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2 weeks post op Brow Lift & lower Eyelid surgery, the lower lid pulling away from the eye & droopy eye. Is this normal? (photos)

When I open my mouth, the downward pull feels terrible. I understood the brow lift would raise all of my eyebrow, but the outer corners are heavy. When I lift the outer brow toward my temples, it relieves the heavy feeling on the outer brow & lifts the droop of my eyes. Everyone says I look sad & I have trouble holding my eyes open. Unfortunately, my surgeon will not see me until 8 weeks post surgery. The nurse thinks it may all be caused by swelling. Thank you so much for any feedback.

Doctor Answers (4)

Post-blepharoplasty lower eyelid retraction, ectropion

+2
Your lower eyelids are contracting and pulling away from your eyes (both lower eyelid retraction and ectropion). Discuss with your surgeon and consider seeing an oculoplastic specialist. It may help to start doing eye squinting exercises and massaging of the lower eyelids. Also, there are injections that can help break up scar tissue.  Also it is important to lubricate your eyes.


Beverly Hills Oculoplastic Surgeon
5.0 out of 5 stars 7 reviews

Aftercare

+2
Thank you for posting here.  I'm sorry your surgeon has refused to see you during an anxious time for you.  Lower eyelid surgery can be tricky and so can the recovery.  I would not be overly concerned at this point (2 weeks) if you have significant tightness (this is actually expected).  I would personally want to see you and evaluate your lower lids though because taping, suturing or exercises can sometimes be beneficial to help with the lower lid eversion (ectropion) that you are experiencing (apparently only with mouth opening).  The tightness should improve as the swelling abates and the wounds mature.  Your browlift appears to have been performed with a pre-trichophytic incision.  I really don't like this type of incision and greatly prefer a trichophytic incision to hide the scar behind the hairline.  When properly performed by a skilled surgeon, this will result in an imperceptible scar.  I have been asked on multiple occasions to perform scar revision on forehead scars from unhappy patients of other physicians who performed a pre-trichophytic incision.  I personally don't like staples on the face either.  Having said that, sometimes these incisions heal acceptably.  I certainly hope you fall into this latter category.  If your surgeon will not see you, I would recommend asking another local facial plastic surgeon or general plastic surgeon to help you in this anxious time.  I wish you well.

Sirius K. Yoo, MD
San Diego Facial Plastic Surgeon
5.0 out of 5 stars 1 review

Lower lid pull

+2
You had some significant swelling after the surgery.  You have a heavy brow, so still have some edema in the outer brow and lid.  I think that your forehead scar looks like it is healing well, and should eventually be hard to see.  When you open your mouth you will always pull on the lower lid.  For that reason we often have patients open their mouth during surgery when deciding how much skin to excise.  When you have your mouth closed, you do have a little scleral show - the white can be seen - but this may resolve with time.  Do some gentle massage upward on the outer lid to help with this.  The outer corner on the left does look a little low which makes you look sad.  As the swelling resolves this may also improve. 
It is very unusual not to see a patient back post-op for 8 weeks. Any post-op patient should have access to the office for any questions they have in the post-op period.  I would call them and ask them if you can stop in.   

John J. Martin, Jr., MD
Coral Gables Oculoplastic Surgeon
5.0 out of 5 stars 7 reviews

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I think your surgeon and office are unprofessional basically telling you to go away.

+2
The lower eyelids are going to be ver stiff due to swelling and inflammation.  The maneuver you are doing will maximally stress the lower eyelid so this will tend to pull the eyelids like you show.  However, this does not mean that the eyelid will heal like this.  Your surgical result with the forehead scar along the hairline is precisely why I do not recommend this type of forehead lift.  Properly structured, hair should eventually grow through this scar but it never looks right in my opinion.  You have a long forehead so it is not surprising that your surgeon recommended and performed this procedure but I do not think changes at the hairline make it worthwhile.  Many surgeons disagree with that statement but I am not sure they really listen to their patients about the results of this type of procedure.

You will get better with time.  WIth more healing the tugging usually gets better.  I think it is very unfortunate that your surgeon has chosen to send you away because he or she does not want hear your concerns.  Yes you need time to heal but that does not mean ignoring patients who are unhappy.   If your eyes are uncomfortable, I would encourage you to see your ophthalmologist to see if dry eye is contributing to your discomfort. 

Kenneth D. Steinsapir, MD
Los Angeles Oculoplastic Surgeon
5.0 out of 5 stars 15 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.