Retraction of eyelid after ptosis repair
usually adjustment can indeed be made in this time frame with simple massage that MUST be guided and monitored by the surgeon who performed the procedure. With the minimal difference your surgeon should be able to guide you with single finger traction excercise that will help adjust the repair without damaging it. Consult with your original surgeon.
All the best,
Rian A. Maercks M.D.
Lid retraction surgery at two months
Lagophthalmus or eyelid retraction is most commonly caused by thyroid problems including Graves Disease or due to traumatic scarring. Partial Mullers muscle resection is commonly performed to relax a scarred and spasmed Mueller's Muscle as seen with Graves. Further lid positioning can then be performed with a levator lengthening procedure, which seems to be your circumstance. Maximum scar retraction occurs at about 6 weeks post-op and can continue if unabated for many more weeks. Scar massage and squinting exercises can help to release the retraction. A 2mm discrepancy is within the tolerance of the surgery at 2 months and will probably not require revision.
Eyelid Asymmetry after Upper Eyelid Ptosis Repair
Facial or eyelid asymmetry is common in nature and a potential outcome with any plastic surgery. 1mm difference is "within normal limits" for many eyelid surgeons, as it's impossible to gaurantee perfect symmetry. Two months may still be relatively early after your revision procedure. Speak with your eyelid surgeon to help determinen appropriate options for you. Best of luck.
Asymmetry After Ptosis Surgery
At 2 months since surgery, seeing a small degree of fluctuation in the eyelid position is not unusual.
With a 1mm- to 1.5mm difference between the left and right eyelids, you are probably best advised to allow more time before deciding on further surgery, as that difference is within the range most surgeons would accept for a final result.
Discuss with your surgeon; some may advise massage to reduce the retraction.
Correction of eyelid retraction
I'm assuming that your eyelid retraction is thought to be due to the most common cause of eyelid retraction, Grave's ophthalmopathy or thyroid eye disease. This can be a difficult problem but with persistence (and sometimes multiple surgical procedures) the lids can usually be adjusted to near perfect symmetry. First of all, surgical intervention should not be attempted until the eyelid levels are stable from visit to visit. There are a variety of procedures that can be employed, and need for revision and adjustment is very common. Post operative massage by the patient is also necessary to titrate the result. To answer your specific question, lid retraction is unlikely to correct itself but eyelid massage in the desired correction may help.
Retraction after eyelid surgery
It is unlikely that both of your eyelids will ever be perfectly symmetric as even without surgery, most eyelids have 1-2 mm of asymmetry. It sounds like you have a good result but your surgeon may be able to better evaluate if steroid injections or massage can help relax your eyelid.
It is more likely that it will retract more rather than relax. That is the usual nature of healing/scarring with contracture from any surgery. Recommend seeing your surgeon and/or an oculoplastic surgeon.
Eyelid retraction surgery
Eyelid retraction surgery can be quite unpredictable, much more so than ptosis surgery [ the opposite situation which you are correcting a droopy eyelid].
In the early post operative period, sometimes active stretching of the eyelid maybe helpful, but at this point, I tend to agree with Dr. McCracken, that you may be at your final state. Your result seems to be reasonable, and sometimes "better" is the enemy of "good".
Two months is still fairly early in the healing process, and there is room for improvement. You can certainly try massaging the eyelid downwards at this stage. Getting the eyelids within 1 millimeter is an optimal result, and it may be that even if you are left with a slight asymmetry, further procedures would be ill-advised because your asymmetry falls within the margin of error inherent to the procedure. I would advise careful follow-up with your surgeon to monitor your progress.
I think it is unlikely that you will see much change in your eyelid position given that you are 2 months out from surgery. My goal in eyelid surgery is to have the eyelids within 1 mm of each other, so if you range from 1 - 1.5 mm of asymmetry, this is quite small and may not warrant further surgery. I recommend that you discuss your concerns with your surgeon.