Im 27 male and had a lower bleph. 4 years ago. I had scleral show after this, 2-3 mm on the left and 1-2 mm on the right eye. I had canthopexy 2 weeks ago, paid 4k and the result is the same before surgery. Why is this? can you help me?
Doctor Answers 4
Canthopexy after Scleral Show
If you had a transconjunctival lower bleph 4 years ago, the scleral show was not the result of skin resection, which is the most common cause for transcutaneous. If you had some laxity of the lower eyelid, then canthopexy was not unreasonable. Although anyone can recommend anything, filler injection is a less invasive option that can improve height in supple skin. A modification of a midface lift can lift the midface tissues to give you more apparent length of the lid and correct the show as well.
This is a tough question to answer without photos. Post-operative scleral show is usually due to forces pulling down the eyelid. Canthopexy does not address this problem and probably will not solve your scleral show since the forces pulling down your eyelid were not addressed. In older patients with loose eyelids, canthopexy can solve scleral show because the cause of the scleral show is addressed.
You are lucky that the canthopexy did nothing.
Poorly trained eyelid surgeons believe some funny thing. One of these beliefs is that lower eyelid scleral show can be improved by performing a lateral canthoplasty or lower eyelid tightening. Unfortunately lower eyelid laxity is seldom present in these situations and that is what responds to eyelid tightening. In your situation, the effect of canthoplasty or canthopexy is to further pull the eyelid down and often to further compromise eyelid shape and function. Many times I see individuals who have had two, three or even four canthal procedures by well meaning surgeons. This is not the solution to your problem. Most likely you need lower eyelid reconstruction to vertically and horizontally lenghten the compromised eyelids. specialized methods are generally needed such as the use of hard palate graft.
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