2 months post-op lower eyelids: Still have chemosis and ectropian and I feel something In my eyes when closed. (photo)

Question

I think I have ectropian,chemosis after surgery.I used steroid drops for ten days,artificial tears day time,lubricant eye gel or ointment bed time.I massage upward then outward everyday.No improvements, with disappointments it turned out fat granule and wrinkles.Eye shape is no longer oval.The doctor stated they were caused by swelling and It took time to heal.Will the chemosis finally go away and the eyelids go back to the proper position by itself after another two months?Please help!Thanks.

John J. Martin, Jr., MD · Answer

This is not a great picture for us to see what is happening.  It looks like you have something called conjunctivochalasis as opposed to chemosis.  This is redundant conjunctiva where the excess conj sits on the lower lid margin.  This can cause irritation and make it feel like you have something in your eye.  Chemosis would have aggravated this and there may still be some swelling in this area.  It may improve on its' own.  Keep it well lubricated as you have been doing.  If it does not go away there are some small procedures which can help with this.  See on oculoplastic surgeon for advice if it persists. It doesn't look like you have ectropion.

Mehryar (Ray) Taban, MD, FACS · Answer

You need personal consultation. Best to discuss with your surgeon or see an oculoplastic specialist. See following link too. There are various treatments for prolonged chemosis.

R. Scott Yarish, MD · Answer

This is not infrequent in lower lit surgery although 2 months is getting a little long. I don't see any evidence of infection or severe irritation.  If you've been off the steroid drops for at least a couple weeks, I would request another round.  Your are doing all the right things with the drops, lubricant, and massage.  Give it another month and if your doctor has not other solution, seek a second opinion from an oculoplastic surgeon.  There is a small possibility that your left lower lid will require tightening.

Bradford S. Patt, MD · Answer

Certainly lower eyelid surgery can have a longer recovery period than expected. I am not sure if you are a smoker, but if you are prolonged chemosis after eyelid surgery is common.  As long as you are slowly improving the chemosis should resolve; occasionally a fluid pocket develops in the conjunctive that can be drained to improve the situation but I cannot tell from your photos if that is present in your case.  I do not see any ectropion on the photo you have presented. I would continue to work with your surgeon and if you truly feel he is not answering your questions seek a second opinion from a board certified facial plastic or oculoplastic surgeon.  Good luck.

Earl E. Ferguson III, MD, FACS · Answer

Although you do have some residual swelling around the eyes, it is not outside of the range of normal at this stage.  You are doing the right things with the ointment application and massage.  Keep at it and you will end up with a nice result, but be patient.  It may take a few more months.

John Dean, MD · Answer

Your photos don't show any significant chemosis nor ectropion but additional views may do so.  I would think that your eyelids would continue to improve as you don't demonstrate any severe problems.  I think that the massage that you are doing will also be very helpful.

2 months post-op lower eyelids: Still have chemosis and ectropian and I feel something In my eyes when closed. (photo)

Answers (6)

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