Purpose: The challenge of accurately predicting eyelid height after upper blepharoplasty and blepharoptosis surgery is well-known problem even in complete hands. Many techniques for the prevention and correction of asymmetry have been developed, but satisfactory method has not yet been found.

Materials and Methods: From May, 1988 to December, 2004, authors reviewed 364 cases(480 eyes) of upper blepharoplasty and blepharoptosis corrected by frontalis muscle transfer or levator resection and had experienced 36 cases(56 eyelids) of asymmetry. 20 cases(30 eyelids) of asymmetry that were treated by early adjustment between immediate post-operation and around 1 week after operation. 16 cases(26 eyelids) were treated by late reoperation at 6 months after surgery to treat asymmetrical eyelid. Among 36 cases, 18 cases were after upper blepharoplasty and 18 cases were after blepharoptosis surgery. Revision after upper blepharoplasty was performed by the resection of excess eyelid, fat graft and corrective upper blepharoplsty. Early and late postoperative correction after ptosis surgery were performed in accordance with the preoperative and postoperative size of eyelid crease and degree of ptosis of patient and considering previous operative technique.

Results: Follow-up period ranged from 6 months to 16 years. The results are evaluated according to the criteria of an ideal correction by Souther and Jordan in ptosis patient and the symmetry of folds of the upper eyelids in upper blepharoplasty and photograph comparison and patient's satisfaction in both. Thirty patients have good or satisfactory results. Six patients(5 eyelids) recorded as poor results(more than 2 mm asymmetry in ptosis patient).

Conclusion: The correction of the asymmetry of the upper eyelids following blepharoplasty and ptosis surgery is not so easy. The resection of excess eyelid, fat graft, correction of levator aponeurosis or Muller muscle are methods of treatment. Even if early or late reoperation can be effective, early reoperation, immediate or seven days within the blepharoplasty and ptosis surgery is better than later reoperation, at least 6 months after initial operation because early reoperation can offer a reduction in time to final result, the ease with which it is performed, potential cost savings.

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