Lifting eye/canthopexy/canthoplasty after blepharoplasty?

Question

Will lifting my eye with another stitch help my scleral show/slight ectropion? Canthopexy or canthoplasty? Or will this make it worse? 7 weeks post op, but scleral show only getting worse. Massaging and squinting daily. Looking for a doctor to help me, my surgeon thinks my eyes look great and perfect so she is not any help. All the doctors I have asked has suggested canthopexy or canthoplasty. Not having any surgery until at least 6 months, but need to know my options.

Zoran Potparic, MD · Answer

As you already mentioned, suggestion is to wait at least 6 months (better longer) since your "deformity" will correct once postoperative stiffness softens with massage and taping. Only when your result matures it would be possible to tell whether any intervention is needed. Time, massage and patience are your best allies. Good luck.

Kenneth D. Steinsapir, MD · Answer

If this were your unoperated appearance, it would be possible to lift the outer corners with canthoplasty. Think of a canthopexy as as a stabilizing procedure. However, you have more going on here. You appear to have had transcutaneous lower blepharoplasty with a skin incision that was continues into a visible area in the lateral orbital rim area. Loss of soft tissue volume in this area contributes to an hour glass deformity. While you do not have a radical shortening across the width of the lower eyelid, the left eyelid in particular is bowed down. During a detailed consultation, the effect of this compromised would be assessed to determine if your reconstruction benefit from a posterior graft. In some of these eyelids, the lower eyelids are actually much more compromised that they first appear. Internal scaring robs these eyelids of their natural elasticity compromising their blink function. I also note that you have lateral eyebrow flare with a large lateral upper eyelid platform exposure from a high upper eyelid crease. It is possible to address all of these changes. Don't work with surgeons who cannot spend time with you to educate you regarding your finding. Don't work with surgeon who want to schedule a surgery for you after a "Skype" or "Zoom" consultation. Your eyes can be your best feature.

Johnson C. Lee, MD · Answer

Thank you for your photos. If you continue to have scleral show in the future, then you may need a canthoplasty/pexy procedure or other interventions depending on the source of the problem such as a spacer graft. Your current amount of scleral show is very minimal and you may have a resolution of your problem as your scar tissues soften and remodel themselves over the first 6 months. I would not feel to anxious at this time and continue to monitor your healing. Hope this helps!

Johnson C. Lee, MD
Board-Certified Plastic Surgeon

Lifting eye/canthopexy/canthoplasty after blepharoplasty?

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Lifting eye/canthopexy/canthoplasty after blepharoplasty?

Answers (3)

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