel B.C.K., Anderson R.L. Naugle T.C. (ed)
Diagnosis and Management of Oculoplastic and Orbital Disorders, Kugler Publications, Amsterdam/New York;1996:59-78.

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