With the promotion of double eyelid surgery, the incidence of postoperative double eyelid asymmetry has increased. Asymmetrical eyelids cause damage to the patient’s appearance as well as different degrees of psychological damage. Surgery is the main means of repairing eyelid asymmetry. The repair focuses on individualized treatment according to the specific cause of the asymmetry. The main causes of eyelid asymmetry include: 1) different skin tension between the two sides when marking the eyelid line, lack of precise measurement or unskilled operation, resulting in the incision deviating from the marking line; 2) different heights of the skin fixed to the lid plate on both sides; 3) different amounts of skin, orbicularis muscle, orbital fat and other tissues removed on both sides; 4) different amounts of local anesthesia injected into both lids or the formation of a hematoma on one side, resulting in a significantly different eyelid shape. The shape of the eyelids is obviously different, thus affecting the intraoperative judgment. In cases of bilateral dissatisfaction, a new double blepharoplasty should be performed. For those who are relatively satisfied with one side of the eyelid, blepharoplasty can be performed on the unsatisfactory side based on the desired shape. However, if you want to achieve as much symmetry as possible, you should repeat the blepharoplasty on both sides.