Will Eyelid Shape from Lower Lid Surgery Retrun to Normal Without More Surgical Intervention? (photo)

I recently had a lower lid lift along with a MACS lift. I had quite a bit of swelling in both eyes with a blister type growth appearing in the right eye. My surgeon is out of state but he did arrange for me to see another plastic surgeon in Florida who recommended I do upward massage. The pictures are at 5 weeks post op. Can I expect more improvement with upward massage or will further surgical intervention be needed to correct this? If so, what would be most recommended?

Doctor Answers 7

Will lower eyelids return to normal after surgery?

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The tightness of your lower eyelids may improve further. I agree that frequent upwards massage of the lids will help and is definitely what you should be doing now. If I were you, I would continue this treatment for another couple of months with frequent check-ups by your surgeon. As long as you see any progress do not give up - continue the massage. If the lids have not corrected sufficiently by 6 months from now, then a revision will be required. A surgeon with cranio-facial experience will be your best bet.

Diana L. Elias MD


Saint Petersburg Plastic Surgeon
4.7 out of 5 stars 26 reviews

Will Eyelid Shape from Lower Lid Surgery Retrun to Normal Without More Surgical Intervention?

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It looks like you have scarring that is pulling your eyelid down.  Often, it improves, but I doubt it will return to its pre-operative state.  The best thing to do is see an Oculoplastic surgeon soon to see if there is anything that can be done now to help.  Surgical revision usualyy is performed after 6 months.

Sam Goldberger, MD
Beverly Hills Oculoplastic Surgeon

Lower eyelid surgery complication

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It looks as if you have what is called a cicatricial ectropion of your left lower eyelid.  Try hourly upward eyelid massages (20 times an hour) along with hourly eyelid exercises (20-30 forced eyelid closures) every hour.  It looks like you may need to have the eyelid raised with another procedure, but start doing the above hourly and it may loosen things up. Good luck.

Richard Weiss, MD
Newport Beach Oculoplastic Surgeon
5.0 out of 5 stars 5 reviews

Why upward massage will not likely return the eyelids to its original position, but they can still be corrected through surgery

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As a specialist in eyelid surgery and face lifting surgery, the typical situation that I come across with someone who had their eyelids pulled in that direction is that within several months after the surgery, even with aggressive massaging or steroid injections, the eyelid will not generally return to its original position.

A MACS lift is essentially a shorter scar face lifting procedure where a lot of aggressive lifting of the cheek area is performed. When so much cheek skin is recruited, skin has to be removed because it bunches up around the eye and the cheek. When it descends eventually descends, it causes the pulling of the lower eyelid and there’s a shortage of tissue to support the lower eyelid.

As a conservative measure, I agree that massage is the first step to help to soften scar tissue so that there’s tissue remodeling and the eyelid comes up as much as possible. Patients who are not fully satisfied about how much their eyelid got higher even with massage typically need some type of revision surgery such as canthoplasty or canthopexy so the lower eyelid is reattached to the bone. Grafting procedures such as the placement of an Enduragen graft or a middle lamella graft may also be done.

There are two key elements to understand: one is that eyelid position is critically important for eye function - the eyelids need to be in a position where the tears are able to distribute properly because when the eyelids are going on a downward slant, the tears cannot be distributed as effectively as when they are on a better position; the second part is that the eyelids need to look good - anatomically, if the eyelids are in a good position, they will look better and protect the eye to ensure the health and integrity of the eye.  I hope that was helpful, and thank you for your question.

Amiya Prasad, MD
New York Oculoplastic Surgeon
4.4 out of 5 stars 80 reviews

Will Eyelid Shape from Lower Lid Surgery Return to Normal Without More Surgical Intervention?

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   Massage, nighttime taping, and active closure are all conservative measures that can be utilized in the early postoperative period.  Adequate lubrication is important as well to prevent dryness.  Kenneth Hughes, MD Los Angeles, CA

Lower eyelid surgery complication

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The problem with having surgery far from home is that you do not see the surgeon frequently enough after surgery to address problems that can occur with healing as soon as they appear. You need to go back to the original surgeon and not treat this lightly. Any other surgeon you see will not want to do very much because they will not want to take on the liability.

I do not know exactly what was done or even exactly what the cause of your problem is. If it is due mostly to scar tissue formation after surgery something as simple as putting a suture in the eyelid under local anesthesia and pulling it to break up the scar tissue can solve the problem and save you from having to have corrective surgery down the line. I am not sure anyone but the original surgeon would be willing to do that. You can massage your fingers to the bone but I don't think that will solve the problem. In my experience the massage is better in preventing this problem than it is in treating it. If you wait to long to break up the scar tissue your only option will be more surgery.

I hope you realize that this format of posting questions and receiving answers lacks the face to face direct communication required for you to make an informed decision regarding your surgery.

My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.

Aaron Stone, MD
Los Angeles Plastic Surgeon

Cosmetic Surgery is an Art and a Science

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Your photos are limited so I will do the best I can.Some patients take longer to heal from surgery. It takes a while for the muscles to recharge after surgery especially in the lower lids. You have been given good advice. So follow your surgeons instructions. All the best

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.