Will I Need Additional Surgeries to Correct my Bad Surgery in Thailand?

On August 27, 2010, I had my upper and lower eyelids operated on while I was on vacation in Thailand. The pictures were taken today, day 47. I am experiencing a saggy right eye, and lid looseness in both eyes. My question is, is this going to get better, or will I need a further operations to correct this. I will not be going back to Thailand. Additional Photos: http://www.realself.com/review/thailand-eyelid-surgery-bad

Doctor Answers 8

Postoperative eyelid ectropion treatment

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A better picture would be to see you in a straight on position without you tilting your head down, but it does appear that you do have some tightening to the lower lids which is called ectropion.  It is a little early to tell you whether any corrective surgery is needed for this condition or not.  This decision would be made 6 months after the original surgery.  In the meantime massage the lower lids in a gentle upward direction as often as you can, keep the eyes as lubricated as you can with Lacrilube, particularly at night when the eyes may tend to dry out more frequently, and continue to follow whatever advice is given to you by your Plastic Surgeon.  You need to be followed by a  qualified surgeon during this healing process.


Good luck.


Frank Rieger M.D.  Tampa Plastic Surgeon

It appears that you have lower eyelid ectropion

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From the pictures you submitted following your eyelid surgery in Thailand, it appears that you have a condition called ectropion of your lower eyelids.  I cannot see the condition of your upper eyelids from the photo.  The ectropion may have resulted from removal of too much skin from your lower eyelids.  Sometimes massaging your lower eyelids gently three times a day may help.  However, I recommend that you consult a board certified plastic surgeon in your area.  If the condition persists, you might need additional surgery to correct the problem.

James Tang, MD
Houston Plastic Surgeon
3.4 out of 5 stars 18 reviews

Will I Need Additional Surgeries to Correct my Bad Surgery in Thailand?

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Your condition is called ectropion. This can be caused by scaring after surgery which usually happens days after surgery and could get better with time or because too much skin was removed. Looking at your pictures you seem to have a condition called negative vector. Your lower lid surgery should have been combined with a lateral canthopexy to tighten your lower lid and protect you from this condition. I think it is unlikely that your right eye will correct, but if you are protected against dryness you can wait and do massaging. You may however need to tighten your lid with a canthopexy or plasty and possibly need a skin graft. You need to find yourself a well trained and experienced plastic surgeon who know how to take care of this kind of complication. I am sorry I am not giving you the most optomistic news.

Thai Eye surgery

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It appears as though you have ectropion.  This can occur from an overly aggressive skin excision or scar tissue formation in the lower lid.  It will occasionally resolve on its own, but not without some intervention on your part.  If you have not yet begun massaging the area, this is an important first step.  Secondly, the lower lid can be taped up (in the opposite direction of its retraction) for as many hours per day as is tolerated.  The ability for this to resolve on its own depends on its severity.  A consultation with your local plastics or oculoplastics surgeon will be beneficial.  Good luck!

Jason Hess, MD
San Diego Plastic Surgeon

Bad Result from Medical Tourism

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You have ectropion.  This is laxity of the lower eyelids.   It can occur after blepharoplasty but can usually be prevented either before surgery (recognizing loose eyelids and planning to tighten them at surgery) or during surgery by not removing to much skin.  You should see a board certified plastic surgeon in your are (Northern CAL) to get recommendations on the best method of correction.  

Dr. ES

Blepharoplasty Blues : (

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After checking your photos, it appears that the lower eyelid has retracted due to the development of scar tissue. The good news is that this may resolve with lower lid stretching and massage; the bad news is that it may take up to a year to return to normal.

The biggest concern at present is eyelid function and prevention of drying of the cornea. If the eye cannot adequately close and/or the tear mechanism does not function well, it can lead to ulceration. This may well be a bigger problem than the poor cosmetic outcome.

Your best bet is to obtain follow-up with a reputable board certified plastic surgeon to help guide you through your recovery.

To those of you considering medical tourism, be aware of the risks as this scenario plays out all too often.

Best Regards,


Kirk A. Churukian, MD
Los Gatos Plastic Surgeon
5.0 out of 5 stars 6 reviews

Ectropion Complication After Medical Tourism Surgery in Thailand

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Hi Berkeley,

Sorry to hear about your bad Thailand vacation surgery experience.  Unfortunately you are not alone in those who have suffered from "medical tourism".  Many times you get what you pay for.  You should consult with an experienced, board certified opthalmic plastic surgeon for evaluation.  Although your retracted lower eyelids may improve a bit, I believe that most likely you will need corrective revision surgery.  Most importantly, hopefully you are protecting your eyes and taping them shut when sleeping (if you are unable to completely close your lids) to protect your corneas from damage.  Good luck and be well.

Dr. Persky

Michael A. Persky, MD
Encino Facial Plastic Surgeon
4.8 out of 5 stars 39 reviews

Eyelid surgery woes

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You appear to have lower lid retraction on both sides with 'scleral show' of the white portion of your eye. In the early post-op setting, these issues can be temporary, and are related to scar contracture of the lower lid. This can resolve with time and diligent lower lid massage. Based on the series of photos you posted and the timing of your procedure (late August 2010), you should try lower lid massage daily for a few weeks and see if you notice improvement. After a few weeks of massage, if you still notice lid retraction and 'white' above your lower lid, seek out the care of a board certified plastic surgeon. You might have lower lid retraction that requires  surgery to improve lid support.

Unfortunately, you cannot easily return to see the practitioner you met in Thailand. Seeking surgical care in a foreign country prevents that after-care that is so important for good surgical outcomes. 

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.