Lower Eyelid Pulling Away from Eye After Lower Bleph/mid-face Lift

I'm 3wks postop & have been massaging & streching the tissue to correct this, but am wondering if I'm doing this correctly. What is the best technique & when should I see results from doing this? Thank you for your time & help.

Doctor Answers 4

You need to discuss this with your surgeon

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You have ectropin that can be secondary to the conjunctival swelling or secondary to the excess skin excision. You should have your surgeon show you the correct message therapy . You also may need to have canthoplasty if starting to get dry eye.  Surgical treatment is the last option.

New Orleans Plastic Surgeon
4.8 out of 5 stars 154 reviews

Lower eyelid pulling away after surgery - discuss with your surgeon

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Although I don't know the details of your case, the combination of midface lift and lower bleph is known to have a higher probability for ectropion which is the eyelid pulling away. Most often it gets better with time but you should definitely be discussing it with your surgeon.

Richard Baxter, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 59 reviews

OK, you are basically in trouble here.

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What you need to make sure is that your surgeon is open and honest with you.  They should be following you closely.  There is no precisely right way to massage the lower eyelid because this physical therapy can't and does not fix all of these problems.  This lower eyelid midface combination has an extremely high rate of this type of complication.  When it occurs, it is usually a combination of nerve damage, too much scaring, and not enough skin left in the lower eyelid.  

Occasionally, early steroid or 5FU injections can help the situation.  Massage can also help.  It is important to understand that just because you are having this problem, it does not mean that your surgeon is a bad surgeon or did something wrong. Typically I recommend letting the eyelid heal and repairing the situation about 6-12 months later.  I will violate this if I feel there is a compelling reason to do surgery earlier.  Work with your surgeon and consider asking for a second opinion if things are not improving.  Time is on your side.

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

Lower lid pulling away

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Not a terribly uncommon phenom. Although more info is needed. If you are only a few days to a week or two out from your surgery, this could be fine. I absolutely have all my lower bleph patients excercise their lower lids to keep them from contracting. The other remarks that my colleagues have made are excellent. Be sure to have close f/u with your surgeon. Long term depending on degree of ectropion, it can be an issue.

Clayton L. Moliver, MD
Houston Plastic Surgeon
4.4 out of 5 stars 36 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.