Blepharoplasty with Macs Lift and Their Complications, What can I do?

3 weeks ago i had an lower eyelid blepharoplasty with macs lift.we have had to correct the ectropion already but i have still the strange "spaniel" look, the lower eyelid doesn't touch the eyeball and i cannot close my eyes totally. the white part still can be you think it will be better (when and if the eventual swelling of the lift goes back) or i will need another operative correction.i cannot massage it because practically i don't have eyelid eyes get smaller and smaller.

Doctor Answers 6

You are having a serious complication from surgery.

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

You are having a significant eyelid complication from your surgery.  The fact that you needed to  "correct the ectropion already," confirms that your surgeon is in the 'weeds."  Ectropion following aggressive transcutaneous lower belpharoplasty occurs because cutting the skin and muscle in doing the lower eyelid surgery damages the motor nerves that supply the portion of the orbicularis oculi muscle that helps hold the lower eyelid margin up against the eye curvature.  In addition aggressive excision of lower eyelid skin and scaring further contribute to destabilizing the lower eyelid.  Your surgeon assumed that tightening the lower eyelid would correct the lower eyelid malposition.  This can work when the primary reason there is an ectropion is lower eyelid laxity.  That was not your post-surgical situation.  

Unfortunately tightening your lower eyelid did not return the lower eyelid to its pre-surgical state.  This is largely foreseeable.  The eye is a curved volume.  On a curved surface, the shortest distance is not a straight line but rather a curved line called a geodesic.  In tightening the lower eyelid, the eyelid follows the mathematical laws of topology to find the shortest curved path between the medial and lateral canthal angles.  You shortened (i.e. tightened) lower eyelid is now sitting below the curvature of the globe.

The important thing here is not to rush to have the next repair.  It is very important not to have hurried, not well thought out fixes.  I recommend that you give yourself time to heal form your recent surgeries.  Because you will have some corneal exposure and dry eye.  It is important to get appropriate management for this condition.  It is appropriate to get a second opinion from an oculoplastic surgeon.  The American Society for Ophthalmic Plastic and Reconstructive Surgery (ASOPRS) maintains a geographic directory (asoprs dot org) that will help you find a well qualified oculoplastic surgeon.  At this point, your plastic surgeon might consider referring you to an oculoplastic colleague for some appropriate input.  

Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews


{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

At present as long as the cornea is protected that is the objective.  It will be tight for a while, but should improve and soften with time.  Follow closely with your doctor.

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

Eyelid problems after surgery

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

the first item of importance is to protect the cornea..   the tightness will diminsh with time.

i would talk to my surgeon about a second opinion with an oculoplstic surgeon..   ointments and tears should be used..  massage and tape at night can help.  talk to your surgeon.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 116 reviews

Late to the game

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

It seems that you posted this question a couple months ago. But the most important thing here is to avoid rushing back to surgery. There are things that can be done to help diminish further scarring and contracture immediately after surgery, but at this point you should wait as long as possible [at least six months, but preferably even longer] before considering further surgery.

COnsultation with an ASOPRS trained Oculoplastics surgeon is your best bet.

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

Blepharoplasty with Macs Lift and Their Complications, What can I do?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

 This, IMHO, is excatly what I have written about conerning Cheek Lifts.  The potential of pulling the lower eyelid down, IMO, is very real with these types of lifts.  You might want to see an eye specialist for treatment and evaluation of the lower eyelid malposition.  

IMHO, finding a plastic and cosmetic surgeon that understands and follows the proper aesthetics of facial beauty is the primary concern when seeking a Face Lift.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 28 reviews

Early Lower Eyelid Retraction After Blepharoplasty

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

While it is not clear what your eye area looked lke before surgery, you do have tightness and a 'shortage' of lower eyelid skin at present. Having had an early ectropion repair, the most important issue now is that you have adequate corneal protection and aggressive management of any dryness of the eyes. This is an issue now of least six months to allow all of the tissues to relax and see what residual ectropion and any associated symptoms remains. The biggest mistake that anyone can make now is to try and surgically intervene too early. The tissue need plenty of time to relax and soften. This does not mean the problem will necessarily completely resolve but the eyelid tissues will be in better shape to tolerate any revisional surgery should that be necessary.

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.