One Eye Won't Close 19 Days Post Op Upper Blepharoplasty? (photo)

I had an upper bleph 19 days ago, and one eye is healing quite well. The other eye has not closed since the day of surgery. There is approximately 2-3mm of scleral show from the middle to the inner corner of my eye, watery, dry, and feels irritated. Already taking all lubrication measures. I know it is early, but since swelling is nearly gone, can you tell from this photo whether too much skin was excised? What other reason could there be for this problem in only one eye?

Doctor Answers 8

Excessive Skin Removal after Upper Eyelid Surgery?

    Although the upper eyelid does appear short, you are early in the postoperative course and conservative measures should be the mainstay of treatment at this point.  Massage and natural skin relaxation with resolution of swelling may provide resolution of the problem.  Obviously, an exam would be mandatory and close followup, prudent.

Los Angeles Plastic Surgeon
4.9 out of 5 stars 492 reviews

Post Blepharoplasty with Scleral Show

I would suggest frequent follow up appointments with your surgeon to discuss your concerns and options for maximizing your healing.  This may possibly heal on it's own over time or may require secondary surgical measures. Your surgeon should discuss eye exercises, massage and eye care to help you in this interim recovery phase.Tear duct plugs may also be used to help if the dryness starts causing further irritation. I wish you a quick recovery and hopefully this will resolve itself. Best regards, Michael V. Elam, M.D.

Michael Elam, MD
Orange County Facial Plastic Surgeon
5.0 out of 5 stars 208 reviews

Inability to close eyes after blepharoplasty

is certainly a concern and I hope you have spoken to your doctor about it and can beter evaluate his/her answer to you after reading these posts.  Though scarring can theoretically lead to such problems, the more obvioius concerns would focus on the amount of skin excised.  Your doctor should be able to help guide you through massages that may help stretch your lid while allowing the healing to occur but if you are unable to close your lids, you will need another procedure to correct that, depending on what the etiology of your problem is.  And if you lose confidence in your surgeon, seek a second opinion.

Curtis Wong, MD
Redding Plastic Surgeon
4.8 out of 5 stars 33 reviews

One Eye Won't Close 19 Days Post Op Upper Blepharoplasty? (photo)

This type of evaluation has to be done in person.  Often times, eyelids heal asymmetrically, so this may not necessarily be a problem.  However, as others have suggested, scarring and deficient skin may also be contributing factors.  The best person to evaluate this is your surgeon.  If you are not happy with his/her answer, you are certainly entitled to get another opinion.

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

Upper eyelid post-surgery issue

Usually scleral show can happen during the early post-op often due to swelling. Sometimes it is due to scarring or too much skin excision. Follow closely with your surgeon.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 28 reviews

Asymmetry in healing following an upper eyelid blepharoplasty

The first stage of wound healing is contracture.  This may be accounting for the differences from one side to another.  Another cause could be over resection of skin on the right side but looking at your photograph this does not appear to be the problem.  I would continue to massage your lid and use the eye drops to prevent corneal abrasion.   You  may even consider taping the eye closed at night.  I would expect you to show progress by  6-8 weeks  post op.  If this persists it is possible that you would need a skin graft but I think your scar matures and settles down you eye will close normally.  Healing is a continuum and it is not symmetric, it is not unusual for one side to do better than the other especially during the early healing period.   If it persists after 3 months then you may need additional surgery but again I think it is unlikely.  If you desire you may seek a second opinion.   

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 19 reviews

Eye won't close after eyelid surgery?

It is common that the eyes don't close all the way after eyelid surgery. This usually lasts a few days or a week. If it has been this way for a prolonged period of time, it may be the result of too much skin removed. You should be evaluated by your surgeon, or another surgeon for this.  This can be a difficult thing to correct and may require addition of skin with a skin graft.

Matthew Schulman, MD
New York Plastic Surgeon
4.9 out of 5 stars 324 reviews

It is not a matter of skin.

The reason why the eyes do not close is damage to the motor nerves that supply the orbicularis oculi muscle on the tarsal platform.  It is so very common for these nerves to be weakened by eyelid surgery.  Some recovery is to be expected.  How much recovery cannot be predicted.  What has not recovered by 6 months general will not return.  Use of artificial tears and ointment is very helpful.  You might consider seeing an oculoplastic surgeon or a cornea specialist for help making the eyes comfortable while you heal. 

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

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.