6 weeks post op lower bleph, eyes have changed the shape and not look round and almost sad. Will it resolve? (photo)

Question

It’s been 6 weeks since my lower eyelid surgery and have finally recovered from some serious chemosis. My eyes however are no longer almond shape and now look rounded and almost sad looking. Do you think it’s still early in the healing process or am I now stuck with round sad looking eyes

Kenneth D. Steinsapir, MD · Answer

You don't need to heal another six months or six seconds to know that your eyes have been harmed by this surgery. You are not healed yet from his surgery but time will not change your outcome here.  The lower eyelids have been harmed by your transcutaneous lower blepharoplasty. Circling the wagons and gaslighting you about the result won't restore the shape of the eyelid.  For that, you will need specialized reconstructive surgery. Your surgeon lacks the necessary skills to perform this reconstructive work.  Don't get talked into having a "stitch" put it. That will only use up tissue that you need for definitive reconstruction. What will be required to reconstruct the eyes is far more complicated that what was required to harm the eyelids. First, the eyelids do need to heal for about 6 months.  Occasionally I do this work earlier for social reasons or due to dry eye symptoms. It is not too early to be assessed. I have personally developed surgery to address this injury. It involved vertically lifting the cheek to replace the soft tissue that has been removed by the surgery.  A small orbital rim implant is hand carved of ePFTE at the time of surgery for you. It serves to hold the lifted cheek permanently in place. A hard palate spacer graft is also used behind the lower eyelid to shape the eyelids.  A lateral canthal reconstruction is also needed.  The eyes is sewn closed for a week while it heals.  For this reason, the two sides are done in separate operative sessions about 1 week apart. I am attaching a video so you have a better idea of the procedure.

Mehryar (Ray) Taban, MD, FACS · Answer

Important to communicate with your surgeon too. It appears you have rounding of the eyes. Best to allow more healing for another 2 months and then re-evaluate. Revision lower eyelid surgery can be considered but hopefully won't be needed.

Reza Rod, MD · Answer

You have to remember that every surgery takes time to heal.  I tell my patients that at 3 months 60% of the swelling is gone and at 6 months that sweling should be resolved. With that said since you had serious chemosis it could take a little longer to heal. Make sure you speak to your board Certified plastic surgeon with any concerns you may have.  Best of luck,

Nicholas Howland, MD · Answer

Hi, thank you for your question! You are still recovering and the skin around your eyes has not had a chance to fully heal or relax. You should give it at least 3 months time to see better results but some patients do not see full recovery for 6-12 months. If you are still unsatisfied with the results at 3 months, I recommend talking to your surgeon to see if a revision surgery is needed. Good luck!

Malena Amato, MD, FACS · Answer

Thank you for your question. There is a good chance you are still going through the healing process just 6 weeks after surgery, especially lower eyelid surgery. Final healing/results you should see in 6-12 months, but you should continue to see improvements from now on. I would suggest returning to your surgeon if you still have concerns.
Kind regards,

David E. Webb, DDS, FACS, FAACS · Answer

I'd give it time before making any conclusions. Six weeks isn't a lot of time for soft tissue healing so I'd be more patient. Its extremely rare that anyone offers revision surgery before 6 months because it takes a long time for the healing (and scarring) process to take place. Your eyes are beautiful, just be patient ;)

6 weeks post op lower bleph, eyes have changed the shape and not look round and almost sad. Will it resolve? (photo)

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