Lower Bleph with Incision - Can This Cause Eyeball to Move?

I had lower eye bleph with an incision about eight weeks ago. My PS told me me that after removing minimal fat, he cut skin and muscle than redrapped the muscle. My question is whether this procedure could cause the eyeball to move up, forward, and slant. If so, will it resolve in more time? Thanks.

Doctor Answers 14

Eyelid surgery, blepharoplasty, micro fat grafting, cosmetic surgery

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Dear Kismet in Chicago, IL

Eyelid surgery can take several weeks to months to settle.  Certainly there can be distortions of the eyelids and cheeks due to swelling and the healing process.  You should visit your surgeon and ask these questions- and if there is anything to help with healing such as supplements and ultrasound.

With Warm Regards,

Trevor M Born MD

Toronto Plastic Surgeon
4.9 out of 5 stars 126 reviews

Blepharoplasty can change eyeball position

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The answer to you question requires significanlty more information regarding the type of surgery performed. Generally blepharoplasty MAY change the shape of the eyeldis but should not cause a signficant change in the position fo the eyeball. what you are describing can happen if the eyelid ligaments (canthal ligamnets) were also tightened causing the eye to shift upwards. In general this can resolve slowly over time. Alternatively the points of attachement can be revised to allow for a looser eyelid. As long as you are not experiencing double vision, diinished vision or eye pain, I would recommend you wait 6 months or more before reassessing the eye position. Good luck

Ebby Elahi, M.D.
New York Oculoplastic Surgeon

Lower lid blepharoplasty will not change the position of the eyeball

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In general, lower lid blepharoplasty will not change the position of the eyeball unless something has been done to one of the muscles that move the eyeball, which is extremely rare. More likely, it has changed the position of the eyelid in relationship to the eyeball which makes the eyeball potentially look like it’s been moved. That may be what’s going on. It often will get better. Sometimes as doctors, we recommend massaging the lid upward if it’s being pulled downward. Or, even putting it on track with tape can be helpful. Often the eyeball will look like it’s looking up because the lid is being pulled down. I would recommend going back to your doctor to see if he can do something with the healing of the eyelid skin. It would be very unusual for the blepharoplasty to effect the position of the eyeball.

Joseph A. Eviatar, MD, FACS
New York Oculoplastic Surgeon
4.7 out of 5 stars 68 reviews

Has Eyeball moved up or eyelid down....

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What needs to be determined is exactly what is different about the eyeball (globe) or eyelid position.  It is not uncommon to see the eyelid move down or become "rounded" after the lower blepharoplasty procedure. This is a recognized "side effect" from the surgery. For the eyeball or globe to move upwards is far less common.  See your operating surgeon and discuss your concerns with him....

Richard D. Gentile, MD
Youngstown Facial Plastic Surgeon
4.5 out of 5 stars 45 reviews

Lower blepharoplasty can cause the eye appearance to change.

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Lower blepharoplasty can cause the eye appearance to change, It depends on what and how it was done. You may only be noting the swelling which will go away. See your surgeon for the answer.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 38 reviews

Lower lid and eye position

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It is hard to figure out what exactly you are complaining about. it is unlikely that the eyeball itself has moved. Certainly the skin around it and the lower lid position may have changed.  An exam would be vital.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Lower Bleph and Eyeball Position

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Before and after photograph would be very helpful in making a diagnosis in your case.  Also it would be helpful to know if one or both of your the eyes were affected and if you noticed the changes immediately after surgery, how have they changed over the last 8 weeks.  While it is uncommon to have an injury to one of the extra-ocular muscles during lower blepharoplasty, this certainly could cause changes in eyeball position and movement. Scar tissue, excess removal of orbital fat and canthoplasty or canthopexy can also change the apparent or actual position of the eyeball within the orbit.

Daniel Reichner, MD
Newport Beach Plastic Surgeon
4.9 out of 5 stars 51 reviews

Lower Bleph with Incision - Can This Cause Eyeball to Move

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Without seeing your photo, it is difficult to imagine what you are referring to.  Are you having any double vision or vision difficulties?  If not, then it may be possible that the upper eyelid position has changed on your eye, which may be giving you the appearance that you are referring to, or your surgeon may have performed a canthoplasty, which can give the appearance of a slant to the eyes.  If your surgeon cut the levator muscle and repaired it, this can change the position of the upper eyelid in respect to your iris and pupil.  The swelling on that side may resolve over time, and look similiar to the other side, but I would strongly suggest that you discuss this with your operating surgeon. 

Amy T. Bandy, DO, FACS
Newport Beach Plastic Surgeon
4.9 out of 5 stars 109 reviews

Unfortunately this approach is associated with complications.

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Obviously you are having some type of issue.  Without a personal examination or photographs, it is difficult to understand what you are experiencing based on your description.  The surgical approach that you had commonly damages the muscle in the eyelid that helps hold the lower eyelid margin in position against the eye.  The surgery actually cuts the nerves that supply the muscle.  Why do surgeons continue to perform this type of surgery then?  The reason is that leaders in the field continue to teach the method and even incorrectly write and lecture that the nerves supply the eyelid in such a way that this procedure will not cause the harmful effects just described.  It continues to be a form of standard care despite the issues it can occasionally cause.

The effect is a lid that falls or is pulled down as the surgery heals.  This creates a dog eyed look.  When white shows under the colored portion of the eye (called inferior scleral show) you might interpret this as the surgery having cause a change in the position of the eye.  Rest assured there are many options to correct the situation if this is necessary.  Time does tend to resolve many issues.  How long should you wait? I generally advise that you wait 6-12 months before having an issue like this repaired.  Please recognize that your original surgeon likely does not possess the skills to repair this which required specialized surgical methods.  However, there are measures that can be recommended such as finger winking, a form of mechanical message of the eyelid.  Consider having a frank discussion of these issues with your surgeon.  If necessary consider a second opinion from an oculoplastic surgeon.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Change in eyeball position after eyelid surgery?

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Lower eyelid surgery is becoming very conservative at the present time.  Some techniques favor making an incision inside the lower eyelid, through which some fat may be removed .  This is combined with a procedure to firm up or tighten the lateral corner of the eyelid, preventing it from drooping.  Only a small amount of skin ever shoild be removed from the lower lid.


The eyeball will never move from its normal position, but when the eyelid position is moved or made to be more firmly positioned along the outer edge of the lid, this may appear to have changed the eyeball position, but it truly hasn't been altered.  If you still have questions about this, please follow up with your Plastic Surgeon.


Good luck to you.


Frank Rieger M.D.  Tampa Plastic Surgeon

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.