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Eyelid Surgery Uneven Eyes. Will Tape After Surgery Really Help? (photo)

I had upper and lower eyelid surgery 10 days ago. My right bottom eye lid is lower than my left. you can see more white under my right brown eye. 5 days after surgery my dr removed stiches and put tape under both eyes for 7 days. I am concerned my eyes are going to stay uneven? My right eye looks bigger than my left? It still looks uneven w tape. I see my dr at Day 14 to remove tape. I am really concerned if I researched my dr. enough? If it stays uneven what should i do?

Doctor Answers (7)

Low or retracted eyelids

+1

You may have some downward movement of your lower eyelid related to the surgery however it is still early in your healing phase. Continue communicating with your surgeon about managing this situation. I routinely perform corrective surgery for eyelids which are low or retracted after surgery done elsewhere so this option may be applicable to you depending on how you heal.


New York Oculoplastic Surgeon
4.5 out of 5 stars 34 reviews

Taping may or may not help

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In all honesty, the presentation of your eyelids this early after surgery is quite normal.

Massage will improve the softening of the scar that forms after all surgery. The taping is probably not doing very much at this point, but certainly will not hurt.

It is way to early after surgery for you to worry about asymmetry. There is significant swelling in the first two weeks after surgery, and sometimes even longer than that. Furthermore, surgical scar will evolve and soften over a period of months. I would not consider revision surgery on anyone until the 3 month post operative visit, and sometimes even longer than that. Scars can mature for up to a year after surgery. Please be patient with your body and let it heal.

 

A.J. Amadi, MD
Seattle Oculoplastic Surgeon
5.0 out of 5 stars 23 reviews

Eyelid Surgery Uneven Eyes. Will Tape After Surgery Really Help?

+1

Great series of post op early bleph. photos. Which show a very normal healing progression! In fact your appearance is textbook. Obviously your pre operative informed consent was either lacking or you may have not fully understood the healing process. Better to be seen earlier if you are so concerned by your surgeon, maybe a little more hand holding will alleviate your anxiety. Otherwise all looks normal. I tape slightly differently, more laterally and upward. Btw this slight scleral show is called minor swelling ectropion that subsides within a few weeks to months. 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.5 out of 5 stars 64 reviews

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Taping after lower eyelid surgery

+1

In the early weeks after lower eyelid surgery, it is not uncommon for swelling and the healing process to restrict the lower eyelids.  Massage and taping generally help and the majority of patients will find that things get better over time.  Minor asymmetries are common and tend to even out as the healing process progresses.  Your best option is to work closely with the surgeon who performed your surgery. 

John Q. Cook, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 8 reviews

Tape will not really make much difference here.

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However, in the chance that it will make a small difference, it is worth trying.  Mostly taping gives your surgeon a face saving mechanism to blame if your lower eyelids are not everything you wanted: Did you tape as much as you were advised?  

 

Why do lower eyelids sag from transcutaneous lower blepharoplasty?  There are so many reasons really.  First incising the lower eyelid skin to gain access to the lower eyelid fat, transect the motor nerves to the lower eyelid margin.  These nerve fibers supply the orbicularis oculi muscle along the lower eyelid margin and are very important in holding the lower eyelid against the eye.  

 

Blame your surgeon for doing the wrong surgery?  Unfortunately they are following peer reviewed literature that suggests that this precise approach is safe.  In fact, these papers are not well supported by a very substantial body of evidence.  It is for this reason that oculoplastic surgeons favor procedures performed from behind the lower eyelid.  In the past, it was taught that "midlamellar" scaring accounted for the pulled down position of the lower eyelid after surgery.   Generally, I believe there is truth to this in addition to the motor nerve damage caused by surgery.

 

In time the swelling will settle and you will need to decide if the issue you are seeing this early from surgery will persist and bother you.  Despite your very reasonable concerns, time does have a way of resolving many issue.  I certainly would encourage you to be patient, follow the conservative advice of your surgeon, and avoid quick fixed that might be offered to you.  Canthopexy or canthoplasty procedures (sometimes described by the surgeon as tucking the eyelid or putting a stitch in) can often make matters worse.  If you are ultimately not satisfied with the way the lower eyelids heal, hear what your original surgeon advises and certainly consider getting a second opinion from an actual eyelid specialist.  The Amercian Society for Ophthalmic Plastic and Reconstructive Surgery maintains a geographic directory on their website that can help you find a well qualified surgeon in your area.

Kenneth D. Steinsapir, MD
Los Angeles Oculoplastic Surgeon
5.0 out of 5 stars 18 reviews

Taping Will Help the Uneven Appearance to Your Eyes After Lower eyelid Surgery

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At this point I wouldn't worry too much about what is going on. It is not uncommon to have some asymmetry for a short period of time after lower eyelid surgery. Massage and taping can be helpful. The younger you are, the better your eyelids are able to come back to a natural, symmetric position after this surgery. You look young enough in the photos that it is very likely that everything will turn out okay. You need to be patient (this is definitely the hard part), and give it some time. Keep a good line of communication open with your surgeon, so he or she can help to reassure you during this process. Good luck.

Michael R. Menachof, MD, FACS
Denver Facial Plastic Surgeon
4.0 out of 5 stars 12 reviews

Eyes uneven after suregry, Will tape Help?

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Yes, tape and massaging your lid after surgery will definetly help restore it to its natural position. Your lid position my actually worsen ove the next few weeks but wil start to improve after 4-6 weeks. Trust your doctor and even the best surgeons have these things sometimes hapen to them. good luck and follow your surgeons intructions.

Jonathan Weiler, MD
Baton Rouge Plastic Surgeon
5.0 out of 5 stars 23 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.