What causes weak muscle after blelph?

Question

I had upper bleph, lower transcutaneous bleph, canthoplasty, and soof lift a couple of years ago. One eye is no longer able to squint while in the sun. The muscle tone is very poor and my brow sometimes droops on that side as well. Could this be muscle or nerve damage? Is it something that can be repaired?

Mats Hagstrom, MD (license on probation) · Answer

I’m not sure your problem is related to muscle weakening.
It is pretty much standard practice to remove both skin and orbicularis muscle when doing an upper eyelid blepharoplasty.
Because gravity helps weakness of the upper part of the orbicularis muscle is rarely an issue.
With a transcutaneous lower eyelid blepharoplasty some surgeons will remove small amounts of skin, and some will remove skin and ocularis muscle.
This typically does not weaken the muscle, but can create a downward tension leading to premature ectropion.
Without seeing proper before and after pictures, we can’t really begin to make quality assessment.
If you don’t have before and after pictures and ask your surgeon to forward the pictures they took if still available.
It’s never a bad idea to have a copy of your medical record, including proper before, and after pictures and your operative report. Should you ever wish to get a proper second opinion consultation, or have revision surgery.
Best,
Mats Hagstrom, MD

James Hoyt, MD (retired) · Answer

Blepharoplasty, commonly known as eyelid surgery, is a cosmetic procedure performed to rejuvenate the appearance of the eyelids by removing excess skin, fat, and muscle from the upper and/or lower eyelids. Weakness in the muscles surrounding the eyes after blepharoplasty can occur for several reasons:
1.	Surgical trauma: During blepharoplasty, the muscles surrounding the eyelids may be manipulated or altered to achieve the desired cosmetic outcome. This surgical manipulation can lead to temporary weakness or fatigue in the muscles as they heal from the trauma of surgery.
2.	Nerve injury: The nerves that innervate the muscles around the eyes may be inadvertently affected during blepharoplasty surgery, leading to temporary weakness or paralysis of the muscles. Nerve injury can result from surgical manipulation or the use of anesthesia during the procedure.
3.	Swelling and inflammation: Swelling and inflammation are common side effects of surgery and can contribute to muscle weakness or discomfort in the area surrounding the eyes. As the swelling resolves and the tissues heal, muscle strength typically returns to normal.
4.	Post-operative care: Inadequate post-operative care, such as excessive rubbing or touching of the eyes, may contribute to muscle weakness or irritation following blepharoplasty. Following your plastic surgeon's post-operative instructions carefully can help minimize the risk of complications and promote optimal healing.
It's essential to communicate any concerns or symptoms of muscle weakness to your plastic surgeon during the post-operative period. Your plastic surgeon can evaluate your condition, provide appropriate recommendations for management, and address any underlying issues to ensure a smooth recovery and satisfactory outcome from your blepharoplasty procedure.

What causes weak muscle after blelph?

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What causes weak muscle after blelph?

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