I had an upper blepharoplasty 6 weeks ago and now have moderate lagophthalmos (5mm of show) of my right eye. Also, my eyes are visibly asymetrical, as too much skin was removed. My surgeon has recommeded raising the crease to correct this. Does that sound reasonable? Can it also improve the lagophthalmos?
Changing Eyelid Crease Help Lagophthalmos After Blepharoplasty?
Doctor Answers 3
Raising lid crease
There are several ways to correct lagophthalmos in the upper eyelids but first I would do several things
1. Give it time - 6 months - it may resolve on its own
2. Put more skin back - skin grafting
3. Levator recession - lowering the eyelid position may help but cosmetically it wouldn't be a good option especially for one eye. It would raise the crease incidentally
I dont think raising the crease will help the lag. If they are going to remove more skin I suspect it would make it worse
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Do not let anyone reoperate on eyelids 6 weeks after a blepharoplasty.
The odds are quite good that your lid will return to its correct position over time. Taping and other non-surgical therapy may be of some help. There is a 100% chance that you haver persistent swelling that is at least partially, if not totally, contributing to your eyelid position problem. Reoperation now would be ill-advised unless the eye itself were in danger.
Inability to fully Close the Eyes (Lagophthalmos) After Eyelid Surgery
An inability to fully close the eyes (Lagophthalmos) may be transiently seen after eyelid surgery. It may be caused by swelling (interfering with eyelid muscle function), by the removal of too much eyelid skin and or muscle or by injury to a branch of the Facial Nerve (VII) powering the muscle bringing about eyelid closure. There are several non-surgical causes for this condition.
The immediate treatment is protection of the cornea to prevent scratches while sleeping and drying while asleep and awake. Taping and eye drops (artificial tears) at least 4 times a day are indicated.
I would wait a few weeks for the swelling to subside and see if the lagophthalmos resolves. I would NOT worry about the level of the crease and certainly not operate on you for this until we have resolution. If the lagophthalmos does not improve it will have to be handled surgically.
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