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1 Month Post Lower Blepharoplasty: Concerns

asked 10 months ago by sally63 in Australia
Latest answer by Vivek Bansal, MD
Question viewed 538 times
Tags: age 75 and up, male, 1 month post-op, causes, cortisone, loose, options, red eyes, revision

My husband had a secondary lower blepharoplasty to repair slight ectropian nearly 4 weeks ago and is very concerned about the outcome. He has been performing the required exercises, yet his lower lids are now very slack and red. He is 75. He has been prescribed cortisone drops which help temporarily. Is this any cause for concern and if so, what is the treatment and how soon should it be addressed?

12 answers to 1 Month Post Lower Blepharoplasty: Concerns

Ectropion following eyelid surgery

Your husband still has ectropion of both lower eyelids. Although 4 weeks postoperatively is not a sufficient length of time to judge the results, I am concerned that with the amount of ectropion evident on the photo and his symptoms the problem may not resolve by itself. Blepharoplasty is not a procedure to treat the ectropion, unless you are mistaking it for ectropion repair. In any case, I would suggest a consultation with an occuloplastic surgeon sooner rather than later... more

Alexander Ovchinsky, MD
New York Facial Plastic Surgeon

Eyelid Surgery

First, an ectropian is not easy to fix. You will need a Board Certified Plastic Surgeon who specializes in eyes, and ectropians. An Oculoplastic can also assist in this provided they are familiar with ectropian repairs and blepharoplasty issues.

Vivek Bansal, MD
Danville Plastic Surgeon

Eyelid ectropion

There are many factors at play here: scarring from the initial surgery [blepharoplasty??], inflammation/scarring from the most current surgery, and pre-existing sun-damaged skin. Often, an exuberant scarring response can be mitigated by steroid injections. In addition, massage can be used to help soften scar. I would highly warn against repeat surgery too soon. Waiting at least 3 months and often longer will allow scar to soften and the situation to improve spontaneously. Your... more

A.J. Amadi, MD
Seattle Oculoplastic Surgeon

Persistent Ectropion

The photos do show that the lower eyelid is rolled away from the eye (ectropion), but the photo also shows the lower lids to be quite swollen. The urgent consideration is protection of the eye, preventing corneal dryness and ulceration: frequent use of artificial tears use a humidifier moist compresses can be soothing night time eye drops taping of the lower eyelid evaluation and monitoring by your ophthalmologist Massage (lymphatic drainage)... more

Paul C. Zwiebel, MD
Denver Plastic Surgeon

1 Month Post Lower Blepharoplasty: Concerns

Unfortunately there is still ectropion issue bilaterally. Allow 3 months for healing than seek a revision including lateral canthal fixation and possible skin grafting.

Darryl J. Blinski, MD
Miami Plastic Surgeon

Cause for concern?

I agree with Dr. Bray; 4 weeks post op is too soon to tell, especially when there is as much inflammatory response as there is in the eyelid skin- time will allow healing and softening of the tissues and you will have a better idea whether or not a revision surgery will be necessary. I also agree that you should be evaluated for corneal dry eye now. You may ultimately need correction, but I would not recommend surgery until your tissues have fully healed. Good luck! more

Amy T. Bandy, DO
Newport Beach Plastic Surgeon

Post op 1 month with recurrent ectropion

To echo some of the comments made. lower lid blepharoplasty does not correct ectropion, it makes it worse. at this point there is moderate to severe bilateral cicatricial ectropion with evidence of conjunctival injection (redness), horizontal laxity and possible corneal dryness. First, stop steroid drops until an opthomologist can confirm you are not creating corneal problems, then help protect the corneas with lubricating drops, ointments and apply a moisture tent (plastic... more

Rafael C. Cabrera, MD
Boca Raton Plastic Surgeon

Various causes for ectropion

Your husband appears from the picture to have a true ectropion. If this occurred after his first blepharoplasty, it is possible that too much skin was removed. If that were the case, he might have needed a skin graft at the second operation. Given his age, he may also have a degree of senile ectropion, which would require an additional procedure to correct the horizontal laxity of the eyelid. We don't know exactly what was done at the second operation, so it is... more

Paul W. Loewenstein, MD
Milwaukee Plastic Surgeon

Ectroprion after eyelid surgery

IMHO, the photos show continued ectropion after the lower eyelid surgery and you might consider a second opinion with an occuloplastic surgeon near you. Good luck and hope this helps.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon

Yes, he has bilateral ectropion.

Lower blepharoplasty is not a fix for lower ectropion. No lid exercises will fix this. Repairing this can be quite complicated. Skin grafts can be used but the result is not cosmetically ideal. I recommend that he first see his ophthalmologist to determine if the lower eyelid position is causing drying of the corneal surface. The ophthalmologist will be able to refer him to the appropriate oculoplastic surgeon. Fortunately, Australia has a number of... more

Kenneth D. Steinsapir, MD
Los Angeles Oculoplastic Surgeon

Cicatricial ectropion

It appears that the lower eyelids are being pulled down from very tight, sun-damaged skin. Tightening the lower eyelids alone won't fix the problem and the lower lids will come down as they have. This requires a skin graft (or flap) to the lower eyelids. You can view before and after photos of similar patients on my website. Consult an oculoplastic surgeon. Dr Taban

Mehryar (Ray) Taban, MD, FACS
Los Angeles Oculoplastic Surgeon

Ectropion after blepheroplasty

Be patient. Massage and exercise may solve your problem. However, you should consult an opthalmologist to evaluate the need for lateral tarsus surgery for suspension.