How Do You Asess 12 Days out if It's Ectropion or Swelling Beneath Lower Lid Causing Retraction?

Post lower blepharoplasty. 12 days out. One eye is great and swollen. The other less swollen and significantly retracted (5mm) with bowing, and slight out turn of lower lid. I'm wishing and hoping that this is swelling below and beneath lid, which is present but minor. What are the odds this will 'self heal'. I'm having significant anxiety. Ps states he is not concerned but body language and tone say otherwise. When do I look at a revision, and what is the cost, recovery for just one eye?

Doctor Answers 5

After surgery, the eyelids should be swollen but basically in the right place.

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It is true that things improve after surgery.  A photograph would be immensely helpful.  However, when I speak to patients coming to see me to get fixed after cosmetic eyelid surgery, they all tell me that they knew immediately that there was an issue.  I think you know you have an issue.  What I can advise you is to be very careful with the surgeon performing a "tuck" or putting in a "stitch" to fix the issue.  Massage the eyelid if this is recommend, use eye drops if needed.  Time can be very helpful but it is improbable that the retraction you are describing will resolve without future surgical intervention.  This needs to be done by an expert in these methods.  Unless there is a very compelling reason, generally the time frame for this is 6 to 12 months after the initial surgery.

Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Recovery after lower blepharoplasty

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It's impossible at 12 days after lower blepharoplasty to judge the results of your surgery.  There would be expected swelling still present that will affect your appearance.  It may take several months to begin to see how your eyes may look once the healing has been completed.  I would give it some more time and be sure to keep your follow up appointments with your surgeon.  

Michael I. Echavez, MD
San Francisco Facial Plastic Surgeon
4.5 out of 5 stars 18 reviews

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At 12 days post op, I would wait for the swelling to come down. I have been there many times with a patient and more often than not, this clears on its own. Hope I am helpful  Dr Thomas Narsete Austin, Tx

Post blepharoplasty eyelid position problem

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Why are you doing eyelid surgery if you don't know the answers to these questions? If the eyelid is everted it is "ectropion". It may or may not need further treatment.

All experienced eyelid surgeons know that asymmetric swelling is common, occasionally produces lid eversion and sagging, and  almost always resolves with time, assuming the surgery was judicious and uncomplicated by hematoma or infection and the preop canthal and tarsal support and anatomy were normal.

Usually horizontal taping to the lid margin skin to lift the lateral canthus will help get patients to a resolution of the swelling and substitute for a flaccid orbicularis for a few weeks. A temporary lateral tarsorrhaphy can also be helpful but should be done judiciously by an experienced eyelid surgeon who can evaluate the pt and decide the best treatment.

Reoperation is seldom needed if preop evaluation and surgical technique is appropriately performed.(Less than 10% of lower lids should need revision for ectropion, usually for scarring in the retractor mechanism as it heals.

My best advice is for you to refer the pt to a plastic surgeon with experience. 

C. Dennis Bucko, MD
San Diego Plastic Surgeon

Be patient with eyelid retraction.

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Often, mild lower eyelid retraction will resolve with time and conservative management. Sometimes this can be helped with gentle massage and/or injection of steroids or other anti-fibrotic medicine [5FU].

I would recommend close follow up with your surgeon so that he/she can decide where you fall in this continuum.

The one thing I would recommend is fight the urge to request revision surgery early. One thing I always stress to patients when they come in for revision surgery is that you can almost NEVER go wrong by operating later [there are a few exceptions to this rule], but its certainly possible to worsen things if you operate too early. Waiting at least 6 months is the minimum...but often a full year.


A.J. Amadi, MD
Seattle Oculoplastic Surgeon
5.0 out of 5 stars 42 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.