Before concluding that you have experienced negligent eyelid surgery, it is helpful to understand the typical recovery timeline. Most people find the initial weeks manageable, though the final results of an eyelid lift may not be fully visible for several months.

What is lower eyelid retraction?

Lower eyelid retraction is a condition in which the lower eyelid is pulled downward or away from the eye, disrupting its normal position. Rather than sitting snugly against the eyeball, the eyelid drops below the lower edge of the iris, exposing an area of the white part of the eye known as the sclera - a visible sign referred to as scleral show.

In a healthy eye, the lower lid should rest at or just below the coloured part of the eye. When eyelid retraction pulls the lid away from this natural position, the change in eye shape can be noticeable and distressing. Beyond the cosmetic impact, the altered position of the lower lid can affect the eye's ability to close fully, which in turn leads to functional problems including dry eyes, excessive tearing, blurred vision, and in more serious cases, corneal irritation and exposure keratitis.

Eyelid retraction varies in severity. For some, it is a mild cosmetic change. For others, the degree of retraction is significant enough to affect vision, daily comfort, and quality of life.

What are the signs of a poorly performed upper eyelid surgery?

When upper eyelid surgery does not go as planned, it can result in various functional and aesthetic complications. If you are experiencing any of the following symptoms long after the initial healing phase, you may have undergone an unsuccessful eyelid procedure.

Noticeable asymmetry and uneven eyelid creases

While no human face is perfectly symmetrical, significant differences in the height or shape of the upper eyelids can indicate a problem. Asymmetry may occur if the surgeon failed to account for pre-existing anatomical differences or if the upper eyelid crease was placed at different heights on each eye. This can result in one eye appearing larger or more "open" than the other.

Persistent droopy upper eyelid (upper eyelid ptosis)

Upper eyelid ptosis occurs when the eyelid hangs lower than intended, potentially obscuring vision. This can happen if there was inadvertent injury to the levator muscle - the muscle responsible for lifting the lid-during the surgery. If ptosis surgery was part of your initial plan and the eyelid remains droopy, the surgical technique may have been inadequate.

Difficulty closing the eyes (lagophthalmos)

One of the most serious complications of negligent upper eyelid surgery is lagophthalmos. This is the inability to close the eyes completely, often caused by the over-removal of too much skin or muscle. If you cannot close your eyes while sleeping, your eyes are at significant risk of severe dryness and corneal damage. This often requires additional surgery to correct.

Hollow upper eyelid and volume loss

A hollow upper eyelid or a "sunken" appearance can result from the removal of too much fat (orbital fat) during the procedure. This is sometimes referred to as an A-frame deformity, where the eyelid looks peaked and hollowed out. While fat removal is a standard part of many procedures, taking too much fat can age the face prematurely rather than rejuvenating it.

Visible scarring and skin texture changes

While most plastic surgeons are trained to hide incisions within the natural eyelid crease, poor incision placement can lead to visible, thickened or hypertrophic scars. Changes in skin texture or a "pulled" look near the outer corner of the eye may also indicate that the procedure was handled poorly.

Persistent dry eye and eye irritation

Dry eye is a common temporary side effect, but it should not become a chronic, debilitating issue. If the eyelids do not close properly, or if the tear film is disrupted, you may experience constant eye irritation, redness and a "gritty" feeling. Management usually involves artificial tears, but if the underlying cause is a skin shortage from the surgery, further intervention may be needed.

Why do surgical complications occur?

Every surgical procedure carries risks, but many complications are avoidable when a skilled plastic surgeon follows accepted clinical standards. A botched eyelid surgery may happen due to:

• Incorrect assessment: failing to properly evaluate the person's anatomy or pre-existing conditions like dry eye.
• Poor surgical technique: removing too much skin or fat, or damaging the levator muscle.
• Inadequate aftercare: failing to provide clear instructions or failing to respond promptly when someone reports serious complications.

Surgeons have a duty of care to their patients. This means they must perform the surgery to a professional standard and ensure the person has given informed consent, having been fully warned of the potential risks.

When does a complication become negligence?

It is important to recognise that a less-than-perfect result is not always due to negligence. Surgery is complex, and even when performed correctly, some complications are recognised risks that can occur without any fault on the part of the surgeon. However, if your surgeon breached their duty of care and this caused you avoidable harm, you may have a legal claim.

Negligence might be present if:

• The surgeon removed so much skin that you cannot close your eyes (lagophthalmos).
• The levator muscle was severed or damaged due to poor technique, causing permanent drooping lids.
• The surgeon failed to recognise and treat a post-operative infection or hematoma promptly.
• The results are so asymmetrical or poor that no reasonable surgeon would have produced such an outcome.

If you have experienced these issues, the first UK cosmetic negligence firm, Cosmetic Surgery Solicitors, can help you understand your options. Led by Michael Saul, our team has secured over £10 million for people who have undergone negligent procedures, maintaining a 95% success rate after obtaining supportive medical evidence.

What are your legal options for avoidable harm?

If you believe you have undergone a negligent upper eyelid surgery, you may be entitled to claim compensation. This compensation can help cover the costs of:

• Revision eyelid surgery: to correct the aesthetic or functional errors made by the original surgeon.
• Further treatment: such as fat grafting to correct hollow eyes or skin grafts for those with a skin shortage.
• Psychological support: to help you cope with the distress of a changed appearance.
• Loss of earnings: if your complications or recovery from revision surgery have prevented you from working.

Every claim is assessed individually. We operate on a no win, no fee basis, meaning there is no financial risk to you if your claim is unsuccessful.

How can revision eyelid surgery help?

Revision blepharoplasty is often more complicated than the initial surgery because the surgeon must work with scarred tissue and, in many cases, a shortage of available skin or fat. However, a skilled surgeon specialising in revision surgery can often restore a more natural appearance and improve eyelid function.

Common techniques in revision eyelid surgery include:

• Fat grafting: to restore volume to a hollow upper eyelid.
• Skin grafts: in extreme cases where too much skin was removed during the first surgery.
• Levator muscle repair: to correct persistent drooping lids.

Most plastic surgeons recommend waiting at least six months to a year until you are fully healed before undergoing additional surgery. This allows the tissues to soften and the final position of the eyelids to stabilise.

Choosing the right surgeon for your procedure

To reduce the risk of an unsuccessful upper eyelid surgery, it is essential to choose the right surgeon from the start. Blepharoplasty involves delicate structures around the eyes, so your surgeon should have the right training, experience and understanding of both cosmetic results and eye function. If you are seeking revision surgery after a poor outcome, this choice becomes even more important, as corrective procedures can be more complex.

Before agreeing to surgery, take time to check the surgeon’s background and ask clear questions about their experience, approach and aftercare. A responsible surgeon should be open about the risks, realistic outcomes and what can be achieved in your specific case.

• Check their registration and specialist experience: make sure your surgeon is registered with the General Medical Council and has suitable expertise in oculoplastic, facial plastic or cosmetic eyelid surgery.
• Review eyelid surgery photos: ask to see before and after photographs of previous patients. Look for natural-looking results, balanced eyelids and scarring that appears well placed within the natural eyelid crease.
• Read patient reviews: genuine reviews can give you an insight into the surgeon’s communication, results and level of aftercare. Pay attention to comments about follow-up appointments and how concerns were handled after surgery.
• Ask about revision rates and complications: an honest and transparent surgeon should be willing to discuss how often complications occur, how they are managed and what support is available if your healing does not progress as expected.
• Discuss realistic expectations: your surgeon should explain what upper eyelid surgery can and cannot achieve. They should also make sure you understand the potential risks, including scarring, asymmetry, difficulty closing the eye, dry eyes or the need for further treatment.
• Clarify the aftercare plan: proper aftercare is an important part of your surgeon’s duty of care. You should know who to contact if you develop pain, excessive swelling, signs of infection, changes to your vision or any other concerning symptoms.

Choosing a qualified and experienced surgeon does not remove every risk, but it can reduce the chance of avoidable harm. If a surgeon fails to assess your suitability, explain the risks, perform the procedure to the expected standard or monitor your recovery properly, this may amount to negligence.