Repairing the upper eyelid

Raffy Karamanoukian, MD answers: Stretch eyelid skin possible after an aggressive surgery?

Is it possible to stretch upper eyelid skin or have a skin graft done to eyes that have been operated on aggressively? There was too much skin and fat removed after my Eyelid surgery. I look so odd. I used to have beautiful eyes and a slight hooded upper lid that was very attractive. Now, I barely have a crease with eyelids that feel tight. It does not look right. I already have Juvederm in the upper eyelids, hoping that it will stretch the skin. What else can be done? I'll be most grateful for an answer.


Raffy Karamanoukian, MD
6 months ago
By Raffy Karamanoukian, MD - Los Angeles Plastic Surgeon

The upper eyelid is an important functional and aesthetic element that should only be approached by surgeons who are knowledgeable about eyelid anatomy, function, tolerance, and the limits of surgical resection. Correcting upper eyelid deformity is often more difficult than just restoring upper eyelid skin. I would advise you to seek a consultation with a board certified plastic surgeon.

In the acute period after surgery, the mainstay of treatment should be observation with protection of the cornea. Lubrication is indicated to prevent corneal exposure during the day and during sleep.

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More answers to “Stretch eyelid skin possible after an aggressive surgery?”

A: I would be somewhat skeptical of any answer to this question without a personal consutlation.

Kenneth D. Steinsapir, MD
6 months ago
By Kenneth D. Steinsapir, MD - Los Angeles Oculoplastic surgeon

 Dear Goldilock

Unfortunately it is very hard to unstir the cream out of the coffee.

Whereas there are a lot of great options for helping aesthetically improve the lower eyelid that has been damaged by prior lower eyelid cosmetic surgery, the options for the upper eyelid are much less palatable and satisfactory.

The frame issue that Dr. Seify is referring to is over resection of upper eyelid fat in the central fat pocket exposing the groove created by the reflection of tendon complex of the superior oblique muscle.  

That is not the problem you are describing.  What you are talking about is that someone removed your upper eyelid fold robbing you of an very important facial feature.  

Restoring the upper eyelid fold is an impossible task.  Nothing will bring back the natural gentle fold that is a very important feature of the face that is removed by an aggressive upper blepharoplasty.  

A skin graft does help with eyelid closure when this had been compromised by too much skin removal with the eyelid surgery.  However, this is simply to achieve the ability for the eyes to close.  It is not helpful in restoring the aesthetic upper eyelid fold.  

Fat transfer or filling with Restylane can also soften the appearance of the sub-brow area but this is not the same thing as storing the upper eyelid fold.

I encourage you to find a surgeon who deals with post-blepharoplasty issues and have a personal consultation.

Dr. Steinsapir

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