Canthopexy After Blepharoplasty?

Dear Scared First being only a few weeks after surgery, it is very difficult to know how you will actually heal. Some things get better and some things get worse in time. Second, lets get our terminology correct. An ectropion is an outward roll of the lower eyelid such that there is a gap between the eye and the eyelid margin. This situation is relatively rare following lower eyelid surgery and would generally be caused by the surgeon removing too much lower eyelid skin in the... more

Sometimes canthopexies are a big help and even necessary for lower lid malposition. But be careful since it can also exacerbate a problem if the correct diagnosis is not made. Sometime your lower lid needs more than a canthopexy or may need support from below the eyelid and a canthopexy may actually pull the lid lower as you try to tighten it. Also, cosmetically it is diffiucult to achieve true and exact symmetry with canthopexies so be prepared for some asymmetry.

You should definitely wait at least six months prior to considering a revision surgery. There are a range of conservative measures that should be considered by you and your surgeon during that period of time. These include taping, massage, and possibly a temporary suture to help support the lower eyelid. The robustness of your lower eyelid support should have been a very important part of your pre-surgical evaluation. This is not to say that your surgeon did not consider this issue. All... more

Ectropion is a result of many things during lower lid blepharoplasty, removal of too much skin, scarring of the orbital septum or damage to the muscle. However, during a normal blepharoplasty we do things that we know will create ectropion so other things must be done to counter this. A canthopexy is part of the procedure to fix ectropion. The second thing that must be done is elevation of the midface to reduce the downward forces on the lower lid. However, you're too early for any of... more

Dear Scared in FLA., The biggest risk to lower lid blepharoplasty is over resection of the skin or muscle resulting in pulling down of the lower lid reminiscent of a bloodhound. Some high profile stars in Hollywood have had these problems - Burt Reynolds, Jack Lemon, etc. In these cases, the proper treatment is to wait until all the swelling has resolved and then treat the problem. For exmple, if too much skin has been removed then replace it with a small skin graft. If too much muscle was... more

Canthopexy can often be used to correct ectropion or scleral show after Blepharoplasty. However, I would not do a canthopexy until I was certain that you had an ectropion and would wait 4-6 months after your surgery. If you have scleral show or ectropion in the immediate post operative period (the first 3-6 weeks), there are many measures that can be taken to stretch the lid and bring the lower eyelid into a proper position to protect the eye. If you have a severe ectropion immediately... more

You need to give the tissues a chance to heal, and the swelling to resolve. You should focus on conservative (i.e., non-surgical) techniques to resolve the problem. Thes include massage, taping, and possibly oral steroids. All of these should be under the direct guidance of your plastic surgeon. sek