Can lower eyelid laxity and space between eyeball and lateral canthus be improved upon?

Following surgery there was a space between the eyeball and lateral canthus, plus the lower eyelid was lax and didn't hug the eyeball. The eyes were dry/irritating. I underwent bilateral canthopexy abroad. 2,5-3 weeks after surgery the laxity of the eyelid and the space between the eyeball and canthus are still the same: there is little difference. The eyes are still irritating/dry. I'm worried - difficult to get a response from the surgeon after I left his country. Will this improve with time?

Doctor Answers 4

70% of my surgical practice is fixing the work of other surgeons.

Correctly positioning a lateral canthal angle is very challenging.  The most difficult aspect is placing the tissue sufficiently posterior so that the lower eyelid margin precisely hugs the corneal surface.  This is essential to properly move tears on the corneal surface.  Then the eyelid margin does not hug the eye surface, drying and vision disturbance is common.  When the problem is severe, corneal breakdown can occur.  The canthopexy is a relatively weak lateral canthal procedure done to provide support.  A canthoplasty is a much larger reconstructive procedure to reposition the lower eyelid margin.  Then needed, a canthoplasty can also be performed for the upper eyelid margin.  There are not commonly needed.  I have a vast experience performing these type of surgeries.  Getting the eyelid positioned sufficiently posteriorly do the eyelid margin hugs the corneal surface is fussy and requires a great deal of experience.  You will need a revisional surgery to fix your issue.  Please see an aesthetically oriented fellowship trained oculoplastic surgeon.

Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Eyelid ectropion-retraction after lower blepharoplasty

You likely have lower eyelid ectropion/retraction, which unfortunately can happen after transcutaneous lower blepharoplasty. There are scar injections that can help. Massaging and squinting exercises are also useful. If it persists after 3 months, may need to consider lower eyelid ectropion/retraction surgery. See an oculoplastic surgeon.

Mehryar (Ray) Taban, MD, FACS
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 72 reviews

Lower eyelid laxity, displacement of lateral canthus

Several possibilities producing discomfort and lack of improvement. 1) chemosis after surgery can push the lid away from the eye - this usually goes away by 4-6 weeks, 2) the upper and lower lid margins/ edges are not aligned - difficult to determine without photo, 3) lid retraction with or without residual laxity - this occurs when there is scar tissue in the plane of the septum, a layer of the lid that may be snagged in the closure of the incision. You may want to establish yourself in the practice of an Oculoplastic surgeon now, so that you are informed of your diagnosis, advised of massage or other treatments, and you have access to prompt correction of any problems. It may be something that will resolve on its own without treatment, but there are many Oculoplastic surgeons in this country who can help you out with healing challenges and give you some reassurance so that you do not have to worry.

Sara A. Kaltreider, MD
Charlottesville Oculoplastic Surgeon
5.0 out of 5 stars 7 reviews

Eyelid issue

Without seeing you in person , it is difficult to say what would be appropriate for you. You should go see a local surgeon for evaluation.

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