I am a 33 year old female and had lower blespharoplasty ten months ago. I was unhappy with the results and had the surgery again 7 wks ago. I now have a droop in my right lower eyelid, it improved slightly for the first month but it has not improved in the last 3 weeks. I am massaging and taping my eye. I am extremely self conscious about it. Is it possible that it will improve at this late stage or what options do I have if it does not improve? I am reluctant to have surgery again....
Drooping Eyelid 7 Weeks Post Operation Lower Blespharoplasty?
Doctor Answers 7
TWO STRIKES AND OUT by Villar
A reasonable rule of thumb in cosmetic and reconstructive surgery is "Two strikes and you are out." Multiple second opinions are now warranted. Waiting for the tissue to mature and soften is prudent. Repeated early intervention in repairs is ill advised and can lead to disaster. That said, if the condition is so severe that an exposed cornea is at risk, suturing the lid closed to protect it is reasonable. Best wishes. Knowledge is power. Luis F. Villar MD FACS
Way too early to worry
Two or three months is absolutely not enough time for the lower eyelid retraction [the medical term for lower eyelid droop] to improve. And you should absolutely be reluctant to have surgery again. It should be a last resort.
Once of the biggest mistakes made is repeat surgery too early in the postoperative healing period. A big component of my practice [and many Oculofacial Plastic surgeons] is revision surgery post-blepharoplasty, and the most important aspect of this process is talking patients down from getting surgery too early.
Having said that, photos would help us give you a better idea of how much improvement is possible. It maybe that time alone may not improve your eyelids enough, but its important to wait as long as possible [up to a year] to achieve best success.
It depends upon why the lid is drooping and what was done
You are a young lady to have a drooping eyelid. There are a number of reasons why someone would have eyelid droop following blepharoplasty, and they are not all treated the same way. In older people, the lid can become loose and elongated, and in these people eyelid droop is typically treated by shortening and resuspending the lid margin. In younger people however, drooping is often caused by the opposite problem. The lid becomes tight and adherent from scarring, and it is shortened. In those people the solution is a bit trickier, and it might involve lifting the entire cheek pad to advance the eyelid back up or even adding an internal spacer to lengthen a shortened and deficient eyelid. Without going into too much more detail here, I think you can see that the issue is hard to accurately diagnose in this forum. While there still may be some improvement beyond 7 weeks, in my experience, if the droop is significant, and especially if the tissues are short and tight, it is most likely not going to get to where you want it to be. As long as you don't have any irritation of your eye from exposure or excessive tearing, I think it is reasonable to give the massage and taping another month to work. If there is little progress by that time, I think it is time to plan for further revision or seek additional consultation. Good luck.
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Stop having surgery with this surgeon.
No photo so it is hard to have a clear idea of what you mean by a drooping lower eyelid. The issues vary. Generally if your surgeon performed your lower eyelid surgery by making an incision through the skin under the eyelashes, it is likely that the surgery damaged the motor nerves supplying the muscle along the lower eyelid margin. This part of the muscle is responsible for holding the lower eyelid against the eye. Damaging the motor function of the eyelid margin will result in the eyelid slumping or pulling away from the eyelid. This can also be seen in conjunction with lower eyelid shortening effective pulling the lower eyelid down. These issues are often complicated by relatively poor projection of the cheek bone. This type of bone structure is a set up for a pulled down lower eyelid after lower blepharoplasty. Surgeons will often mistakenly perform a "tuck", canthoplasty, or canthoplasty to correct these types of problems. Unfortunately this can and often makes the problem even worse. You can search my prior Realself posts to learn why this happens. The brief answer is related to the topology of the eye surface. While you are very early from your most recent surgery, I recommend that you do your homework and identify an eyelid plastic surgeon who takes care of issues after cosmetic eyelid surgery and have an early consultation.
Drooping Eyelid 7 Weeks Post Operation Lower Blespharoplasty?
Hi Sasha and thanks for your question.
If your lower eyelid is drooping at 7 weeks it will not improve with time. I cannot advise you without seeing your photo but I suspect you will need a surgical operation to tighten the lower eyelid by a procedure called canthoplasty. Please see your Plastic Surgeon.
Droopy lower eyelid
You are doing all the right things already with massage and taping. I would continue to be patient as there is still more healing possible with the lower eyelid, especially in a previously operated site. I can understand being hesitant with further surgery as repeated surgery increases scar tissue in the area and could make things worse. However, if this does not improve in 6 months the best option is for repeat surgery and the technique depends on whether there was laxity of your lower eyelid to begin with on preoperative photos and what the cause is for the droopy lower eyelid (scar tissue, overresection, etc.) In the meantime, be patient because time is the best medicine.
Drooping lower eyelid 7 weeks after surgery
Pictures would be helpful to give you the best answer, but I would say that it still is possible that you would get further improvement in your lower eyelid with more time. At 7 weeks after your revision lower blepharoplasty, there would still be some healing taking place. If it does not improve, there are really no non-surgical treatment options for that problem.