Eyes Are Smaller After Lower Eyelid Lift

I had the surgery in Jan of this year...I voiced my concerns to my doctor last week...he said my eyes still need to "settle"?.Its been 3 months and I'm very concerned that this is permanent. My heart is broken..I just wanted to lose the bags,,,not lose my big beautiful eyes that were my very best feature.. WHAT have I done!! Is there any chance they will return to orginal size? Other people have noticed as well. I'm very depressed. What can be done?

Doctor Answers 8

Smaller eyes after Lower eyelid surgery

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 Smaller appearring eyes after a lower eyelid surgery typically are caused by a malposition of the lower eyelids.  Transcutaneous (incision on outside of eyelids) lower eyelid techniques have a higher reported incidence of this compared with the transconjunctival (incision inside the eyelid) lower Blepharoplasty technique.

 Lower eyelid malposition can be rotation, of the lower eyelid, inward or downward.  Downward rotation, of the lower eyelid, causes the outer section of the lower eyelid to move towards the nose making the eyes appear smaller and more rounded.

 You may consider having a second opinion with a plastic and cosmetic surgeon or occuloplastic surgeon for evaluation and recommendations to treat the lid malposition, if that's what is diagnosed.

Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 28 reviews

Changing eyelid shape after surgery

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It would be great if you could post some before and after pictures.  It would make it much more informative for other patients and also give us the opportunity to give you more specific advice.  That said, only three months after surgery, you will still see changes as the tissues settle and the swelling resolves.  At this point, I would suggest seeing you doctor again in three months for a re-evaluation.  


Good Luck.

Lower eyelid abnormality

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The eyelid shape/contour can change after lower eyelid surgery due to various reasons, such as muscle weakness and/or scarring or if too much skin taken off.  It may be possible that your problem will resolve with time, however you may consider consult with an oculoplastic surgeon for second opinion.

Dr Taban

Mehryar (Ray) Taban, MD, FACS
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 91 reviews

Eyes and size

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Your eyes themseleves do not change size.  Sometimes with an upper lid bleph there is an illusion of having smallr eyes after the upper lid extenede creast( folded skin) is removed.  If the lower lid had a canthopexy, it might have slighlty angulated your lower lid.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Please add your pictures

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It is hard to answer your questions without pictures. The eye shape should not change  with regular eye lift.

Kamran Khoobehi, MD
New Orleans Plastic Surgeon
4.8 out of 5 stars 154 reviews

Eyelid change in shape after 3 months.

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Eyelid change in shape after 3 months is common and will probably go away in another 3 months to a year. It is easily corrected if it remains after that, but I doubt that it will.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 38 reviews

Impossible to answer you definitively without photographs.

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Dear Question 1234

After eyelid surgery, the eye shape can change in a variety of ways.  Much depends on precisely what was done surgically.  It is common now for general plastic surgeons to combine some type of internal canthal support procedure (such a canthopexy) with their lower transcutaneous blepharoplasty to reduce the risk of pulling the lower eyelid down after surgery.  This can happen as a common outcome of lower eyelid surgery because generally, this type of surgery permanently damages the nerves that innervate the orbicularis oculi muscle that holds the edge of the eyelid up against the eye.  Also scar tissue can form in the planes of surgery pulling the lid down and finally, some surgeons habitually removed more skin and muscle than is ideal.  Canthal surgery does hold the corner of the eyelid up.  Unfortunately, this also cuts off some of the white sclera seen just outside of the colored part of the eye.  This change makes the eye look smaller.  Is this your issue?  I can't tell you because I have no photos.  Ultimately a personal examination is needed to answer these questions.  Will it settle in time?  Some things do settle but at 3 months, it is probable what you are describing will not get more satisfactory with time.  Generally it is appropriate to wait a few 6 to 12 months before considering a revisional procedure to realize any settling that may occur.  Please recognize that post-blepharoplasty reconstruction is very specialized and your original surgeon may lack the skills to diagnose your issues and/or correct them.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Eye Shape after Lower Blepharoplasty

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Hi Question1234,

I'm sorry to hear of your concerns.

As other cosmetic surgeons and specialists have stated, it's difficult to provide a more specific answer without photographs. The eye shape can change in a variety of ways after eyelid surgery. After a lid lift, more commonly the eyes may look smaller possibly due to your plastic surgeon tightening a weak lower eyelid. This tightening is performed to help prevent the opposite problems of sagging lower eyelid and generally settles eventually for a balanced eyelid. Speak with your eyelid plastic surgeon to help determine appropriate options for you. Best of luck.

Dr. Chaboki

Houtan Chaboki, MD
Washington DC Facial Plastic Surgeon
4.9 out of 5 stars 89 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.