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

Question

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?

Kenneth Hughes, MD · Answer

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.

Matthew Schulman, MD · Answer

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.

Kenneth D. Steinsapir, MD · Answer

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.

Curtis Wong, MD · Answer

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.

Sam Goldberger, MD · Answer

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.

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

Answers (8)