Problems Post Endotine Periorbital Lift Doctor Answers, Tips
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Problems Post Endotine Periorbital Lift

I had an endotine brow and cheek lift (through the mouth incision) several years ago. I am 56, and had had a standard face and brow lift in my late forties. In hopes of reducing nasolabial folds, the SOOF lift through the mouth was performed, with good results; the endotine brow lift was outstanding, resulting in a beautiful, natural-looking eyebrow position.

Although the procedure was helpful, I asked if the nasolabial folds could be further improved upon, and a periorbital entrance with blepharoplasty was recommended. Pre-op, the office nurse told me swelling would be down in three weeks. The day of surgery, the surgeon said he could also lift the corners of the eye with the procedure. I was uneasy about the relative newness of Endotine, but had had such a good result with the previous surgery that I went ahead.

Post-op, my eyes had very different shapes; the scars, especially on the more slanted eye, was visible and much wider than the other side. I was concerned that this eye's sutures were opening, but the surgeon, at three days post-op, was unconcerned. A week later, he said some skin grafting might eventually improve the appearance, and that I knew that I was at a higher risk for complications, because I'd had so many prior surgeries. Should this not have been discussed pre-op? If it had, I wouldn't have had the procedures.

One year later, the eyes are still somewhat uneven, but can be disguised with make-up. The tight eye side's upper cheek bone still hurts to the touch, and the cheeks are still somewhat asymmetrical. I have, too late, read that many surgeons no longer use the periorbital entrance, due to the long healing and sorts of complications I have experienced. I have spent nearly $4,000 on fillers trying to improve the lower lid hollowness and cheek asymmetry.

I have been left with hollow temples, pulled down upper lids, and hollow eyes. What can I do at this point? I would appreciate your opinions. Thank you.

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15 Doctor Answers | Asked by woodswoman in Mattoon Il
+5

Endotine facelift problems are common and hard to fix.

I don't think Endotine has a useful role in facial rejuvenation.  It is a foreign body and creates unnecessay scarring and inflammation.  Your problems are very complex and possibly irreversible.  You should consult with a plastic surgeon very well versed in problems of facial aesthetic surgery.  A revisional procedure could be disastrous if poorly executed.
+3

Consider a Second Opinion

I am sad to hear that you have had such troubles.  The issues you describe are very complex and really can't be properly addressed without a hands-on exam.  While the endotines may be causing some of your issues, there is certainly more going on here. I would recommend that you proceed slowly and cautiously with any revision surgery.  Be certain that your healing is complete before undergoing any additional surgery.  This typically means a minimum of 6 months... more
+3

Lower lid reconstruction is warranted

A picture will be very helpfull but it seems that you need lower lid reconstruction with canthal support. Many operations are described to handle this problem. a proper analysis and plan need to be discussed with a plastic surgeon with training in occuloplastic techniques. Feel free to send a pic to help with the analysis.

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+3

Post Endotine complications

You already know you have a very complex problem, and the lower lids are not forgiving. You had a SOOF lift and CANTHOPLASTY plus other procedures but these two affect the eyes significantly. and you have too much skin removed from the lower lid. You need full evaluation and exam by a board certified PS and may be an expert in periorbital area for the eyes.
+3

Revision eyelid surgery

You should seek consultation with a surgeon with interest in the midface and revision lower eyelid surgery. Your problem is quite complex and the suggested treatment, if any, will most likely be geared toward improving the eye shape, possibly reducing lateral orbital dystopia and rounding of the lower eyelid, a common problem with subciliary procedures, and of restoring a less operated appearance to the eyes. Your problem is best considered in the context of the entire face, and a plan made... more
+2

Endotine problems

I personally dont use endotine. I feel it another foreign thing for the body to accept. I remember the father in the movie "My big fat Greek wedding" who recommended windex to fix everything. I am a major proponent of volume replacement. Around the eyes fat placed by an expert can replace upperblepharoplasty, mid facelift, lower blepharoplasty not to mention all fillers. I recommend Dr. Little in Washington D.C as an expert in this field
+2

Endotine lift

Unfortunately you have complex complications and scarring after an approach that is lovely when it works and disastrous when it doesn't - so conservative surgeons avoid it when possible. You should see a Board Certified Plastic Surgeon who is experienced with evaluating surgical complications of facial surgery. You should call around and see at least three. Look for someone who might be able to design for you a very careful conservative treatment plan - low risk, possible... more
+2

Repairing Complications

Sorry to hear of your difficulties. As you know, fillers are temporary, a "stop-gap." The hollow areas may do better with careful fat grafting. It sounds like you are struggling with retraction of the lower eyelids, an unfortunate but known complication of eyelid and midface surgery. Repair is possible and may require scar release and possible grafting. Speak with your surgeon about these techniques, his/her recommendations, and maybe get some second opinions.... more
+2

Revision facelift

The key is the correct diagnosis of the lower eyelids and midface.get a proper analysis,formulate a diagnosis and then correct.scarring maybe an issue. fat will help with temples,so would sculptra
+2

Complications After MidFace Lift

The description you give leads to believe you have some form of lid retraction after your lower lid approach midface lift.  This is a described complication and a very distressing one for patients.  I have never used endotines in the midface because sutures work just fine; endotines add more expense and can be problematic.  However, I think endotines work very well for endoscopic brow lifts.  I would advise that you see an experienced Facial Plastic Surgeon regarding... more
+2

Revision Surgical Procedures Can Be Difficult

As most of the other surgeons have pointed out, your problem is quite complex and trying to suggest what your best course of action without an evaluation is impossible. I would suggest visiting a facial plastic surgeon and talk with him about facial fat if you have seen good results with facial fillers. Unfortunately, you may need several procedures to get your desired results.
+2

Eyelid and Cheek Malformations Postoperatively

Periorbital irregularities are very distressing since the whole reason we do facial surgery is to make the eyes look better.  It sounds like you would benefit from revision surgery of the midface and possibly of the eyelids.  Fat transfer will probably be helpful to soften and conceal the irregularities.  There will not be an easy anwer to this complicated-sounding problem.  Certainly competent revision surgery should make you look and feel a lot better about how you... more
+2

Problem with lower eyelids after Endotine periorbital lift

I am sorry that you have are having so many problems. It sounds like a very difficult problem to treat. Without seeing you and examining you it would be difficult to suggest solutions. There really can be so many variables to assess. 
+2

Options for this particular problem continue to increase

The lower eyelid can be one of the most challenging areas to deal with in plastic surgery especially if complications occur. However, there are excellent surgeons in many areas of the country who could help you. I would suggest including your pictures, this may enhance the level of advice we are able to provide.
+2

See an experienced Oculoplastic Surgeon

Your problems sound complicated enough that I would recommend visiting an experienced oculoplastic surgeon. While many plastic surgeons have excellent training in periorbital problems, you may need the expertise of a plastic surgeon who focuses his/her practice on problems occurring around the eye. A good place to start might be to ask your ophthalmologist who to see. Sounds like you have options, but be very careful before proceeding and realistic in your expectations. Best of luck to you. more
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