I had lower Blepharoplasty done 2 years ago, and I've been back to my doctor several times to have the left eye bag corrected, as I am not happy with the results. Eventually, my surgeon said he would redo if I insisted, but it could make things worse, with complications in healing possible too. Is it really not possible to have Blepharoplasty results safely and successfully corrected?
Correcting Blepharoplasty Results
Doctor Answers (17)
Eyelid Surgery Revision
Correcting Blepharoplasty result is possible. Doing it safely and successfully requires a surgeon with great understanding of the Anatomy of the lower lid structures and support systems.
After thorough examination of lower lid and mid face your surgeon should be able to make a diagnosis of the cause. Then a list of possible options should be available to consider.
From your descirption, you most likely need repositioning of fat as well as muscular support of the lower lid.
If your surgeon does not feel comfortable, ask him to refer you to someone who is experienced in correcting such problems.
Hope this is helpful.
Revising a blepharoplasty (eyelid surgery)
A secondary or revision blepharoplasty of the lower eyelid can be done but needs to be approached very carefully. The main risk is that of ectropion where the lower lid can end up being pulled away or down from the eye. This can lead to excessive watering or dry eye and also to a cosmetically unappealing eye. You may need a canthopexy which is a procedure to tighten the lower lid to prevent an ectropion.
I would consult with one or more plastic surgeons or oculoplastic surgeons for a second opinion if you have any concerns.
If you are unhappy with your results at 2 years after your procedure, it is reasonable to consider a revision. However,without photos, it is difficult to assess the problem that you have, the level of benefit you will receive from another procedure, and the level of risk involved with a revision. Your Surgeon is correct in stating that another procedure could potentially lead to complications and a poor result; this statement is standard in informed consent.
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Blepharoplasty revision possible
Without knowing exactly what your issues are, it's hard to give you a specific answer. 2 years is certainly long enough to see final result. If your current surgeon doesn't seem eager or confident in your planned revision, you might consider seeking a second opinion.
Revision eyelid surgery
Revision Blepharoplasty can be a rather complex surgical procedure and should be performed by some one with skill and experience in this field. Ask your surgeon if he would rather refer you to some one else. Every revision Blepharoplasty case needs to be analyzed thoroughly, as not all residual fat bags in fact need to be removed. There are many anatomical factors to consider to choose the best surgical technique.
Revisional surgery of the eyelids is occasional a generally safe.
I'm not sure about your specific problem but revisional surgery, although uncommon in eyelid surgery, sometimes will help the patient. You have waited long enough for healing to be complete. It is true that revisional surgery is a bit more hazardous than primary surgery, but it is necessary on occasion.
Blepharoplasty results can be corrected
Revision blepharoplasty is complex and requires expertise and skill on the part of your surgeon.
Your doctor is quite correct in warning you that complications and unhappy results are more likely "the second time around."
The risk of problems depends on what needs to be corrected. If you simply have residual fat or puffiness it can be a fairly simple procedure to remove the excess fat-preferably through an internal transconjunctival incision.
However, if the problem is excess skin, a secondary blepharoplasty to remove excess skin through an external incsion does have a significant risk of ectropion or "pulling down' of the lower eyelid, which is a very serious problem.
Another possible solution for excess skin after blepharoplasty, if you have good lower eyelid support, is laser resurfacing which can tighten the skin without necessitating another lower eyelid incision.
If you have concerns about the advice of your doctor seek a second opinion from an experienced board certified plastic surgeon who does a lot of eyelid surgery.
Blepharoplasty can be revised at two years after the procedure. In experienced hands it should not make things worse, as long as the healing process goes well. Be very clear about the expectations of what the proposed revision surgery will accomplish.
Revision lower Blepharoplasty
The three riskiest words in plastic surgery: revision lower blepharoplasty.
When patients are unhappy with their lower blepharoplasty results, any revisional surgery should include several elements:
1. Very focused surgery on the problems that bother the patient. The goals should be very concrete. Make sure the revision surgery doesn't do exactly the same thing that the first surgery did.
2. Restoration of normal eye function (i.e. often sagging or pulling down of the lower eyelid is present).
3. Acknowledgement of asymmetries of the eye that cannot be corrected, i.e. orbital dystopias (differences in set of the eyeballs in the bony eye socket)
4. Acknowledgement of existing scar tissues, which can often be minimized but seldom removed completely.
5. In no patient will absolute symmetry be obtainable, because many aspects of both eyes are always different. The key is to minimize the appearance of asymmetries.
So no easy task. It is helpful to select a board certified plastic surgeon who is skilled in and interested in revision lower eyelid and cheek lift / midface surgery.
Upper Eyelid Surgery and Correction of Assymetry
Upper eyelid surgery must be meticulously performed. In rare cases, the body may form scar tissue that will impair the long term outcome. In these cases, consideration to the risks and benefits of further surgery must be addressed. This would entail a careful examination of the functional and structural elements of the eyelid and the residual capacity of the eyelid tissue to withstand further surgical stress.
Consult with your original surgeon who is most familiar with your surgery and the consequent healing that occured thereafter.
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.