I had a lower eyelid surgery 5 weeks ago and my eyelids are still very pulled down and swollen. I am really worried. (photos)

I am 64 years old and The procedure consisted in repositioning the fat under my eyes. My eyelids are still very pulled down and swollen. I am really worried as I do not feel any improvement.I went to the ophthalmologist who said I had an inflammation and prescribed some drops. Is what I am going through normal?

Doctor Answers 8

What you are going through is not normal.

This is a complication associated with your eyelids surgery.  The lower eyelid malposition will need to be corrected.  You need to see an oculoplastic surgeon for this type of repair work.


Los Angeles Oculoplastic Surgeon
4.9 out of 5 stars 23 reviews

Ectropion

I am sorry that you are having issues about your procedure and thanks for sharing your question. I can appreciate your concern.

You seem to have ectropion or pulling down of your eyelids. After 5 weeks it is unlikely that this is going to improve. It is difficult to determine the cause, without physical examination or photos prior to your surgery

Finally, make sure that your doctor is aware of your process. He should be able to guide you best in your care.

Wishing you the best in your journey

Lower Lid Ectropion

Thank you for your question and photo!  It looks as though you have developed lower lid ectropion.  I would advise you to seek a board certified plastic surgeon who specializes in such and see what your options are.  Best of luck!


Dr Dhaval Patel

Double Board Certified 

Plastic Surgeon 

Chicago 

Hoffman Estates

Oak Brook

Dhaval M. Patel, MD
Hoffman Estates Plastic Surgeon
4.8 out of 5 stars 79 reviews

Lower eyelid ectropion after blepharoplasty

That is significant lower eyelid ectropion. Although it will likely not get back to normal with surgical revision, it is best to wait 3 months after last surgery to allow tissue healing. See following link.

Mehryar (Ray) Taban, MD, FACS
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 61 reviews

Ectropione

Thank you for your question and photograph.   Your healing is not normal after lower eyelid surgery.  You have ectropions, or eversion of the lower lid margins.   Keep your eyes lubricated and massage the lower lids.  I recommend seeking a surgeon who is experienced with ectropion repair.  

Raj P. TerKonda, MD, FACS
Beverly Hills Facial Plastic Surgeon

Post Blepharoplasty Ectropion

Hi there. Greetings from the UK! You've developed lower lid ectropion. Although many ectropions following lower blepharoplasty are temporary and are due to gravitational traction on the eyelid from the increased weight of the swollen skin, some ectropions do remain persistent and can occur due to over aggressive skin excision by the surgeon coupled with failing to recognise and tighten any horizontal laxity within the eyelid. The lower lid is important for maintaining a normal tear film against the lower half of the eye and as such you may develop some irritation due to the bottom half of your ocular surface drying out. Frequent lubrication is therefore important often with an ointment based viscous lubricant. Some surgeons do advocate upward massage to try and stretch the skin upwards. It's often just a question of observing to see what happens long term. Most surgeons wouldn't advocate revisional surgery until the swelling has all resolved. I'd definitely recommend seeing an ophthalmologist if your surgeon wasn't an oculoplastic surgeon as you need to be monitored for corneal damage due to dessication. Similarly if your ectropion remains persistent then I'd also recommend you consult an oculoplastic surgeon. Best Wishes. David

David Cheung, MBChB, Bsc(Hons), FRCOphth
Birmingham Oculoplastic Surgeon

Lower eyelid swelling

The pulled down eyelid (ectropion) you have since the surgery is may be  due to the loss of elasticity of the lid with the aged eyelid and the surgical swelling of the lower lid.  This ectropion can also be due to scar tissue developing after the the re-positioning of the protruding fat.  Depending on the clinical evaluation there are appropriate methods to correct the problem. 

The biggest immediate issue is the excessive exposure of the eye becoming dry and the cornea becoming damaged.  By your description, your ophthalmologist is treating you for that.

Your Plastic Surgeon or surgeons experienced correcting ectropion can evaluate and give you recommendations.

David M. Creech, MD
Chandler Plastic Surgeon
5.0 out of 5 stars 7 reviews

Painful

I can see your eyes must be painful and dry. Lower lid retraction is a common side effect early after eyelid surgery. 

My advice is to massage the scars up and out to try and encourage the lid to meet back up to the eye. 

Some fine surgical tape can also be used by your surgeon to try and return the lids to their natural position. 

Occasionally this problem can persist though and even require a second smaller operation. Keep in contact with your surgeon weekly and see how things go.

Hope that helps. 

Adam Goodwin

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.