One Eye Looks Smaller Than the Other After Ectropion Repair and I Have Impaired Vision when I Look to my Left? (photo)

You analysis is correct.  The left lateral canthal angle is disinserted.  This causes the eye to look smaller.  A lateral canthoplasty not a canthopexy is what you need.  The canthoplasty is an open canthal reconstruction that reattaches the lateral limb of the eyelids to the orbital rim.  The challenge here is that sometimes in correcting the ectroption, the surgeon removed some portion of the lower eyelid margin.  This effectively shortens the lower eyelid permanently.   This makes correcting the position of the outer corner of the eyelids very difficult.  I suspect this is your issue.  Also the surgeon you are referring to is Dr. Lisman and he described modification of earlier ectropion surgeries.  My recommendation is let yourself heal more and do very careful listening before making a decision as to who should attempt to correct the eyelid.

Great photo documentation. Your issues are real but over the internet very hard to give advise in this detailed situation. Best to seek many second opinions in person. I say this because the deforming issue in the photos appears very minor, thus only in person evaluation can demonstrate the issue. 

You should wait. . .another 4 to 6 months.  Time won't hurt you really but premature revision surgery may.

 

You're issue is not that uncommon in ectropion repair even in the very best hands.  

 

This can be revised but give things time to settle.  I would also see a few Oculoplastic surgeons before moving forward.  The surgeon who performed your ectropion repair got the tough job and so have him/her follow you and give them an opportunity to be a part of your care, but again, get a few more opinions.  You need a canthopexy to over and support the corner of the eye.  However, as time passes you may find this bothers you less if at all.

 

Best of luck

Chase Lay, MD