Eyelid Surgery to Correct Protruding Lacrimal Gland?

My upper eyelids are laxed and lacrimal gland is presently showing. I haven't gotten the surgery yet. I'm just trying to get a little insight on it before I decide to go through with it.

I'm going to be seen by one of the top oculoplastic surgeons in New Jersey. I'm still a little frightened. Any suggestions on what I should do?

I'm 21 and I hate to be called names cause of the excess skin and lacrimal gland that protrudes out the side of my eyes. I want a better appearance but I'm scared it may not work how I want it to

Doctor Answers 17

Lacrimal gland resection

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If you are seeing an oculoplastic surgeon then he is likely very well qualified to know the indications for the removal of your skin, and potentially resuspending your lacrimal gland. Honestly, I would only go to a diplomate of the American Board of Plastic Surgery or an Oculoplastic surgeon. It is the simplest thing to suspend but over a period of a few years, the difficult thing is for it to stay. Although placing a suture on the inner surface of the orbit is very, very simple, the gland's tendency is for it to drop. Sometimes, the gland can be partially transected IF it's the problem.

As stated earlier, the skin must be opened first then he'll need to dissect through the orbicularis muscle to see what's inside. It kind of looks like you have prominent eyes, if that's the case then you may have somewhat dry eyes - that all needs to be evaluated and your oculoplastic surgeon has likely already taken all of this into consideration.

Best Wishes,


Dallas Plastic Surgeon
4.9 out of 5 stars 125 reviews

Not so fast with eyelid surgery for lacrimal gland prolapse

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Dear Gaps

It would be very unusual for someone who is 21 to have lacrimal gland prolapse. Also you have abnormal upper eyelid creases in the area of eyelid fullness. I think before you have yourself ready to go for cosmetic eyelid surgery, someone needs to figure out why you lacrimal glands are enlarged. There are a few causes and you need to have the eyelid surgery work you up for conditions like Sarcoid and a few others.

It might be appropriate to obtain a CT scan to determine how large the glands are and other features of the gland. A biopsy of one of the glands may also be appropriate before settling on an eyelid treatment. Once the cause has been determined and any appropriate treatment has been undertaken then it might be reasonable to surgically address any remaining issues. However, an appropriate work up is what should be done first.

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

Eyelid surgery for protruding lacrimal gland very straightforward

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I would say that a ptotic lacrimal gland is not that common and is not a typical feature that is corrected in upper blepharoplasty. When it is present, however, it is not difficult for the surgeon to tuck the gland under the boney rim of the eye socket while doing an upper blepharoplasty. Facial plastic surgeons, plastic surgeons and oculoplastic surgeons can all perform this procedure.

Good luck,

Dr. Ahn

Min S. Ahn, MD, FACS
Westborough Facial Plastic Surgeon
4.6 out of 5 stars 35 reviews

Protruding lacrimal gland needs to be evaluated

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First off, a protruding lacrimal gland is something that needs to be evaluated. Enlargement of the lacrimal gland can be caused by inflammatory diseases such as sarcoidosis, sjogrens disease, wegener's disease or even some type of blood disorders. I would not go ahead and get this fixed until those are evaluated.

Chris Thiagarajah, MD
Denver Oculoplastic Surgeon

Check credentials and trust your gut

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Thanks for the photo. It sounds like you have done a good job in selecting a surgeon with the qualifications to address your problem. I would recommend that you revisit with your oculoplastic surgeon and ask any additional questions, have him/her review the procedure and discuss his/her experience with the procedure. Once you have reached a comfort level with that surgeon's qualification and the manner that he/she will handle your issue it is okay to proceed. It is very normal to be a bit nervous before surgery.

I hope this is helpful.

Upper Eyelid Fullness

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Lateral upper eyelid fullness can really only be caused by two things. First, the lacrimal gland can descend from under the orbital rim. Second, certain people can get a significant amount. of ROOF (retro obicularis oculi fat). It's often a very find line in diagnosing the difference between the two. Some times you can fell the lacrimal gland but often there is a combination of the two.

The only real way to diagnose the situation is at the time of surgery. Either way if the gland had descended it is resutured up under the orbital rim. If it's ROOF fat this is also easily removed.

Don't worry, if you have faith in your surgeon and he knows how to handle each of these situations you'll be fine.

Are the lacimal glands normal but prolapsed or are they too large?

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Your photographs clearly illustrate a swelling in the region of the lacrimal glands of both eyes. This could be on the basis of prolapse of the lacrimal gland from its normal anatomical position. Alternatively, this may represent enlarged lacrimal glands due to inflammatory disease or otherwise.

In our practice, we generally recommend a CAT scan to evaluate whether the lacrimal gland abnormal contour is due to malposition or rather perhaps lacrimal gland enlargement. If the swelling is due to malposition of the glands, standard procedures are available to reposition the glands and are commonly done by members of the American Society of Oculoplastic and Reconstructive Surgery.

On evaluation of your photographs, I see no reason why you should not anticipate an excellent result from your surgery.

J. Timothy Heffernan, MD
Seattle Oculoplastic Surgeon
4.6 out of 5 stars 12 reviews

Correcting the upper eyelid

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From your photos and you story, it sounds as if you have a great plan. Elective surgery is always a little anxiety provoking, but by tacking the lacrimal gland back against the orbit, you will find that your upper lids will look much improved and I bet you will be very pleased. The upper lid incision is very well tolerated and aside from a little swelling, your postoperative recovery should be relatively quick.

Lacrimal ptosis

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It sounds like you are in good hands with your choice of surgeons. Fixing a ptotic or drooping lacrimal gland is a relatively easy undertaking. Relax and enjoy your new look after surgery. 

Sounds like you made a good choice

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Your worries are normal, however this condition is something that is readily correctible. The surgery can be performed under local anesthetic alone, like going to the dentist. Or you can have intravenous sedation using drugs like Valium to put you more at ease during the surgery. Your eyes will be closed during the surgery, but you will be able to open them when asked. Good luck!

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.