Will Blepharoplasty Affect my Vision?

The short answer to your questions is that after surgery, you will still be able to see when looking down. There are different ways to correct the scleral show - the whites of your eyes being visible. The most likely scenario for you is a midface lift with hard palate graft. As an oculoplastic surgeon, this is a procedure that I do routinely. There are other options, but I would need to examine you to know for sure the best treatment options.

You have a prominent eye which is called proptosis. Your eye ball is bulging or pushed forward against the lower eyelid. The result is that the lower eyelid is pushed forward and does not completely cover the eyeball which is why you see white of the eye below your Iris and pupil. The white eye tissue is called sclera and when you see white below the Iris and pupil it is called 'scleral show". A lower eyelid blepharoplasty done through an external incsion will shorten the lower eyelid... more

A properly performed upper and/or lower blepharoplasty will not affect the vision. If there happens to be severe dermatochalasis of the upper lids which is interfering with vision, this will actually improve the field of view, if not the acuity of the eyelids. A physician can perform just upper blepharoplasty, just a lower blepharoplasty, or both.

With the multiplexity of solutions provided by our excellent doctors online, it becomes important to discern what technique will elevate the lower lid with the least chance of creating another aesthetic disturbance. Volume filling can accomplish this with release of the orbicularis occuli muscle. The other techniqes can also achieve this but side effects are commom and they would not be my first choice. We have published techiques on elevation of the lower eyelid by subperiosteal... more

I've seen some interesting answers to this question. First I don't think you have proptosis. This means your globe is moved forward, "bulging" eyes. Because your upper lid in sligtly ptotic, low, you don't have proptosis. So you have a congenital, either lid laxity or ectropion. No problem. You need a canthopexy. The lower lid canthus, suspensory ligament, is divided then resutured higher up on the orbital rim. To be honest you likely will have temporary vision changes but not... more

The other surgeons' comments about the stability of your lower eyelid retractors allowing you to see normally when looking down after a lower eyelid recession are correct. However, a lower eyelid "tightening" procedure will not help your scleral show, it may actually your globe appear more prominent, similar to how tightening a belt on an obese person will just make the belly hang over the belt even more. Another option is to address the fundamental aesthetic problem: your... more

I just read Dr. Steinsapir's insight and advice which demonstrates the complexity of your situation very well. Scleral show and rounding of the lower lids is a known complication after lower blepharoplasty. Even in practices of busy cosmetic blepharoplasty surgeons yours is a very rare problem. Certainly, a tarsal-strip procedure or canthopexy will likely not be effective. My advice would be to seek an oculoplasty surgeon experienced with state-of-the-art midface work and eyelid... more

Hi Dino You need a complex surgery to address your relative proptosis. The eyes are prominent with a relatively weak orbital rim. In addition, you have midface descent. As a result, the weight of the cheek is not supported by the cheek bone at the orbital rim. The weight of the cheek pulls at the lower eyelid causing the lower eyelid to ride too low. A simple canthoplasty will not correct this situation. You need to have the cheek lifted vertically to the orbital rim and then the... more

Dino, Great photographic documentation of your current appearance and where you'd like to go. Fortunately, it's not quite accurate with regard to the third photo, which depicts the lower lid being held up and blocking the pupillary opening. Meaning that you can have your scleral show corrected and not affect your field of vision. In the photo, you have COMPLETELY defunctionalized the lower eyelid muscle retractor system. In reality, when you tighten or raise the lower eyelid the... more

Hi! Both your lower eyelids and the outer corners of your eyes are too low. Both contribute to the undesirable look and both need to be corrected. The surgery does not replicate the motion you are doing in the photo and should definitely not affect your vision. You need a lower blepharoplasty and a canthoplasty. This is tricky surgery. Be sure you go to someone who does a lot of this. An oculoplastic surgeon is a good choice. Ask to see before and after pictures.

You are correct, your lower lids are lower than normal, resulting in excess scleral show and that "scary" look you describe. You will require a lower lid tightening and raising procedure and that should not affect vision. This is a bit tricky so be sure that you go to an experienced surgeon, and be sure that he feels very confident that he can help.

When you look down, your lower eyelid rector muscle pulls the eyelid down with the movement of the eye itself. When you are holding your lower lid in an upward position, you are not allowing the natural lower lid eyelid rectactor muscle to work. Just as if you held your upper lid in in the same position when you looked up, your field of vision would be decreased. The upper eyelid also has a rectractor muscle that elevates the lid when the eye looks up. This being said, most people suffer... more