Will Lifting Bottom Eyelid Improve Chemosis?

I have ectropion in my eye and doc says that's what's causing the chemosis. Will lifting the bottom eyelid, so that the eye can close properly make my chemosis better?

Also, I need to have fat put back in to the bottom of my lid because my other ps left my eye hollow and sunken in.

Doctor Answers 6

Consider a second opinion

Hi Eric

Again it is possible that improving a pulled down eyelid after a cosmetic eyelid surgery associated with chemosis will make a difference with the ectropion. However, there is no substitute for a personal consultation. If you are emailing us regarding your concerns, this suggests that you are not entirely comfortable with the surgeon you consultated who is advocating a lot of surgery very early after the original eyelid surgery. I think it is highly likely that you will eventauall benefit form surgery. However, it is generally best to wait a full 6 to 12 months after the original surgery.

I suggest that you get some additional opinions. Look on the website of the American Society for Ophthalmic Plastic and Reconstuctive Surgery (ASOPRS.org). They maintain a directory by geographic location for high qualified eye plastic surgeons.

Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Lifting lower eyelid can improve chemosis

Yes, lifting the bottom eyelid upward and outward will tighten up the lower lid and make chemosis better. Fat grafting can be done at the same time. A canthopexy or canthoplasty can also be done simultaneously to improve chemosis.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 145 reviews

Lifting the lid will work in some instances but not all

The cause of the chemosis after eyelid surgery is not well understood, but does represent a noticeable problem from many patients. If the cause of the chemosis is excessive eye exposure, then lifting the lower eyelid should improve chemosis. More commonly it has to do with interruption of the lymphatic drainage from the outer cornea of the eye and secondary fluid buildup. Raising the lid would not help this

In brief, tincture of time is virtually always curative and is to best bet.

J. Timothy Heffernan, MD
Seattle Oculoplastic Surgeon
4.6 out of 5 stars 12 reviews

Chemosis and ectropion

Any irritation of the lower eyelid can cause a chemosis. This certainly can get worse with ectropion.  By correcting the ectropion, the chemosis should eventually improve, but it may take some time.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Lifting bottom eyelid improve chemosis

"I had lower and upper eyelid surgery done 3 1/2 months ago. My doctor removed too much fat and I have sunken hollow eyes. I also have ectropion in one eye along with chemosis..." - I am truly sorry to hear of your predicament but it sounds to me like you are rushing head long into another complication. For the absolute best revision results all traces of inflammation must be gone and the eyelid tissue must be supple. Operating before 5-6 months have passed invites miscalculation and further and worse complications.

An ectropion is the eversion and loss of contact of the rim of the lower lid with the eyeball. It can be caused by multiple processes or combination of processes such as tissue weakness (INVOLUTIONAL), scar tissue (surgery, injury, burn, lasers- CICATRICIAL) and, or by eyelid muscle paralysis. In your case, it is probably due to either one or all three of these processes. IF the chemosis is caused by the process(es) causing the ectropion, repair of the ectropion should also correct the chemosis.

Fat grafting of the eyelids in the best of hands is a 50-50 proposition. When fat is placed in the lower lids and is not quickly supported and nourished by a blood supply, the fat dies leading to palpable nodules and reappearance of the hollowed look supplemented by a bunch of bumps. No one way of treating fat and grafting the fat has completely solved this problem. So - it is hard to say how long the fat will live except to say that if it does live, it will remain alive for years. The challenge is in getting all or most of the fat to survive.

Peter A. Aldea, MD
Memphis Plastic Surgeon
4.9 out of 5 stars 109 reviews

It is a good idea to fix an ectropion

If you have an ectropion (eyelid turned outward) or lower eyelid retraction (edge of eyelid too low) it is worthwhile having that problem repaired so that your eyelid returns to its normal position.

Most likely the chemosis will resolve if the lower eyelid is in the correct position and functioning normally.

Hope this helps.

Marc Cohen, MD
Philadelphia Oculoplastic Surgeon
4.8 out of 5 stars 24 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.