Thank you for your question and photo. There are situations where this does improve, especially if it's this early in recovery. Sometimes damage to the muscle near the lower lid edge or swelling of the eyeball pushing out the lid can contribute to this lid malposition. In my practice, I would do the following for this problem 4 days out of surgery:
- Maintain moisture of your eyeball with artificial tears during the day and ointment at night
- Massage the lower lid up and out, hold for 10 seconds; repeat frequently
- Steri tape the lower lid up
If this does not resolve, it would likely require revision surgery.
Make sure you maintain frequent follow up with your surgeon and mention any changes to your condition. Hang in there and best of luck to you...
You have a significant ectropion here. It is still early in the post-op phase so this may improve with time. Try warm compresses, tape up the lid, massage. If it does not resolve you will need a revision.
That does not mean this eyelid will get better without revisional surgery. If your cornea is comfortable and not having issues with drying, then it is reasonable to be conservative and see if the eyelid will recover. The problem here is a motor nerve injury to the lower eyelid orbicularis oculi muscle. These are often permanent caused by the incision in the front of the eyelid. This is not something your surgeon messed up. All of these transcutaneous lower blepharoplasties create some type of motor injury to the lower eyelid, some worse than others. Follow your surgeon's directions. If you are having a corneal issue (dry eye, reduced vision, eye pain), then an early repair is indicated. Ask your surgeon for a referral to an oculoplastic surgeon.
Thank you for sharing your question. You have a better chance of having the ectropion recovering since it is so early in the post operative period. See your surgeon, but in the meantime perform daily massaging of the eyelid in an upward direction and tape it upwards most of the day. Considering how significant the ectropion appears, you might require surgical correction.
This can be a very difficult problem. You should notify your surgeon immediately so that they can evaluate you, determine what has happened and institute a treatment program to improve your retracted lower eyelid.