Need further evaluation of your dry eye problem

I would not be so concerned about appearance of the lower eyelid as I would with the function of the lid itself and protection of your eye. There are many points of caution for your to consider. 1. this is a repeat surgery, there may already be problems with your lower eyelid function since you continue to have dry eyes. 2. You should be evaluated by an ophthalmologist as to your existing tearing function. A 4 lid blepharoplasty will, at least temporarily, effect the dryness of your eyes. This coupled with your existing problem will make it much worse unless prevented and addressed before surgery. 3. If there is some pre-existing bulging of your eyelids some consideration should be made to your thyroid function. Bulging of the globe will effect the lower lid position. This will change the location for the placement of your canthopexy or canthoplasty. I hope that your procedure goes well