I'm 25 asian.Done revisional double eyelid,cant close my eyes fully-a 2-3 mm gap.So surprised when the surgeon told me even after months of recovery if the eyes dont close fully at night or during the day in less than 2mm,it has no significant effect to your eyes.True?He claimed to cut away a bit of fat + skin(3mm).Maybe overcut skin. If after 6 months,the lids gap is 2-3 mm apart, does a patient require skin grafting to the upper eyelid or just proper eyecare for years to come?5-6 years?
Unable to Close my Eyes Fully After a Revision Upper Bleph- Options?
Doctor Answers (5)
Asian blepharoplasty and unable to close eyes with gap
Not being able to close your eyes after an Asian blepharoplasty or other types of blepharoplasty is not really uncommon. But I try to avoid this at all costs. If you are not having issues, you may not need to do anything. skin grafting is an option but it will be very noticeable depending on where you take the skin. Many things could go a way that is less than desirable with skin grafting. The other options is lubricating your eye with ointment, etc if you do have issues.
Unable to close eyes after revisional Asian eyelid surgery
It would be helpful to see all of your photos. A common reason patients undergo revisional surgery is due to asymmetry from the first procedure. Mild pre-existng ptosis (eyelid droopiness) left unaddressed is probably the most common reason for the need for revision. In this scenerio, ptosis repair performed at the time of the revision surgery can cause incomplete eyelid closure which may or may not be temporary. I would definitely discuss this with your surgeon and consider a second opinion as well. Only your doctor and someone who has access to your full history can give you the appropriate recommendations.
Lagophthalmus, inability to fully close the eye after upper lid surgery is very serious.It sounds you are long after the healing peroid. Therefore this is permanent and will not get better.
You need to see your plastic surgeon and decide what is the exact cause, though the most common cause is taking too much skin, or scarring. Then decide on the plan of correction. You need to know how much muscle, orbicularis was taken out , what was the exact technique used for thr revision.
You may need to release the scar and may need a skin graft.
Meanwhile you need to protect the eye from aberasions and drying, especiallt at night. you need to use a lubricant at night. If there are symptoms of corneal irritation or aberasion you may need more measures to protect the eys.You will need an aggressive treatment verysoon.
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So sorry to learn that you are having this issue.
When the eyes do not fully close, this condition is called lagophthalmos. My experience with managing patients with this condition differs sharply with that of your plastic surgeon. It is my opinion that any degree of lagopthalmos is significant. After eyelid surgery lagophthalmos can be caused by resecting too much skin, tethering of the upper eyelid due to scarring in the internal eyelid structures, or muscle weakness due to damage to the motor nerves in the upper lid that supply the orbicularis oculi muscle responsible for closing the eyelid. In some cases there are multiple causes contributing to the situation. Generally, it is desirable to avoid upper eyelid skin grafts which are very unsightly. WIthout a personal consultation, it is impossible to know precisely what you need. I would recommend that you seek management of your eye comfort with a cornea specialist or an oculoplastic surgeon. Do not assume that your plastic surgeon actually knows how to manage this situation. Artificial tears and ointment at bedtime can be helpful. Occasionally high water contact lens can help eye comfort during the day.
Sorry to hear about your experience. Are you able to fully close your eyes with maximal effort? Sometimes this can temporarily happen right after the surgery, but at 6 months out, you need to seek medical attention. Being unable to close your eyes can lead to drying out of your cornea and needs to be addressed. It can occur from cutting out too much skin or from taking out some of the underlying muscle. The solution will depend on your condition, but generally you need to start with eye care promptly!!! and seek a more permanent solution.
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