Ectropian and Retraction Post-Blepharoplasty...Temporary?

I have just seen my PS for a 1 month post op check following a lower blepharoplasty. I raised my concern about a slight ectropian on the rims of both eyes. He somewhat dismissed it and had a wait and see attitude,and he did not offer me any advice on what I could do to help the situation. I am 55 years old and did have somewhat poor tone before surgery. I have no scleral show, but I do have a slight retraction in both eyes that have caused dry eye. Any thoughts?

Doctor Answers 5

Photos would be helpful

A slight retraction early is not unusual, but there are some temporary treatments can be done to minimize scarring and further retraction. Injections with 5FU and/or Kenalog [steroid] can sometimes be offered.

Getting a second opinion from an Oculoplastics surgeon would be helpful. You can find a well trained ASOPRS Oculoplastics surgeon on ASOPRS dot org.

Best of luck

Seattle Oculoplastic Surgeon
5.0 out of 5 stars 37 reviews

Ectropian and Retraction Post-Blepharoplasty...Temporary?

 You may wish to get another opinion at this point and should ask your plastic and cosmetic surgeon for a referral to an occuloplastic surgeon.  

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 24 reviews

Ectropian and Retraction Post-Blepharoplasty...Temporary?

I think you need to see an Ophthalmologist or Oculoplastic surgeon to determine the extent of the dry eye and if any treatment is needed.  If you are unhappy with the lack of advice, you could see an Oculoplastic surgeon as another opinion. 

Sam Goldberger, MD
Beverly Hills Oculoplastic Surgeon
4.7 out of 5 stars 16 reviews

Your early but not that early.

Rather than be dismissive, it would be much better for both you and your plastic surgeon to validate and acknowledge what both of you can see.  Time can make these better but very often lower eyelid surgery does cause unwanted lower eyelid changes.  When these persist for more than a few months it is likely that the changes will be permanent.  This does not necessarily mean that you will need revisional surgery.  That is reserved for unacceptable changes that are visually disturbing or contribute to eye discomfort.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Slight retraction of lower lids after bleph not uncommon

you are still quite early after your procedure. Given your age and the pre-existing decrease in lower lid tone per your description, the final result will take close to 6 months. In the mean time I find daily massaging of the lower lid and cheek tissue in an upward and lateral direction gradually improves any slight retraction and ectropion and generally achieves good results in a few months. Your description of the retraction is expected and will improve over the next month. Discuss your progress and concerns with your PS. 


Edwin Ishoo, MD
Cambridge Facial Plastic Surgeon
4.4 out of 5 stars 20 reviews

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