I had lower bleph and too much fat was removed, so the left lower eyelid hangs 1 mm too low with scleral show. I went through 2 failed canthopexy revisions with my PS to attempt to tighten the eyelid. Then I went to an oculoplastic surgeon who performed another canthopexy and said I didn’t need a graft, but this didn’t work. Tightening won’t raise the lower eyelid, as it does not have enough fat to support it. Taping it hasn’t helped. Should I try AlloDerm, fat graft, or Restylane?
Answer: A well performed Injectable Filler treatment may be employed to restore lower eyelid volume after lower blepharoplasty surgery.
I read your concerns and reviewed your photos. You look better than you think. Your "scleral show" on your left is barely perceptible. And your lower lids do not have a hollow, operated appearance. If I had to guess, you're either using Latisse, or you're blessed with long, thick eyelashes. I don't think you should consider any further eyelid surgery.
You appear to have typical lower eyelid grooves which could be improved by a well performed Injectable Filler treatment. You should make sure your physician is experienced in the delicate art of filling lower eyelids. My personal preference is to use Silikon-1000, an off-label filler, for permanent results.
I hope this is helpful for you.
Helpful 5 people found this helpful
Answer: A well performed Injectable Filler treatment may be employed to restore lower eyelid volume after lower blepharoplasty surgery.
I read your concerns and reviewed your photos. You look better than you think. Your "scleral show" on your left is barely perceptible. And your lower lids do not have a hollow, operated appearance. If I had to guess, you're either using Latisse, or you're blessed with long, thick eyelashes. I don't think you should consider any further eyelid surgery.
You appear to have typical lower eyelid grooves which could be improved by a well performed Injectable Filler treatment. You should make sure your physician is experienced in the delicate art of filling lower eyelids. My personal preference is to use Silikon-1000, an off-label filler, for permanent results.
I hope this is helpful for you.
Helpful 5 people found this helpful
Answer: Not bad... less is more
When you are smiling in the right-most photo the scleral show is not visible. In the photos on the left, there is about 1mm of scleral show. You could try gentle upward massage of the lower eyelid to try to lengthen the tissues. I would recommend conservative Restylane in the periocular hollows to revolumize and Botox for dynamic wrinkles by an Oculoplastic surgeon or someone experienced with injectables in this area. I would only use a hyaluronic acid based filler, not a permanent filler, because you can reverse it if needed. No surgery is indicated at this point. Less is more.
Helpful 1 person found this helpful
Answer: Not bad... less is more
When you are smiling in the right-most photo the scleral show is not visible. In the photos on the left, there is about 1mm of scleral show. You could try gentle upward massage of the lower eyelid to try to lengthen the tissues. I would recommend conservative Restylane in the periocular hollows to revolumize and Botox for dynamic wrinkles by an Oculoplastic surgeon or someone experienced with injectables in this area. I would only use a hyaluronic acid based filler, not a permanent filler, because you can reverse it if needed. No surgery is indicated at this point. Less is more.
Helpful 1 person found this helpful
February 10, 2011
Answer: Loosening the orbicularis with fat grafting can raise the lid
Based on some studies with trans malar repositioning of the orbicularis we notice improvement in lower lid position with a "undermining" of the orbicularis occulis during a microfat grafting procedures. This will release the attachments of the lid and allow it to be raised by inflation. This works well in patients with more scleral show than you manifest. I agree canthoplasty surgery will probably not be high on the list of choices.
Helpful
February 10, 2011
Answer: Loosening the orbicularis with fat grafting can raise the lid
Based on some studies with trans malar repositioning of the orbicularis we notice improvement in lower lid position with a "undermining" of the orbicularis occulis during a microfat grafting procedures. This will release the attachments of the lid and allow it to be raised by inflation. This works well in patients with more scleral show than you manifest. I agree canthoplasty surgery will probably not be high on the list of choices.
Helpful
September 13, 2017
Answer: Lower lid problem
You made a couple of comments that require some clarification for other readers.
1. Putting fat back into the lid will not make a malpositioned lower lid go back up.
2. Lid malposition & scleral show is not caused by taking the fat out. It is caused by a shortening (usually from scar) of one of the 3 layers ("lamella") of the lower lid.
Correction of this problem gets complicated and technical- more than this forum can do. Your photos actually look pretty good - I don't see any scleral show in them. At this point, consider just a little HA in the lid - but avoid further surgery unless there is a really good indication.
All the best,
Helpful 1 person found this helpful
September 13, 2017
Answer: Lower lid problem
You made a couple of comments that require some clarification for other readers.
1. Putting fat back into the lid will not make a malpositioned lower lid go back up.
2. Lid malposition & scleral show is not caused by taking the fat out. It is caused by a shortening (usually from scar) of one of the 3 layers ("lamella") of the lower lid.
Correction of this problem gets complicated and technical- more than this forum can do. Your photos actually look pretty good - I don't see any scleral show in them. At this point, consider just a little HA in the lid - but avoid further surgery unless there is a really good indication.
All the best,
Helpful 1 person found this helpful
February 7, 2011
Answer: Too much eyelid surgery
First of all, I agree that you should not have another surgical procedure. If anything, have an HA (Resytlane or Juvederm) injected - and only small amounts. Second of all, it is impossible to evaluate your before and after since you are unanimated in the before pictures and smiling in the after pictures. When you smile, your cheek is naturally going to raise and cause some wrinkling in your lower lids.
Good Luck.
Helpful
February 7, 2011
Answer: Too much eyelid surgery
First of all, I agree that you should not have another surgical procedure. If anything, have an HA (Resytlane or Juvederm) injected - and only small amounts. Second of all, it is impossible to evaluate your before and after since you are unanimated in the before pictures and smiling in the after pictures. When you smile, your cheek is naturally going to raise and cause some wrinkling in your lower lids.
Good Luck.
Helpful