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Concerned About Possibility of Scleral Show After Lower Bleph

asked 1 year ago by Sacramento7478 in Sacramento, CA
Latest answer by Edward J. Domanskis, MD
Question viewed 917 times
Tags: age 45-54, lower eyelids, scleral show

Im thinking about to having a lower bleph. I am very concerned about possibility of lower white of eye showing , or eye shape changing. what are the percentages of these undesired results. If they occur, can they be repaired. My goal is to eliminate minimal bags and reduce sagging skin. I also have harsh line in tear trough. My age is 49

16 answers to Concerned About Possibility of Scleral Show After Lower Bleph

+2

Increased scleral show after lower blepharoplasty- how to avoid and treat

I believe that the incidence of changes of lower eyelid shape with a conventional lower blepharoplasty is very high indeed.  After all, you are removing skin and fat through a lower eyelid incision.  The lower eyelid is weak and pulls down.  The eyes round subtly or they pull down in the corners.  Even in series of greatly respected surgeons, this phenomenon is noted. In our practice, we NEVER perform a conventional subciliary blepharoplasty on any patient for this... more
Brent Moelleken, MD

Beverly Hills Plastic Surgeon

www.drbrent.com

+2

Fat grafting will help the tear trough and reduce scleral show

Scleral show is a very challening risk which requires both having skill, experience, and luck! Never the less, in most people scleral show can be temporary. In my experience fat grafting to the lower eyelid and the tear trough helps to build up lower eyelid support and reduces the incidence of scleral show.
S. Sean Younai, MD

Beverly Hills Plastic Surgeon
+1

Eyelid, blepharoplasty,tear trough

It sounds like you are a good candidate. If you wanted to definitely avoid those problems you could have a "scarless" blepharoplasty but that would only remove the fat and do nothing to tighten the skin. The chances of the things you mention are usually small depending on the surgeon. Watch my videos.
Edward J. Domanskis, MD

Orange County Plastic Surgeon
+1

Risk of scleral show after lower blepharoplasty

Using the transconjunctival approach where the lower lid fat is removed from the inside of the eyelid significantly minimizes any risks of scleral show. If there is any extra skin that needs to be removed, a very conservative pinch at the lash line on the outside can be done. The transconjunctival approach with or without the pinch technique will minimize the risk for any scleral show. Scleral show typically occurs when the muscle is violated during a traditional blepharoplasty procedure... more
William Portuese, MD

Seattle Facial Plastic Surgeon

www.seattlefacial.com

+1

Scleral Show is the Sign of an Inferior Result From Eyelid Tuck

'Scleral show' occurs when lower eyelids have been treated with traditional lower eyelid surgery, often seen with 'lateral bowing'.  What does that all mean?  When the eyelid has been operated on with traditional techniques, the following results are common: The lower eyelid was smoother, but the lid no longer covers the lower part of the iris (the colored  part around the pupil), and the shape of the edge of the lower lid is altered so that the lower lid... more
Claudio DeLorenzi, MD

Toronto Plastic Surgeon
+1

Scleral show following blepharoplasty

This is certainly a valid concern, and the possibility of this depends on two factors:  You and your surgeon.  if your eyelid has good elasticity, the possibility of scleral show is less common.  If you have a define tear trough, fat repositioning or fillers may correct this.  Check surgeon credentials and before and after pictures.  Good luck!  Performing a lower blepharoplasty is like walking a tight rope.  If too little skin is excised, a less... more
Jason R. Hess, MD

San Diego Plastic Surgeon
+1

Lower eyelid cosmetic surgery

The statistics for scleral show and other complications are technique and surgeon dependent.  Look at your surgeon's "before and after" results upon other patients.  Do not proceed unless you like the results, and trust the surgeon.  Frankly present your concerns to your surgeon.  He or she should want the best result for you, and should be willing to revise the eyelid result if problems develop.  Find out how often he or she needs to perform these... more
Steve Laverson, MD

San Diego Plastic Surgeon

feelbeautiful.com

+1

Pitfalls of Lower Bleph

Shape change and scleral show can occur with any form of lower eyelid surgery. Prevention is much easier than correction. The tear trough groove can be hidden by using the fat that is bulging at the time of the eyelid surgery. It is possible that a chemical peel or laser procedure is all that is needed if the laxity is only minimal. A formal evaluation would be necessary to answer all of your questions properly. I hope this helps. 
James M. Kurley, MD

Champaign Plastic Surgeon
+1

Avoiding scleral show is easier than treating it

I am not aware of any specific statstics regarding scleral show after lower blepharoplasty as there are several differant techniques used and several variables.  This much is true; scleral show can happen to even the most experianced plastic surgeon after the most perfectly done operation.  To decrease the risk your surgeon should carefully examine lower lid "snap back", your individual anatomy to see if you are prone to drooping lids after surgery and obviously be... more
Jeffrey M. Darrow, MD

Boston Plastic Surgeon
+1

Concerned About Possibility of Scleral Show After Lower Bleph

Maybe consider a transconj. blepharoplasty to help minimize the scleral show. Seek in person opinions from boarded surgeons in your area. From MIAMI DR. Darryl J. Blinski 305 598 0091
Darryl J. Blinski, MD

Miami Plastic Surgeon
+1

Lower lid blepharoplasty

The risk is generally low, but no one can give you any exact qunatification.  you need to know that it is a subtle operation, and being consrvative is the key. 
David A. Lickstein, MD

Miami Plastic Surgeon
+1

Concerned About Possibility of Scleral Show After Lower Bleph

You are correct to be concerned about this potentially devastating problem.  My practice, like that of many Ophthalmic Plastic Surgery practices, is filled with patients who have developed eyelid retraction and scleral show after blepharoplasty and want revision.  You do not want to go that route.  Make sure you seek a physician who understands your concerns and will work with you to get a good cosmetic result as well as a natural result..  It is easier to... more
Sam Goldberger, MD

Beverly Hills Oculoplastic Surgeon

www.neweyelids.com

+1

Scleral Show after Lower Blepharoplasty

There are many variables that can cause scleral show after a lower blepharoplasty. Much of these are based on the technique of the procedure. Since there are so many different approaches, there are no good statistics on the incidence of the problem. I do a very aggressive trans-cutaneous lower blepharoplasty that eliminates the tear trough and also elevates the cheek. I essentially do not see scleral show because of lateral anchoring and canthoplasty/canthopexy on every eye. Other good... more
Robert T. Buchanan, MD

Highlands Plastic Surgeon
+1

In my practice, Injectable Fillers are the treatment of choice for lower eyelid rejuvenation.

I read your concern. Lower eyelid bags and "tear troughs" are best treated with Injectable Fillers rather than surgery. I prefer Silikon-1000, an off-label filler, for permanent results. In my view, excessive lower eyelid skin is not easily treated with blepharoplasty. Your lower eyelid is a free margin, so removing too much lower lid skin may lead to scleral show or a change in the shape or position of your lower lid. All the best from NJ.
Eric M. Joseph, MD

West Orange Facial Plastic Surgeon
+1

Scleral show after lower blepharoplasty

There are a multitude of factors contributing to scleral show after a lower blepharoplasty. Statistics are not very helpful unless you isolate all the variables, Some patients have naturally occurring scleral show (i.e. show of the whites of their eyes below the lower iris border). some are set-ups for this condition because of their normal anatomy. Some the result of poorly performed surgery or perfectly performed surgery with poor healing or some unforeseen complication like bleeding or... more
Robin T.W. Yuan, MD

Beverly Hills Plastic Surgeon
+1

It is appropriate to be concerned about this.

Dear Sacramento No one has done studies of the incidence of lower eyelid contour disturbances following lower eyelid surgery.  The risk is greatest with transcutaneous lower blepharoplasty.  I am biased because much of my practice involves surgically repairing individuals with lower eyelid contour issues after cosmetic blepharoplasty.  However, conservatively, I believe that when transcutaneous lower blepharoplasty is performed closed 100% of the time there will be a... more
Kenneth D. Steinsapir, MD

Los Angeles Oculoplastic Surgeon

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