Possible Levator Muscle Injury from Eyelid Surgery?

I had upper eyelid surgery on both eyes on June 25th of this year. My right eyelid is not opening all the way when I look up or out to the side. When I raise my eyebrows, my entire right eye pulls up. The left eye is not having any of these problems. Also, I have raised scars on the outside of both of my eyes.

Could my doctor have injured the levator muscle in my right eye, or possibly extracted too much fat, causing a ptosis effect?

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10 Doctor Answers | Asked by Ro in bp in New York

Doctor Answers (10)
Community Comments (1)

You may have a levator muscle injury after blepharoplasty

Your history sounds as though you may have a levator injury. However, there is a big difference between an injury and an actual cut of the levator muscle. The lid droop you mention is called ptosis. Sometimes the levator muscle is stretched or injured but not cut, and the levator is weak for 4-6 weeks after surgery, causing a temporary ptosis. This usually resolves in 4-6 weeks-hopefully this is your situation. If the levator was cut or disinserted (pulled out) form the tarsal plate, then a... more

Levator muscle and repair in upper lid blepharoplasty

You are now 2 weeks out from the surgery and by this time, you eyelids should have accomodated to each other. If you still have signficant ptosis at this point, it is likely that the levator muscle or attachment to the tarsus is not functioning fully and will likely not resolve with further waiting. In other words, the transient effects of medication, brusing, swelling, etc, should have mainly dissipated. There are a number of possibilities that are causing your eyelid asymmetry at this... more

Possible levator injury to eyelid

Initially swelling can cause some muscle dysfunction appearing like what you are describing. If it persists after 4- 6 weeks, then intervention might be needed. There might be some Iopidine eye drops that can be used to strengthen Mueller's muscle until it gets better, but if that does not help, then a levator repair would be indicated. I would allow at least 6-8 weeks to pass after the surgery as if more surgery is needed, you want those tissue soft and pliable before anymore surgery is... more

It is possible

Hi, Thank you for your question! It is possible that your muscle was damaged during the surgery. It is difficult to say without examining you. It could be several things. It would be a good idea to go back to your doctor or consult a plastic surgeon that specializes in this area. As for your scars, they should heal up over the next few weeks and not be as raised. Best regards, Dr. Speron

Probably a temporary issue

When extensive work is done on the lids there tends to be extensive swelling. This includes swelling of the muscles as well as the skin and surrounding tissues. This and the work can cause a temporary decrease in function of the muscle. It's not unexpected. Since you're very early out from surgery give it some time. If there's still an issue after 6 months then it should be addressed.

Eyelid issuessi

Your concerns are something that should be evaluated by your surgeon. Yes, you may have a levator injury or you may be swollen or the muscle is contused. You may also have had some element of ptosis prior to your blepharoplasty that was brought out during the surgery. Raise scars are a concern as well and should be evaluated by your surgeon

Steven Wallach, MD

12 reviews

Manhattan Plastic Surgeon

Consider a consultation with an eye plastic surgeon

Dear Anonymous You are relatively early from you surgery. It is quite possible that heaviness in the eyelid that you are describing is due to swelling and will resolve with time. On the other hand, it is possible for the tendon of the upper eyelid to become disinserted or loose. This can be the direct but unintended result of the eyelid surgery or in someone who is predisposed, swelling in the eyelid associated with the surgery can contribute to this. It is my impression that the... more

Kenneth D. Steinsapir, MD

8 reviews

Los Angeles Oculoplastic Surgeon

Post Blepharoplasty healing

Dear Anonymous, i am sorry that you are having issues with healing. You should return to your surgeon for review and if they are not familiar with your condition then they should refer you for a consult with a surgeon who can deal with your problem. With Warm Regards, Trevor M Born MD

Levator could be a problem

Your Levator muscle (upper eyelid lifter) may have been injured, partially torn, or stretched in and around surgery/recovery. Please recheck with your doctor. It could get better with time, but may need some tightening on the weakened side. Your doctor will examine you and come up with a plan. Good luck.

Consult with an oculoplastic surgeon

I'm sorry to hear of the problems you're having after your eyelid surgery. It is possible that the muscle was damaged. Unfortunately, it's hard to say what's going on without seeing you. Perhaps your right eye was droopy before surgery but you didn't notice it before? The raised scars should settle down over the next few weeks. If you have concerns about the eyelid ptosis, I suggest you consult with an oculoplastic surgeon who is specially trained to deal with issues in eyelid plastic... more

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Comments (1)

tessy d 27 Mar 2013

I am wondering how you are doing now ?? I am three weeks post op from an upper bleph and also have one drooping lid :-( I saw a occuplastic surgeon today and she wants me to wait four weeks to see if maybe some of the swelling is causing this. Please let me know how you did. I hope it was just the swelling that caused it.

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