Problems Post-Blepharoplasty and CO2 Laser

Your history suggests that you've had a major surgical procedure on your eyelids with a complicated post-operative course. Since surgery, you've had dry eyes with stiff, swollen, droopy, lower eyelids. These findings suggest the development of an early ectropian. This condition occurs when scarring causes the lower eyelid to pull in a downward direction.This complication can occur with lower lid blepharoplasty when excess skin is removed or the underlying orbicularis muscle loses it's tone. CO2 lasers can also contribute to this problem by causing excessive skin tightening.Although your history is helpful, it's impossible to make a specific recommendation without pictures or a physical examination. It's probably reasonable to start lower eyelid massage at this point. If the ectropian is severe, secondary surgery may also be indicated.It's important to maintain close contact with your plastic surgeon. Your surgeon should be able to formulate a treatment plan that addresses this problem.

Your question is helpful for those considering lower blepharoplasty with skin resurfacing. This combination is an excellent choice for enhancing the appearance of lower eyelids, but can run the risk of making the skin too tight. Fortunately, 2 weeks is not nearly enough time to judge the results. Followup visit should be made for  2-3 weeks after the surgery. Artificial tears can be used to lubricate the eyes. Upper eyelid swelling is not unusual following lower eyelid surgery. Thank you for sharing the question.

What you are experiencing is not atypical after CO2 laser resurfacing.  After all, you have received a second degree burn of the skin.  It takes time to heal and 2 weeks may not be enough for you.

I would be concerned about the lower lid position.  I would recommend that you discuss with your surgeon some repositioning therapy to keep this from becoming a problem that demands and operation for correction. 

The redness and swelling will assuredly resolve, later than you would like, but still will.  In the mean time, protect the lower lid position.

It’s important to work closely with your doctor to prevent the lower eyelids from pulling downwards. The CO2 laser is effective in reducing wrinkles (I routinely use a MixtoSX Microfractional CO2 laser in my practice) however the heat from the laser can cause the skin to contract significantly. It’s difficult to provide a complete diagnosis without an examination,

Recovery after eyelid surgery varies from patient to patient. While most lower eyelid surgery is healed within two weeks, some patients take longer for various reasons. I would definitely talk with your surgeon about what is happening as this may represent normal healing or can represent infection or some other complication.