What causes rounded corners and retraction after a lower bleph with an inside incision?

I am sorry to hear about your problem. Lower eyelid traction and rounding is due to scar tissue that developed as part of the healing process. Using an internal conjuctival incision minimizes the risk of complication of lower eyelid retraction but doesn’t completely eliminate it. Retraction can improve up to a year, but if it is still significant at 6 months revisional surgery will probably be necessary

Hello! I'm sorry you're having trouble with your lower eyelid surgery results. It sounds like you're experiencing ectropion. This is when the lid moves away from the globe and can cause dryness and deformity of the lid. It can occur when the supporting mechanisms of the lower eyelid become damaged during the procedure. Aging increases the risk of this occurring as the tendons are already weakened. It is a risk with any lower eyelid procedure but does need to be addressed so permanent issues with the eye don't occur. It's often a relatively easy fix. I would seek consultation with another surgeon if you feel like you're not being taken seriously. I hope you find resolution soon!

Deformity that you discribe is occasionally seen after any type of lower blepharoplasty, including transconjuctival. Bowing of the lower lid rim is due to swelling and scar formation; massage with stretching of eyelids is something that should be started immediately after surgery. It may help in this stage if proprly done. Wait at least 12 months before considering revision unless deformity is significant. Second opinion, in person consultation, with a board certified plastic or oculoplastic surgeon, with good reputation in eyelid surgery, is recommended. Good luck.

Pictures would be helpful because this is an unusual occurrence for a transconjunctival blepharoplasty. Also it would be useful to know if you had any adverse post op events in your recovery. Also was a skin pinch incision done as well? At this point, you could go on consultations for revision surgery.

Scarring in the lower eyelid can cause lower lid retraction after blepharoplasty. A rounded outer corner with the lid pulling away (ectropion) can result from failure to address lower lid laxity during the operation. You need to see an ASOPRS affiliated Oculoplastic surgeon for an in person exam and consultation to properly evaluate your lids and offer a customized treatment plan.

Hi Katy,
Sorry to hear that you are not thrilled with your outcome. Given that there are no photos it’s tough to say what the real issue is but by your description it sounds like there isn’t much support of your lateral canthus. This would give a “rounding out” look to the lateral part of your eye and could also allow the lid to migrate away from the globe creating that “space” you mention. What can be done about it? That is unfortunate that the original surgeon is not responsive to your concerns. My best advice is to seek a board certified plastic surgeon or oculoplastic surgeon that may offer a revision using likely what is called a canthoplasty or tightening/repositioning of that lateral canthal support system. Again, it is hard to say without photos and actually examining your eyes but this is my best guess based off your description. Good luck and seek out a second opinion :)