Lower Eyelid Pulling Down After Cheek Lift and Eyelid Surgery

Dear M Unfortunately, this combination of procedures humbles many a midface surgeon. Generally the biggest issue is a failure to understand how lack of cheek projection affects lower eyelid support. Lifting up the cheek fat places a downward pull on the eyelid tissues and this can cause the lid contour to be disturbed after surgery. Unfortunately, there is no simple fix to this problem. I would encourage you to discuss your concerns with your surgeon but you may or may not get a... more

Did you have the cheek lift through a lower eyelid incision? Or did you have a cheek lift using incisions within the temporal hair together with a lower blepharoplasty? In these two situations, you may have a higher risk with prolonged lower lid retraction. Usually, this will improve (or normalize) spontaneously with time. If you did not have any of the above procedures or procedure combinations, most likely the problem will limited in time. You should lubricate your eyes and follow the... more

See your doctor and discuss this with him. Very often after a cheek lift there is swelling of the lining of the eyelid causing it to look pulled down. This will go away after several weeks. If too much pull was exerted on the cheek, that can be another cause: time will tell. Eye drops will help the swelling of the lining.

If your right lower eyelid is pulling down after 3 weeks, then it probably won't come back up by itself.  You need to see an oculoplastic specialist who can evaluate your problem, and then give you the best approach for repositioning the eyelid.  I would make sure that the surgeon who repairs the eyelid has a lot of experience doing this because the more procedures you have done for a pulled down eyelid, the harder it is to get a good final result..

Keeping the lower eye in position is of critical importance for aesthetic purposes as well as functional purposes.  In an eyelid which is pulled down, the eye can be exposed, leading to dryness of the eye, abrasions, and other issues with the function of the eye. Myself and a colleague have written an article on the preservation of eyelid position and its importance, as well as a technique we have found effective for specific situations.  

If your lower eyelid is pulled down after surgery, this can be very uncomfortable. It can also lead to dry eye, and chronic irritation. If you're eye feels dry or uncomfortable then start using lubricating eye drops. You could also consult a board-certified ophthalmologist for specific advice. If you're not pleased with the response of your surgeon, then consider consulting a board certified oculoplastic surgeon for a second opinion. I hope this is helpful, and best regards....