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Dr. Wants to Do a Canthopexy to Fix my Lower Eyelid After He Took Too Much Skin? (photo)

It has been 5 weeks since my lower eyelid surgery to remove loose skin and wrinkles, and my left eye (reversed in picture) still has an ectropion. The dr. (plastic surgeon) who did the surgery says it is an easy in office procedure that requires only a 1 stitch canthopexy to fix it. He said he could do it next week. I need to know if this will fix it, or should I have an occuplastic surgeon do the correction? The eye had an ectropion from day 1 and I cannot live like this anymore. Do I trust him

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8 Doctor Answers | Asked by lilah04

Doctor Answers (8)
Community Comments (6)

Canthopexy is not "one stitch" and is not "easy."

You have a pretty significant ectropion, and while aggressive skin removal is one cause of this problem, there can be others. Re-operation may be necessary on a more urgent basis if you have corneal drying issues, but if your tear film and corneal lubrication is adequate, the longer you wait, the softer your scar tissue will be, and the more likely successful your canthopexy (and final appearance improvement) will be. Pulling on tissues that are firm and edematous (scarred) is like... more

Dr. Wants to Do a Canthopexy to Fix my Lower Eyelid After He Took Too Much Skin?

Without examining you, it is impossible to know whether the canthopexy will be enough or if some of the removed tissue needs to be replaced to allow your lid to lift and again protect your eye. I do agree that massage will likely help with this issue but is unlikely to completely remedy it. In the meantime, make sure your eye is protected at night time and that you're using drops to prevent dryness of the eyes. If you have any concerns about the plan, seek a second opinion and an... more

Canthopexy is not easy

We agree that given your experience and photos, canthopexy is the likely solution to add lift and support to the lower lid. The comment that canthopexy is an easy in office procedure with one stitch however is a misconception. Problems are harder to fix than to prevent. There is a red flag here that might have you consider a second opinion.

Lower eyelid retraction after blepharoplasty

Canthopexy may or may not correct the problem. There are two main reasons why your lower eyelid is retracted: 1) tight lower eyelid skin; 2) weak orbicularis muscle, responsible for blinking. It takes time (up to 6 months or more) for the latter to recover, for which surgery is not recommended. It is wise NOT to do any further surgery for at least 3 months (and hopefully 6 months) to give time for things to heal. I recommend you see an oculoplastic surgeon. more

Canthopexy Ectropion Correction

Canthopexy can be an effective solution to a mild lower eyelid ectropion after blepharoplasty surgery.Tthe key is the timing of this revisional procedure. It is better to wait until the tissues are softer and less inflamed as the result can be better. But if the symptoms warrant it (dry eye and irritation) then earlier intervention can be done. It can be done as an office procedure under local anesthesia.

Ectropion after blepharoplasty 5 weeks.

It is too soon for any surgery. Wait at least6 months. The swelling is pushing your lower lids down. Steroid drops will help.

Toby Mayer, MD

7 reviews

Beverly Hills Facial Plastic Surgeon

www.bevhills.com

The Role of Canthopexy

A Canthopexy procedure is meant to give strength back to the attachment of the lower eyelid to the outer corner of the eye. Some things to know to guide you best down the road to recovery: A close exam of the muscle and skin of the lower eyelid BEFORE surgery can often predict who will be prone to ectropion (pulling away of the lid from the eye) Canthopexy can be done at the same time as the lower lid blepharoplasty or in some cases after if an ectropion is noted The... more

Ectropion after lower eyelid blepharoplasty

You are not completely healed at 5 weeks post op, meaning your eyelid could become more ectropic as it completely scars. It isn't unreasonable to want to fix it now, but you should be aware that it may still change further. Upward massage on the eyelid can help some, but is unlikely to correct this problem. I would recommend a consultation with an oculoplastic surgeon to determine if there is scarring of the eyelid layers or just laxity. This can change the management... more

Matheson A. Harris, MD

6 reviews

Salt Lake City Oculoplastic Surgeon

www.utahoc.com

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Comments (6)

lilah04 6 Oct 2012

I think it's pretty safe to say that if A doctor was negligent enough to cause a horrible disfiguring result the first time around, then there's no way he is going to have the expertise or knowledge to fix his mistake, since it is easier to do it right the first time around than to do a very complicated revision. But yes, I am definitely proactive, Thank You.

lilah04 7 Oct 2012

although a doctor may not have any lawsuits against them, most of the time they settle out of court, which doesn't show up on their record.

Hisdaughter 7 Oct 2012

That is great advice! I would not have thought of that! No wonder there are so many unqualified surgeons out there doing inferior work on unsuspecting patients, and they still have a thriving practice! Go figure! I guess it comes down to a guessing game. Who do you choose? I am looking for a surgeon in florida and I have read pros and cons on one that I was considering. Not any more. Good luck to you.

Hisdaughter 6 Oct 2012

Too many different answers! Please see another doctor who has many years experience doing "revisions". Also ask to speak to patients who have had the same problem. If the doctor doesn't allow that, then it is a "red Flag" to get another opinion, or several opinions!! Be careful! There are too many doctors out there that don't have the experience to do revisions. Check with the Medical Board in your county to see if any have any malpractice lawsuits against them!! Be proactive!! Good luck to you.

lilah04 29 Jul 2012

I really don't think the ectropion is from scar tissue seeing how it was ectroped right after surgery when there wasn't time for scar tissue to have formed yet. Correct me if I'm wrong, I'm no doctor. The doctor who did the surgery even said he over-corrected it. The other eye even has a very slight ectropion and sclera show.

lilah04 27 Jul 2012

I like how some doctor's say to wait 6 months to a year. It's like your saying it's 6 days or something!! 6 months is a long time to walk around disfigured.