Eye won't close after upper blepharoplasty. Will it eventually close all the way? (Photo)

Question

I had the upper blepharoplasty surgery 1 week ago. When I close my eyes or am sleeping, my eyes, especially the left side is not closing all the way! Will it eventually close all the way? They are also watering a lot while I am asleep.

John J. Martin, Jr., MD · Answer

You have a small amount of incomplete closure.  This occurs quite commonly after upper eyelid surgery, and as the swelling resolves, the lid should start to close better. The nerve sometimes is also affected from the edema, and this will improve with time.  Use a lot of artificial tears during the day, and put some ointment in at bedtime.  If you are still feeling dry you can get a protective shield to wear at bedtime.  With any dryness after surgery patients will experience excess tearing.  This will improve as the blink improves.

Earl Stephenson, Jr., MD, DDS, MBA · Answer

Thank you for your picture. Since you are only one week after surgery your eyelids close you should approve over the ensuing weeks. In the meantime to protect the globe of your eyes I would recommend placing ointment between the eyelids and taping eyelids closed at night while sleeping. This Will prevent dry of the globe of your eyes and possible ulcerations.

Kenneth D. Steinsapir, MD · Answer

You are in trouble now.  The upper eyelid is unable to close due to a motor nerve weakness in the orbicularis oculi platform muscle.  That partly accounts for why you are having trouble close the eye.  This actually occurs very commonly after blepharoplasty but is very common after aggressive upper eyelid surgery.  What we don't know since you are only 1 week out from surgery is how much recovery are you likely to experience in this eyelid as you heal.  I am concerned about the corneal exposure you are having.  You need aggressive lubrication for the ocular surface. If your surgery was performed by a general plastic surgeon or a facial plastic surgeon, they lack the equipment, training and skill to manage post blepharoplasty dry eye.  I encourage you to be assessed by your general ophthalmologist or if necessary, and oculoplastic surgeon.  You need to follow up with your surgeon but I think you are going to need more help to keep the eyes comfortable while you heal.  Please keep us posted about your progress.

Scott W. Vann, MD, FACS · Answer

One week is very early to tell about the final outcome. Let your surgeon know of you issues especially your sleeping problem. They may have you use an ointment or eye patch to protect your eyes till the lids are working better. Once you are allowed to massage your lids you should see some improvement. Follow up closely with your surgeon until healing complete. Good luck.

Remus Repta, MD · Answer

Eyelids are delicate structures and very small forces from skin removal and/or swelling can impact their function.  I suspect that you will see an improvement or complete resolution of the issues with time since it is only one week after your surgery.  Discuss this with your plastic surgeon as he/she may recommend massage to help the process.All the best,Dr. Remus Repta

Suzanne Kim Doud Galli, MD, PhD, FACS · Answer

It is possible the postoperative swelling is preventing complete closure of the eye. It is important for you to protect your eye during this period with lubricating drops and taping them shut during sleep. Please see your surgeon!

John R. Burroughs, MD · Answer

Your photo shows plenty of skin, so as your eyelid muscle strength returns it should close.  Use eye ointment at night and drops during day.  Let your surgeon know your concerned, but I think it will begin to close well within a few weeks to a few months.  Best regards.

Darryl J. Blinski, MD · Answer

ONLY 1 week!!! If still can not close at 3 months than seek possible treatment. But way to early NOW!

Eye won't close after upper blepharoplasty. Will it eventually close all the way? (Photo)

Answers (8)

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