Droopy Eyelids After Facelift and Upper/Lower Bleph?

I had a facelift and upper and lower Blepharoplasty one year ago, overseas. Because too much skin was removed, my lower eyelids are drooping, causing very irritated and extremely dry, teary eyes and outside corners are stretch, leaving my eyebrow without natural curve. Taping and surgically tightening outside corners from inside, helped only temporally. Now, my new eye plastic surgeon recommended take a skin strips from my mouth, and implanting it, internally in to my lover eyelids. Please,Eva

Doctor Answers 11

My lower eyelids droop after a facelift and lower blepharoplasty

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It sounds like you have an ectropion which can occur when too much skin is excised during a lower blepharoplasty. It also sounds like you have had a canthopexy as well. This can be a challenging problem to manage and the most important thing to consider at this point is that you have a surgeon who is very experienced in eyelid reconstruction procedures. It sounds like you are on the right track.

Newport Beach Facial Plastic Surgeon

Lower Eyelid Malposition After Facelift

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What your surgeon suggested may be the best option for you. However, some recent studies have shown that volume restoration with fillers can sometimes help to control these types of situations if malposition is seen. Perhaps you could bring this up with your plastic surgeon.

Babak Azizzadeh, MD
Beverly Hills Facial Plastic Surgeon
4.1 out of 5 stars 9 reviews

Malposition of the lower lids after facelift and lid surgery can be a difficult problem to solve.

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Malposition of the lower lids is a major complication after face and eyelid surgery.  Too much removal of skin should be avoided.  Patients at risk because of certain anatomical situations need to be carefully managed.  Correction might require further surgery.

Drooping lower eyelid can be repaired

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As I'm sure you now know, your have an ectropion of you lower lid.  This simply means that the scar created during your facial surgery is tight enough to "pull" down on the skin of the lower lid and expose the eye where it should be adherent to the eye.This normal adherence provides appropriate lubrication and drainage of tears.  It sounds like you have enough scar that a combination of lateral eyelid lift, or cathoplasty, and mucosal grafting will be needed.  An experienced surgeon should be able to show you pictures of the repairs that have been done in this fashion.  Good Luck

Neil Gottlieb, MD
Philadelphia Plastic Surgeon

Droopy eye lids (ectropion) after lower lid surgery

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You seem to have an ectropion - scarring that has pulled down the lower lid. Usually -

  • If excess skin was removed during a lower lid lift, a skin graft would be done
  • For scarring inside the lower lid, a mucosal graft from the mouth may be done
  • Both kinds of grafts and/or additional procedures such as a canthopexy (surgery to support the eyelid) may be needed.

Ask your Board Certified Ophthalmologist or Plastic Surgeon to explain to you how the mucosal graft will fix the problem - if removing too much skin caused it.

A second opinion is often a good idea for such complications.

Sorry you are going through this. Best wishes.

Droopy eyelids after facelift

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  well, the droopy eyelids are almost certainly related to the eyelid surgery, not to the facelift that you had.  It is hard to say if this is the best course of action but I think you are smart in seeking help from an oculoplastic or eye plastic surgeon.  Without photos, it is difficult to assess what would be best for you.  Consider seeing another oculoplastic surgeon (ASOPRS) for a 2nd opinion if you have concerns.

Lawrence Kass, MD
Saint Petersburg Oculoplastic Surgeon
4.8 out of 5 stars 140 reviews

Lower eyelid retraction after lower blepharoplasty

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Unfortunately, your problem is not uncommon.  Lower eyelid retraction can occur after lower blepharoplasty.  It is important to be evaulated by an oculoplastic surgeon for possible treatment options, which are available.  Make sure you lubricate your eyes often in the meantime.

Mehryar (Ray) Taban, MD, FACS
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 91 reviews

Lower eyelid problem after blepharoplasty

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I am sorry to hear about your experiences. The key to correcting your problem is to first identify the cause. There are several important layers for your lower eyelids, skin, internal membrane, and inner mucosa. In addition with prior surgery, you may have built up of scar tissues within your lower eyelid. The only way to identify the cause is through an physical examination of the affected area. If your surgeon has clearly identified the issue then the recommendation is fine. There are other ways to fix this challenging problem. If you are unsure about it then seek 2nd opinion.

Best Wishes, 

Stewart Wang, MD FACS, Wang Plastic Surgery

Stewart Wang, MD, FACS
Los Angeles Plastic Surgeon
4.6 out of 5 stars 28 reviews

The Problem With Lower Lid Ectropion

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The taking of too much skin from the lower lid is less frequent than it used to be. That fact does not help you but it means there seem to be fewer Plastic Surgeons that have encountered this problem. It seems you have had all of the conservative measures and now require an accomplished reconstructive surgeon. What your surgeon has recommended is one way to obtain tissue to use as an internal "spacer" to release the scars beneath the skin. There are other ways including cartilage grafts that serve the same function. On occasion a skin-cartilage graft may be necessary to release the skin tightness also. Finally, lid tightening and even a temporary stitch to sew the upper and lower lids together maymbe used.

Paul S. Howard, MD, FACS
Hoover Plastic Surgeon

Over resection of eyelids can cause difficult problems

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I'm sorry that you've had this problem.  It seems as though you've experienced an ectropion, where the scarring from eyelid surgery causes aesthetic distortion and exposure of more of the eyeball than is meant to show.  This can be a difficult problem to correct, and does often require more than one surgery.  Your current surgeon is likely correct in that the best way to improve these situations is often to bring tissue from other spots, like the mouth, to augment or replace the problematic scar tissue and allow the position of your lids to return to normal.  Sounds like he or she knows a good plan for you and I would think this will likely make a good improvement for you.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.