Eyes Are Smaller After Lower Eyelid Lift

A cosmetically successful lower eyelid surgery nearly always makes the eye appear slightly larger simply by removing the puffy bag and highlighting the eye shape itself..... but before we get there you can hold on to prolonged swelling of the lower eyelid, (like you been crying all night), making your eyes look smaller until the post-operative swelling completely resolves... up to as long as 3 month for first time surgery... 6 months or rarely, even longer for revision lower eyelid surgeries.... on the other hand,  excess removal of tissue in upper eyelid surgery can hollow out the eye lending the eye to appear smaller as the final surgical outcome, which to me is aesthetically counter-productive... many famous actors suffer from this type of outcome, almost making their once generously large attractive eyes, almost “beady” in appearance.... it would be nice to see a before snd after pictures of your eyes to make a better assessment.  Please go back to your Surgeon and get his/her perspective in the matter...  Good Luck

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

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

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.

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.

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.

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.

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

 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.