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Lower Eyelid Drooping After Blepharoplasty

I had upper and lower eyelid surgery. My lower lid on one eye is drooping. The doctor tightened it, but it's still away from the eye and causing extreme dryness. My vision is also horrible. Should I go back for corrective surgery? I am afraid he will not fix it but make it worse.

Asked 38 months ago by lbohgirl in Denver,CO

Revision lower eyelid surgery

Revision lower eyelid surgery is complex. It involves midface techniques (i.e. cheeklift), possibly grafts into the lower eyes, and complex canthal surgery. The skillset and paradigm required for the revision surgery of the lower eyelid is entirely different than for the primary surgery. Surgeons undertaking this surgery should have an interest in these areas before attempting a third time redo lower eyelid surgery. There was no time limit specified in your post. Shortly after surgery,... more

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Brent Moelleken, MD

Beverly Hills Plastic Surgeon

ASAPS ASPS

Drooping lower eyelid most often will correct itself with time.

Temporary drooping of the lower lid after eyelid surgeon is not uncommon. The vast majority of patients will have this resolved assisted perhaps by taping and massaging the lid towards the proper position. Reoperation too soon can create a disaster. Should a reoperation be necessary, it should be done by someone who specializes in solving these types of problems. In any event, you owe it to yourself to get another opinion.

Vincent N. Zubowicz, MD

Atlanta Plastic Surgeon

ASAPS ASPS

Massage, taping and then repeat eyelid surgery if needed

I am not sure how far out from surgery you are, but the non surgical methods are to massage the lower eyelid in an upward direction and tape up the lower eyelid. This usually works in the early postoperative cases. Keeping the eye moist during the day with drops and placing ointment in the eye at bedtime is a must. If, at around 6 months, this still persists, then surgery is warranted. At that point there are different procedures (lateral tarsal strip, cantoplasty, cantopexy, etc...)... more

Farbod Esmailian, MD

Orange County Plastic Surgeon

ASPS

Work with your Doctor if you can

This is not an uncommon problem and there are many ways to fix this problem. To answer if you must go back to the surgeon, that depends on many factors: your relationship with him or her; his or her skill level; and the degree of the problem, etc. Generally, it is best to return to the original surgeon and express your concerns. Be honest with your doctor and tell him or her that you are worried that he or she may not be able to correct the problem. Do it in a kind and polite way because... more

Lane Smith, MD

Las Vegas Plastic Surgeon

ASPS

TLI. too little information

Ibohgirl, It would be nice to know your age, how long ago your surgery was and what the tightening procedure was. Without this information we can only speculate on your condition and its treatment. The findings that you describe may be caused simply by the expected post surgical swelling and may be amenable to massaging and eye lubrication. They might also represent a condition known as ectropion, which may require further surgical intervention. Hopefully, your surgeon is guiding you through... more

Kenneth R. Francis, MD

Manhattan Plastic Surgeon

ASAPS ASPS

Lower eyelid drooping after blepharoplasty

Eyelid surgery, and surgery on the face is some of the most delicate surgery in all of plastic surgery. Correction of the drooping after blepharoplasty mandates advice from an expert in facial or eyelid plastic surgery. Myself and a colleague have recently written an academic paper (see below link) on avoiding this complication after blepharoplasty.

Anil R. Shah, MD

Chicago Facial Plastic Surgeon

Lower eyelid repair in Denver Colorado

Jerry Popham at Park Avenue Oculoplastics is a good surgeon in Denver. I would give it some time first and see how things are in 6 months. The best thing to do is first try massage to help elevate the lower eyelid. You may need some future procedures to get the lower eyelid where it needs to be. You probably wouldn't hurt to see your original surgeon and see what they have to offer. If you are not happy you can ask for a second opinion. You surgeon does not want you to have... more

Chris Thiagarajah, MD

Washington DC Oculoplastic Surgeon

Correction of an eyelid droop after surgery

Mild lower eyelid droop after eyelid surgery can occur on occasion. Typically it is expected to resolve in a few weeks. Prevention of this complication should start during preoperative visit with your surgeon. It is paramount for a surgeon to examine the lids in a thorough fashion to determine the optimum surgical approach to avoid any so called "retraction" complications of the lower eyelid. This way a proper procedure is planned and executed, as one... more

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Boris M. Ackerman, MD

Newport Beach Plastic Surgeon

ASPS

Pulled Lower Eyelid Is A Tough Complication To Fix

A pulled out (ectropion) or pulled down (rounded) lower eyelid after a skin removal lower blepharoplasty is a problem that is far too common and difficult to correct. Skin removal in the lower eyelid is something I avoid as it rarely produces benefit and is high risk for complication. Without knowing the exact time course of events it is hard to say what should be done. Initially the eyelid should be taped or a special stitch put in between the eyebrow and lower eyelid to... more

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Louis W. Apostolakis, MD

Austin Facial Plastic Surgeon

Drooping eyelid after blepharoplasty requires an expert eyelid plastic surgeon

The drooping of the lower eyelid after blepharoplasty is called an ectropion. The fact that your eyelid is still drooping after one attempt at revision is a serious concern. The eyelid position must be corrected to protect the eye. This may require a complex reconstructive lower eyelid procedure. Such a procedure is often outside the expertise of many plastic surgeons. Lower eyelid reconstruction requires either a board certified plastic surgeon who is experienced and specializes in eyelid... more

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Brooke R. Seckel, MD

Boston Plastic Surgeon

ASAPS ASPS

Find someone who is well-versed in facial or oculoplastic surgery

It sounds like the skin was probably tightened too much on the lower lid and you are having dryness, scleral show and/or ectropion. A canthopexy or canthoplasty would be the best option for a patient in this case. Someone who is very well-versed in facial or oculoplastic surgery would be the one to perform one of these procedures.

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William Portuese, MD

Seattle Facial Plastic Surgeon

Most likely another corrective procedure will be needed.

It sounds like you have an ectropion. It may resolve with time and massage but most likely will require another procedure to tighten the lower lid and relieve tension on the lid. You may want another opinion or even two to get a better perspective of your options. All the best.

Talmage J. Raine, MD

Chicago Plastic Surgeon

ASAPS ASPS

Eye drynesss after blepharoplasty

It is somewhat common for some patients to have issues with their eyes after blepharoplasty. The eyelid may be pulling away from the eye becasue of swelling of the conjunctiva or tightness in the lower eye lid skin. Keep working with your doctor, and keep the eyes moist at all times. You may also need to massage the lower lid.

Steven Wallach, MD

Manhattan Plastic Surgeon

ASAPS ASPS

Eye protection measures are important to initiate.

Exposure of the cornea following cosmetic blepharoplasty is not uncommon. Several factors can contribute to this post operative finding including the position of the lower eye lid before surgery , protusion of the globe ect... Minor cases are usually corrected by lower eye lid massage and lubricating the eye ball during the day by using tears and at night using ointment. Reccurent cases or cases with severe dryness of the eye ball would require some sort of surgery revision to protect the... more

Hisham Seify, MD, PhD

Los Angeles Plastic Surgeon

ASPS

How long ago was the surgery?

In order for the lower lid to assume its final shape, all the swelling has to be gone and the scar tissue has to be soft. You may be experiencing normal sagging of the lower eyelid.