Correction of scleral show/ dropping lower eyelids, Surgery or fillers? (photos)

Question

I am 24 years young and I have a inherited scleral show. Furthermore I've been battling with dry and irritated eyes for several years now, maybe caused by the dropping corners of my eyes. I've read a lot about of surgerys like canthopexy and hyaluronic fillers, which can allegedly fix scleral show. Could you please give me any advise on how to improve it, what steps I should take further? I'm so dissatisfied, when I look into the mirror! Any answer is much appreciated! Thanks!

Mehryar (Ray) Taban, MD, FACS · Answer

Please see link below for more details on possibly obtaining more almond shape eyes. You do have inherited lower eyelid retraction with sclera show. The exact treatment depends on many factors including eyeball position, lower eyelid position, lower eyelid laxity, etc.

Sheila S. Nazarian, MD · Answer

First, see your eye doctor about your dry eyes if you haven't already. Then, schedule a consultation with a board certified plastic surgeon or oculoplastic surgeon to discuss canthoplasty surgery. My best,
Dr. Sheila Nazarian
@drsheilanazarian on Instagram

Kenneth D. Steinsapir, MD · Answer

Fillers are used to push up the lower eyelid.  The effect is modest but it can be removed or modified if needed after the service so that is important.  Lateral canthal surgery shortens the lower eyelid.  Eyelids do not defy the laws of physics.  Shortening the eyelid does not magically raise the lower eyelid.  That shortened eyelid will ride under the curvature of the eye and end up at a lower position.  The only way to modify the lower eyelid position is to change the relationship between the eye and the orbital rim.  A rim implant can do that and so can a cosmetic orbital decompression.

James R. Gordon, MD, FACS, FAAO · Answer

Thank you for sharing your problem. Sorry to hear of the grief it is giving you. Make sure to lubricate your eyes with artificial tears and see an Oculoplastic Surgeon in person. There might be a couple of surgical options available to treat your issues and an eyelid specialist will be able to give you proper guidance. Good luck,

Robert S. Schmidt, MD · Answer

Thanks for your question. In my experience, fillers won't really correct scleral show. A canthopexy or canthoplasty may help. These surgeries elevate and re-suspend your lower lid. If you're having dry eye that isn't responding to medical therapy- visit with an ophthalmologist first- then it would be appropriate to explore canthoplasty surgery. Good luck!

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