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Eyelids Won't Shut After Blepharoplasty

asked 3 years ago by AchingEyes in USA
Latest answer by Stephen Prendiville, MD
Question viewed 6,702 times
Tags: 6 weeks post-op, closed, complication

I had an upper Blepharoplasty 6 weeks ago. My eyelids still do not shut all the way. I can make my eyelids shut if I "muscle" them down, but if I shut them gently then about 2 mm of sclera shows, particularly from the center of the eyes to the inner corner. My eyes also open now when I sleep. My plastic surgeon said that the amount of sclera showing is mild and will correct itself over time. Is this normal, and is he being honest? I really worry that I'll need to have skin grafts or some sort of corrective surgery.

26 answers to Eyelids Won't Shut After Blepharoplasty

Upper Lid Blepharoplasty

There are two different questions open right now... the first from aching eyes who has had a bleph approximately six weeks ago. The important issue for you at this point is your ability to protect your cornea. A small amount of lagopthalmos (inability to fully close your lids over the globe) is not unusual immediately after a blepharoplasty. This typically resolves within the first few days and can be related to the local numbing medication and swelling. Lagopthalmos that lasts beyond... more

Steven H. Williams, MD
San Francisco Plastic Surgeon

Some things you can do right now

It is very, very rare to need skin grafts after an upper blepharoplasty. So, eventually, you should be fine. In the mean time, there are three things you can do to help: 1) Massage. If you massage your lids downward for 5 minutes twice a day, this can stretch the lids just enough to get closure. Ask your doctor to show you how to do this. 2) Exercises. Close your eyes very, very tight and hold them like this for 10 seconds. Repeat 10 times. Do this series 3 or 4 times a day. This exercises... more

George J. Beraka, MD
Manhattan Plastic Surgeon

Eye Lids Not Shutting 6 Weeks After Blepharoplasty

Hi Aching Eyes, The most important aspect of your recovery at this time is to protect your corneas both when sleeping and awake. Consult with your surgeon, and even your ophthalmologist regarding the best method of cornea protection. Moisturizing eye drops during the daytime, and taping the eyes shut when sleeping is recommended. In my 23 years of performing upper blepharoplasty, after every case I have kept the excised skin for the first few days until I see that the lids are shutting... more

Michael A. Persky, MD
Los Angeles Facial Plastic Surgeon

Protection is better part of valor

If you know your eyelids do not shut completely while you sleep, you should use some eye ointment at night to protect the cornea. Usually, the Bell's phenomenon causes the eyeball to rotate upwards when you close the eye and this protecs the cornea but this may or may not be sufficient in individual patients. Often, surgeons will leave a little "scleral show" at the conclusion of the upper blepharoplasty because tissues do relax. You might ask your surgeon if the failure to close... more

Robin T.W. Yuan, MD
Beverly Hills Plastic Surgeon

Incomplete eyelid closure after blepharoplasty

If you had an upper blepharoplasty (eyelid surgery) about 6 weeks ago, it's normal to still have incomplete eyelid closure(lagopthalmos) due to swelling. You should be sure to use eye drops and lubricants to ensure that your cornea does not become dry during the night. Unless your surgeon removed too much skin during the surgery (which is rare) your swelling should resolve over the course of weeks. Be sure to follow up closely with your surgeon or see an... more

William Bruno, MD
Beverly Hills Plastic Surgeon

Eyelid lag correction after upper Blepharoplasty

As mentioned above, a small amount of scleral show is normal after upper eyelid blepharoplasty. However, this should get better within several weeks. You may be able to help this along by massaging the lid in a downward direction to help prevent scar tissue from keep the lids from closing. The main issue is while this slowly works out is to make sure your eye is protected by applying lubricant at nights and during the day. From the sound of it, you are doing a good job with this so far. I... more

Amir M. Karam, MD
San Diego Facial Plastic Surgeon

www.drkaram.com

Keep a Lid On It - Vision Before Vanity

A mild degree of tightness and temporary inability to shut the eyes completely is within the normal realm of post-operative healing in the first few weeks after Upper Blepharoplasty. However, it is unusual to have "scleral show" after an upper blepharoplasty, since this generally describes the exposure of the white of the eye (sclera) above the lower eyelid, most commonly occurring after Lower Blepharoplasty, and noticeable when the eyes are open. There is a protective reflex... more

Athleo Louis Cambre, MD
Los Angeles Plastic Surgeon

Upper Blepharoplasty and Eyelid Closure

A small amount of lagophthalmos (inability to close eyelids) is not unusual after eyelid surgery and can persist for days or even weeks afterward. In your situation, I would use a thicker form of eye drop at night time (Refresh PM). Some degree of a dry eye feeling is normal for a few weeks after the surgery, so make sure you use artificial tears frequently. Discuss your concerns with your Surgeon so that he/she can keep close tabs on you and appropriately direct your care.... more

Stephen Prendiville, MD
Fort Myers Facial Plastic Surgeon

www.drprendiville.com

Properly lubricate eyes at night after blepharoplasty

In my practice, I tell my patients that they should have no problem closing their eyes after blepharoplasty. It’s important you properly lubricate your eyes with artificial tears and ointment (at night). Seeing an eye doctor can help you avoid problems related to eye exposure.

Amiya Prasad, MD
New York Oculoplastic Surgeon

www.prasadcosmeticsurgery.com

Eyelid Closure Problems After Blepharoplasty

Normal post-operative swelling and healing will often make the upper eyelid a bit "stiff" for a while and prevent complete closure, which is especially noticeable if both the upper and lower lids are done at the same time. Time and gentle massage will be most helpful. If your eyes are irritated at night, you may need lubricating ointment to keep them from drying out. Your doctor can give you the best advice.

Randy J. Buckspan, MD
Austin Plastic Surgeon

Closing Eyes After Upper Eyelid Surgery

The inability to close your eyes is called lagophthalmos (lag for short). It is very common to have subtle amounts of this condition in the immediate post-operative period. For most patients, this resolves within a couple weeks. Six weeks is further out than I am accustomed to seeing this problem. I would expect, however, that this will still correct on its own. With two mm at 6 weeks, I wouldn't be surprised if it takes several months. Provided... more

Louis W. Apostolakis, MD
Austin Facial Plastic Surgeon

www.dr-apo.com

Persistent incomplete eyelid closure

Having this level of incomplete eyelid closure after surgery can occur in some patients. As you are only 6 weeks from having had surgery you still have healing and swelling reduction to occur. As has been mentioned, the key is to keep the eyes lubricated, especially at night. Artificial tears during the day and an ointment (such as lacrilube) at night works best for maintaining a protective coating while you sleep. Additionally, performing exercises to squeeze your eyes close will also... more

Thomas A Lamperti, MD
Seattle Facial Plastic Surgeon

Inability to close eyes after eyelid surgery

At this stage of your healing slight lagophthalmos is normal. Make sure that your eyes/cornea are will protected with lubricants or eye patches at night during this healing period. Your doctor should be able to guide you in this healing process. On the other hand after a few months the patient's ability to close eyes after eyelid surgery should not be compromised. It can happen if too much skin is removed. In my opinion it is not optimal to remove maximum... more

Boris M. Ackerman, MD
Newport Beach Plastic Surgeon

www.doctorackerman.com

Complication

I perform revision blepharoplasties which are basically eyelid surgery to correct problems after surgery by another surgeon which includes skin grafts. Six weeks after surgery is a short period of time. I would give it a full six months. This inability to close the eyes tends to improve over time. I would use ointment at night and artificial tear drops during the day. Also, your ophthalmologist can place punctal plugs to block the tear ducts to allow more tears to stay in the eye... more

Chris Thiagarajah, MD
Washington DC Oculoplastic Surgeon

Normal eyelid function may take several months to return after eyelid surgery (blepharoplasty)

Eyelid surgery involves handling the muscle that is responsible for eyelid closing. The combination of direct trauma to the muscle and swelling may disallow normal eyelid function for weeks and even months. Almost always, the function will return to normal. In the mean time, patients may be required to use lubricants to protect the eye and remain in close contact with the surgeon. Do not let anyone reoperate on you now. That would be a huge mistake. ... more

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon

Eyelid Closure Following Upper Blepharoplasty

I think your surgeon is being quite honest. It is within normal range of healing that you have to put some effort into closing your upper eyelid completely. This is particularly true within the first two months of healing. With additional time the remaining eyelid skin will likely relax enough to allow complete closure without effort. As many other surgeons have pointed out, it is important to keep the exposed portion of your eye well lubricated to avoid complications from drying... more

John M. Hilinski, MD
San Diego Facial Plastic Surgeon

Scleral show after Blepharoplasty does happen

Greetings, A small amount of scleral show or inability to close the eyelids after blepharoplasty surgery does occur. This can still resolve over 2-3 months. In the mean time it is very important to keep your eyes well lubricated, especially when sleeping. If it does not resolve and you are having eye problems, skin grafting can be undertaken after all of the healing has occurred to repair the problem.

D.J. Verret, MD
Dallas Facial Plastic Surgeon

innovationsfps.com

Not uncommon, but protect your eyes

A mild scleral show (1-2 mm) due to inability to close your eyes is not uncommon during the first few weeks of surgery. Daily exercises to close your eyes will help. During this time, it is very important to keep the eyes lubricated with drops and ointment at night. Incomplete closure will result in some degree of dry eyes, which will also irritate the eyelids to some degree. Any irritation will cause some degree of eyelid edema or swelling, which further delays healing. Thus, keep... more

Corey S. Maas, MD
San Francisco Facial Plastic Surgeon

Keep your eyes lubricated

It can take several months for all of the changes to occur after a Blepharoplasty. In the meantime, keep your eyes protected and lubricated, especially at night. Follow up regularly with your doctor. I suspect you will continue to see improvement over the next 2-3 months.

Dean Fardo, MD
Atlanta Plastic Surgeon

Eyelids won't shut after blepharoplasty

Your experience with difficulty closing the upper eyelids is common for the first 4-6 weeks after upper eyelid blepharoplasty . This almost always normalizes with time. Using the moisturizing ointment especially when sleping at night is very important. Using a sleep mask and cotton balls to help kep the eyelids closed at night will help. A viscous eye drop such as hypotears pm during the day is also important. If the problem persists after 6 months or if dry eye becomes a serious problem... more

Brooke R. Seckel, MD
Boston Plastic Surgeon

www.drseckel.com

Not able to close eyes after upper bleph

Dear AchingEYESUSA You should return to your MD with your concerns. Immediate protection of the corneas is important and a full assessment of your eyelid function and corneas is a priority. There are many steps that can help with this at the momemt- lid massage, lubrication like TheraTears, taping your eyes closed. However a long term solution may be needed and that is where an expert may be required to help you. With Warm Regards, Trevor M Born MD

Trevor M. Born, MD
Toronto Plastic Surgeon

Dry eye syndrome after blepharoplasty

Your symptoms point to the diagnosis of dry eye syndrome. Four years following eye lid surgery is a long time for a regular improvement to occur. The general lines of treatment include surgical revision if the cause of the dry eye symptoms is inability to close the eye lids. Lower lid ectropion repair or upper lid release could acheive this. Problems related to tear production are much harder to treat, a simpler way to do is using punctal plugs. This will increase the available tear film and... more

Hisham Seify, MD, PhD
Los Angeles Plastic Surgeon

The eyes have it

Inability to completely close the eyelids after an upper blepharoplasty is not an uncommon event and usually resolves over time. The fact that you are not complaining about dryness or irritation means that you are achieving enough closure to protect your cornea. Follow the instructions of your surgeon, who should have suggestions as to how you can speed up the skin relaxation process and achieve complete lid closure. Good luck.

Kenneth R. Francis, MD
Manhattan Plastic Surgeon

Not uncommon

Ideally, you want to close your eyes completely without any significant effort. It shoudl get better with time. For now, lubricate the eyes, and massage them. If you notice any irritation or significant itchiness or redness, go back and see your doctor.

Steven Wallach, MD
Manhattan Plastic Surgeon

Protect your eyes

Since your eyes are not closing completely, the most important thing at this point is for you to protect your eyes with lubrication. Six weeks after surgery your eyes should be able to shut. However, your tissue is still healing and settling, so do not loose hope. Usually when you have blepharoplasty you will have a reflex depression of your eyebrows. If you had a brow lift at the same time as your blepharoplasty, then you may not get as much relaxation of the brows and less compensatory... more

David Shafer, MD
New York Plastic Surgeon

It is hard to say over the phone!

Without the benefit of an examination, it is hard to diagnose whether your concerns are justified. However, of all the concerns that you can have, this sounds reasonable. As time goes, the eyebrows will settle down and then the eyelids should close. The only thing you need to be concerned about is protection to your eyes. Are your eyes excessively dry, or are you tearing a lot. If either of these questions is answered with "yes," then you must see an ophthalmologist right away... more

Robert M. Freund, MD
New York Plastic Surgeon

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