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

    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.

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.

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. 

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.

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.

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.

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.   

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.