What Procedure Will Best Fix Lower Lid Retraction from Skin Pinch Incision?

I am now 4 months post op from lower blepharoplasty with a skin pinch incision that left me with ectropion / retracted lower lids. What procedure best fixes my problem -- canthopexy or canthoplasty with cheek lift? Would restylane help boost my lids up or will I need surgery? Also, seems most oculoplastic surgeons who specialize in such repairs are in CA. Any recs for Chicago doctors who routinely fix this issue? I can't risk another failed surgery so would travel to the best. Many thanks.

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7 Doctor Answers | Asked by lala5 in Chicago, IL

Doctor Answers (7)
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WIth all due respect for the other surgeons suggesting that canthopexy will resolve this, they are wrong.

First, your right eye appears much more prominent than the left eye. This is most likely a preoperative status that was unnoticed by your plastic surgeon. A canthoplexy, or its more involved cousin, canthoplasty are surgical procedures that shorten the lower eyelid. Surgeons who perform these procedures on individuals in your circumstance are guilty of linear mechanical thinking: Shorten the eyelid and you will pull it up. Unfortunately, what is going on here is... more

Kenneth D. Steinsapir, MD

8 reviews

Los Angeles Oculoplastic Surgeon

It depends

Your photo shows a slight ectropion on the right only. At 4 months it may still be possible to massage and stretch the lid up a bit at the corner. If that is not successful, it may be best to consider a revision surgery for which likely a canthopexy would be sufficient and the least invasive of the three surgical options you mentioned. Restylane injection would not likely be successful at improving the problem. You should consult with your treating surgeon first for... more

Lower blepharoplasty revision

Your lower eyelids turn out at the edges. They do not look retracted as the lids are not pulled away from the eyeballs and the white does not really show under the irises. I suspect your previous surgeon removed the part of the eyelid closing muscle that lies directly over the cartilage in the eyelid (pretarsal orbicularis muscle). This is the part of the muscle that lies directly below the eyelashes. When we perform a lower eyelid blepharoplasty we try to preserve the pretarsal portion of... more

Lower lid retraction after blepharoplasty

You have already had problems with eyelid surgery so you should go to someone who is experienced in improving your problem. Distance should be a secondary factor. It does appear that you are lacking enough skin which is pulling your lid down. By simply tightening the lower lid (canthoplasty or canthopexy) won't work and it will make it worse. You need skin. The two ways to get is either by skin graft/flap ("switch flap") or midface lift. Repeat... more

Lid retraction after lower lid rejuvenation

The pull on the lower lid margin can be caused by removing too much skin, or by a lid that lacks support. Lid laxity and subsequent lateral bowing are usually seen in older individuals and tightening the corner (canthus) will provide better support to the lid and correct the retraction. If the skin is simply too tight the lid can be released and a graft placed to release the pull. As you appear young in the photo you may wish to take more time and massage the lid upward to see if the skin... more

Canthopexy can fix lower lid retraction after bleph surgery

You've got unilateral lower lid retraction with mild scleral show - I think a canthopexy on the right side would restore lid position symmetry. Although midfacial fat grafting and dermal fillers can help support lower lid position, they are not the standard restorative procedure for this problem.

Correction of Lower Eyelid Retraction

Your eyelid retraction appears to be on just one eyelid. While feeling the lower eyelid and determining how much if any laxity exists is the best test, I would speculate that a canthopexy procedure may be all that you need. You appear fairly young, hence the concept of a pinch excision, and elevating'/tightening that one corner may be sufficient. I don't think you would need something as 'extreme' as a cheek lift with it but that would depend on how tight the lower eyelid... more