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Droopy Eye After Mid Face Lift

asked 1 year ago by Linda in SC
Latest answer by Sam Naficy, MD
Question viewed 586 times
Tags: droopy, blink, revision

mid face plastic surgery 15 days ago. right eye does not blink & lower eye lid has started to droop, eye also tearing. Dr has me tape at night and now in day, wants to schedule corrective surgery in 12 days. He told me 3 days ago to wait nerves may regenerate..now since I called him about lid drooping and eye tearing..wants to do surgery.Why so urgent now. why not wait for rejuvenation

19 answers to Droopy Eye After Mid Face Lift

No Rush for More Facelift Surgery or Midface Surgery

There is no rush. The best way is to treat conservatively for 3 to 6 months. You will be fine. There are many ways to protect your eyes....ointment....gel drops.....tears artificial......tapes.....patches at night plus ointment....humidified room....protective gloasses when outside........The whole trick is prevent dryness and you will clear up. As the swelling gos you will come up and be fine. Now there is a time to operate if you are way down or experiencing... more

George Commons, MD
Palo Alto Plastic Surgeon

www.pacfps.com

Droopy eye after midface lift

Facial nerve branch injury after midface lift is not that uncommon. Usually this will regenerate without long term issues. Two weeks is still early and I would probably give it more time before reoperating. The eye should be kept moist and taping should help. I do not believe there is any downside to waiting a little longer as long as the eye properly protected. Donald R. Nunn MD Plastic Surgeon.

Donald Nunn, MD, DDS
Atlanta Plastic Surgeon

Droopy eyelid following midface lift

Hello and thank you for the question. It is possible that in the process of the midface lift, a facial nerve motor branch injury was incurred, thus explaining the droopy lid. This is under the assumption that you did not undergo concomitant blepharoplasty as well, which can produce droopy eyelids in some cases. Without examining you, it is difficult to make a determination as to why your surgeon wants to perform a re-operation in the short course. A lack of lower eyelid support... more

Glenn Vallecillos, MD
Beverly Hills Plastic Surgeon

Surgery in the short term after nerve injury

I agree with the other posters - the likely issue is midface facial nerve branch injury, and this often improves spontaneously. While it is difficult to know for sure, I think your surgeon's sudden concern and desire to operate may be due to the degree of tearing and eyelid droop. There is really nothing he can do operatively to repair tiny midface nerve branches, but he may be actually considering a temporary procedure to prevent your eye from remaining exposed, dry, and... more

Laxmeesh Mike Nayak, MD
Saint Louis Facial Plastic Surgeon

www.nayakplasticsurgery.com

Droopy eyelid after midface lift

I assume that you did not have a blepharoplasty (surgery to the lower lid) which could also cause the lower lid to droop. If all you had was a midface lift then the mostly likely cause was injury to the nerve going to the muscle that encircles the eye (orbicularis oculi). This nerve can be damaged particularly during a deep plane lift as the nerve enters this muscle on its deep surface. Hopefully the nerve was just stretched which has a better outcome than if the nerve was... more

Mark Loury, MD
Fort Collins Facial Plastic Surgeon

WIthout a personal consultation it is just speculation to discuss your situation.

Linda You will need to weigh your confidence in your current surgeon to know the right thing to do. There is no substitute for an in depth personal consultation. Occasionally the lay description of what is going on and what is actual going on are not the same. If you were 100% confident in your surgeon, you would not be casting about for opinions from strangers. I am going to advise you to listen to your feelings. Please do not blindly follow the recommendations of this surgeon... more

Kenneth D. Steinsapir, MD
Los Angeles Oculoplastic Surgeon

Droopy Eye After Mid Face Lift

There are many reasons to wait and let the nerves regenerate and very few reasons to take surgical action. The main priority is to keep your eye from drying.

Sam Naficy, MD
Seattle Facial Plastic Surgeon

Facelift

I would take the doctor’s advice and do as they recommend. They may have a suture around a nerve causing this problem or something else. If they are not a Board Certified Plastic Surgeon, I would involve one at this point. You want someone trained on complications, and one who has seen a few variations on the theme.

Vivek Bansal, MD
Danville Plastic Surgeon

Droopy tearing eye after Mid Facelift indicates nerve injury and surgical eyelid support is important

During a Mid Facelift the motor branches of the Facial Nerve that go to the eyelids may be injured. If so the eyelid becomes weak and droops and if tearing occurs it means the eye is not adequately protected from dryness. Usually these nerve injuries recover as there is a double innervation to the eyelid. However the nerve takes time to heal and some action must be taken to protect the eye during this time. If taping does not work effectively, the lower eyelid can be supported... more

Brooke R. Seckel, MD
Boston Plastic Surgeon

www.drseckel.com

Droopy eyelid after facelift

At 15 days post Facelift surgery, you are still in the early post operative period. The incision will be quite tight and your tissues and skin are still swollen. It is not unusual for a lower eyelid to droop during this time. With eyelid support (taping) and protection of the eye with saline eye drops and eye ointment, this situation may well improve over the next several weeks. You may not require revisionary surgery on your eyelid. However, your surgeon... more

Vincent D. Lepore, MD
San Jose Plastic Surgeon

Eyelid position is a serious problem with the midface facelift.

The midface lift attempts to lift the fat of the cheeks through an incision usually for lower eyelid surgery only. In releasing a ligament (arcus marginalis), a strict anatomic barrier between the lower lid and the cheek converts the lid and cheek into one anatomic unit. If there is any loss of support for the repositioned cheek, the lid falls with it. It's somewhat hard to fix.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon

Doctor-patient relations and communication breakdown.

The fact that this question is being asked in this forum indicates that you do not enjoy very good communication with your surgeon. If a doctor was suggesting to me that I have surgery in 12 days, I'd want to know why, what's the diagnosis, what is the procedure expected to accomplish, what are the risks and expectations. You must find these things out. The eye complaints may be facial nerve related.

Ritu Chopra, MD
Beverly Hills Plastic Surgeon

Facial droop after facelift

It appears that somehow in your surgery a branch of your facial nerve was injured. This occurrence is extremely rare. It's possible it was just stretched and should come back. I was wondering, have you ever had Bell's palsy? I've heard a few anecdotal reports that a facelift can trigger an old Bell's palsy. Regardless, it seems like you and your surgeon are having some problems communicating. If there is anything that doesn't seem to... more

Catherine Huang-Begovic, MD
Beverly Hills Facial Plastic Surgeon

Droopy Eyelid after Mid Face Lift

Hi Linda in SC, Thank you for your question, but there are many variables to your question that it's difficult to provide a specific answer. The inability to blink with a droopy lower eyelid suggests a possible weakness of facial muscles. Generally, muscle function returns with watchful waiting. 15 days is still relatively early after facial surgery. Mid face lift can be performed via many possible approaches, and the proposed corrective surgery can mean several things. You... more

Houtan Chaboki, MD
Washington DC Facial Plastic Surgeon

www.potomacplasticsurgery.com

Mid Facelift and Eyelid Droopiness

I'm not sure of the mechanism of the upper and lower eyelid injury. In a typical midface Lift, the multiple branches that innervate the eyelid muscles should not be in the plane of dissection...unless there was some surgery to the eyelids as well. Nerves may regenerate but this occurs about 1mm per day and depends on where and how the nerves were injured. You may want to consult an opthalmologist regarding your eyelids.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon

Nerve injury after mid-face lift

The dissection during a midface lift is in the area of nerves that supply the muscles around the eye. Normally, the surgery occurs in a different plane, so the nerves aren't cut, but stretching or cautery can rarely cause temporary injury. It's hard to comment about the upcoming surgery without knowing what is being planned exactly. Usually, it is more a matter of time for the nerves to heal (presuming they're not cut).

Thomas A Lamperti, MD
Seattle Facial Plastic Surgeon

Re-do surgery after mid-face lift droopy eye--Please reconsider!

If you have injured motor branches to the orbicularis oculi muscle, time and healing may be a better option than re-operation. More scar tissue and more injury may result from an ill-advised attempt to "fix" things! It should be clear just what your surgeon plans to do with this re-operation. You may be (incorrectly) assuming he will find and repair the nerve(s) that were bruised or severed, and that just like plugging in your holiday lights, all will be back to normal. This... more

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon

www.mpsmn.com

Drooping eyelid after midface lift, possible nerve injury

A midface lift is completed on a deeper tissue plane and facial nerve branches may be at risk. If your eye does not blink and the lower lid has drooped and is tearing as you say, it does fit with injury to the nerves to the lid. We suggest taping at night with protective ointment, and drops as needed during the day with glasses that protect from wind or irritation. In the middle of the face the nerves do have a good potential to recover and waiting may be the best option. The aid and support... more

Peter E. Johnson, MD
Chicago Plastic Surgeon

Droopy Eye After Mid Face Lift

You likely have muscle and/or nerve injury from the surgery. The function of the muscle and/or nerve can return over the next few months, and I recommend observation (with frequent ocular lubrication) in the meantime. Further surgery at this time can further damage the muscle and/or nerve. You should consult an oculplastic surgeon. Dr Taban