Lower Eyelid Pulling Down After Cheek Lift and Eyelid Surgery

Dear M
Unfortunately, this combination of procedures humbles many a midface surgeon. Generally the biggest issue is a failure to understand how lack of cheek projection affects lower eyelid support.
Lifting up the cheek fat places a downward pull on the eyelid tissues and this can cause the lid contour to be disturbed after surgery. Unfortunately, there is no simple fix to this problem. I would encourage you to discuss your concerns with your surgeon but you may or may not get a satisfactory response. I would be careful regarding rushing to fix the issue. You are likely to need a definitive reconstructive surgery to address the problem. Having small revisional surgeries that don't full fix the problem are emotionally taxing and create even more scar tissue that can compromise the ultimate outcome.

For unique cases where a variety of modalities could be used to treat the condition, I would suggest an in-person or virtual consultation to develop a custom and effective treatment plan. It is difficult to precisely define the best option without collecting the same information. I suggest reaching out to an expert for a consultation with surgical and non-surgical methods to get a comprehensive option. Best, Dr. Emer.

If your eyelid is pulling down after eylid surgery then massage on the lower lid from medial to lateral is indicated. If it persist then consult your surgeon or an oculoplastic surgeon for definitive treatment.

Keeping the lower eye in position is of critical importance for aesthetic purposes as well as functional purposes.  In an eyelid which is pulled down, the eye can be exposed, leading to dryness of the eye, abrasions, and other issues with the function of the eye.

Myself and a colleague have written an article on the preservation of eyelid position and its importance, as well as a technique we have found effective for specific situations.  

Did you have the cheek lift through a lower eyelid incision?
Or did you have a cheek lift using incisions within the temporal hair together with a lower blepharoplasty?
In these two situations, you may have a higher risk with prolonged lower lid retraction. Usually, this will improve (or normalize) spontaneously with time.
If you did not have any of the above procedures or procedure combinations, most likely the problem will limited in time. You should lubricate your eyes and follow the care instructions of your plastic surgeon. Close follow up with your doctor is key!