Corrective Measures for Eyelid Closure Problems After Blepharoplasty?

I had upper and lower blepharoplasty 2 years ago and since then, I have aching eyes and problems with closing them fully. I can get them closed maybe at 95%, but they still let in crack of light. At night time it seems my eyes tighten, and I find I need more and more sleep to feel rested. Are there any options to correct this problem? Thank you.

Doctor Answers (10)

Closing eyes after blepharoplasty

+2

The problem you describe seems to be due to excessive eyelid skin being removed. The surgical option involves replacing some of that skin with a skin graft. A temporary measure may be to place botox on your forehead to drop your brows a little. This may give you that 5% back for a temporary time.


Miami Facial Plastic Surgeon
5.0 out of 5 stars 39 reviews

Inability to close eyelids following blepharoplasty

+2
The problem you have described is one that as surgeons we try very hard to avoid. it sounds like too much skin was taken at the time of surgery. If that is the only problem, then skin grafts from the lower lids or other places where the skin is similar in texture and thickness can be used as a grafting material in order to manage this disorder. There are other solutions to this problem if the levator (elevators of the upper lids) are affected or if deep scarring is the problem.

Philip S. Schoenfeld, MD
Chevy Chase Facial Plastic Surgeon
4.5 out of 5 stars 6 reviews

Eyelid not closing after blepharoplasty

+1

This is a complex problem. After two years, you will not likely improve further with conservative measures.  You may need a full thickness skin graft to reduce the risk of corneal abrasion in the future.

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
5.0 out of 5 stars 47 reviews

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Revision for Eyelid Closing Problems After Eyelift

+1

I'm a Cosmetic Oculofacial (Speciaizing in Eyelid and Facelift Surgery) Plastic Surgeon practicing for 15 years with offices in Manhattan's Upper Eastside. Your problem is not unusual. I see patients with this problem from all over the world who seek help for revisional or corrective surgery due to an eyelift they previously had with another surgeon. Usually this problem is caused by lower eyelid retraction (the lower eyelid is not at the same level as the border of the iris or colored part of the eye). Proper examination and performing the right eyelift procedure or corrective procedures can probably provide you with some improvement of your problem with closing your eyes after having had blepharoplasty surgery to your eyes.

Amiya Prasad, MD
New York Oculoplastic Surgeon
4.5 out of 5 stars 30 reviews

There are ways to correct the problem with inability to close eyes...

+1

You should not have these issues 2 years after lower eyelid surgery.  Symptoms like this should resolve a few weeks after surgery.  You have one of two possible problems.  Too much skin may have been removed from the upper eyelid.  If this is the case, it can be repaired with a skin graft from behind the ear.  The other possible problem is malposition of the lower eyelid.  Correction of this problem depends on what the root source of the problem is.

Options...

1.  Too much skin removed from lower eyelid,

2.  muscle of lower eyelid not tightened, or

3. scar tissue of conjuctiva of lower eyelid.

Raghu Athre, MD
Houston Facial Plastic Surgeon
5.0 out of 5 stars 34 reviews

Inability to close eyes completely after blepharoplasty

+1

If you have difficulty closing your eyes 2 years after blepharoplasty, then either too much skin was removed from the upper eyelids, the lower eyelids became weak and drooped, or both.  If the upper eyelids are the problem, the a skin graft placed to restore some of the excess skin that was removed is a good option.  If the lower eyelids are drooping, then either they can be tightened, or in some cases a skin and/or cartilage graft must be used to strengthen the lower lids.

Minas Constantinides, MD
Manhattan Facial Plastic Surgeon
5.0 out of 5 stars 1 review

Eyelid Closure Difficulty Following Blepharoplasty

+1

What you have described regarding your surgical outcome implies that too much skin was removed during the blepharoplasty. As other surgeons have noted, a skin graft is really one of the only true options available to you at this point. Essentially you need to have the skin replaced to some degree and this can be accomplished by taking skin from another location and using it to lengthen the upper eyelids. Make sure you seek consultation with a facial or eye specialist for this type of procedure.

John M. Hilinski, MD
San Diego Facial Plastic Surgeon
4.5 out of 5 stars 19 reviews

Getting Your Eyes Closed

+1

Unfortunately, after two years and no spontaneous resolution of your problem, you should not expect it to go away on its own.  From your description, it seems as though your problem is quite severe and impacting your life to a great extent.

The only option in this situation is to put skin back into your upper eyelid.  The upper eyelid has the thinnest skin on the body and as such there are no great sources for similar skin to serve as a grafting source.  The lower eyelid is going to have the most similar skin, but that is a challenging source.  When skin is removed from the lower lid, there is a chance that it could cause that lid to pull down and compound your problem and even threaten your vision.  While I would not rule that out, I would take every precaution possible to ensure that indeed your lower eyelid has the skin to give and that the structural stability of the eyelid is excellent.  The skin behind your ear can be an acceptable match and is a very safe donor site.

Unfortunately, the cosmetic result may not be what you want, but at least you should be able to be comfortable again.  Expect it to take many months for the skin graft to fully integrate and become supple and you will need to work closely with your surgeon during that time.

Louis W. Apostolakis, MD
Austin Facial Plastic Surgeon
5.0 out of 5 stars 16 reviews

Blepharoplasty revision to enable eyelid closure

+1

The only other corrective procedure to perform after a blepharoplasty with inability to close the eyes is to place a skin graft along the incision site to expand the upper lids to give them more room to close. An experienced facial plastic or oculoplastic surgeon is whom you should consult with.

William Portuese, MD
Seattle Facial Plastic Surgeon
5.0 out of 5 stars 58 reviews

Post-blepharoplasty problems

+1

Not being able to completely close the eye or even not being to blink fully can cause severe dry eyes and irritation. This could be due to two things in your case: 1) scarring or lack of eyelid tissue preventing eyelid closure; 2) orbicularis muscle weakness which is the muscle that causes eyelid closure.

Good news is that there are some surgical and nonsurgical options to help close the eyes. No matter what, it is important to keep the eye lubricated and moist.

Best,

Dr T

Mehryar (Ray) Taban, MD, FACS
Beverly Hills Oculoplastic Surgeon
5.0 out of 5 stars 9 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.