Follow-Up Question: Bad result from lateral canthoplasty. How long should I wait to revise.

Asked a question some days ago regarding lateral canthoplasty. I'm now adding photos. Please advise what should I do now as eyes look/feel "wrong".

Doctor Answers 5

Post-operative canthoplasty

I agree with the other responses. You have swelling (Chemosis). This can be aided with topical steroids, however your eye pressures need to be monitored if steroids are used for any extended period. You need to protect the eye and cornea. This can be done with an eye gel and / or corneal shield while you are asleep. In the day you may consider using saline drops or a gel. It is important your eye does not dry out form exposure. If the cornea becomes overly dry this can be a serious problem.The final results of canthoplasty surgery often takes weeks to months. Post-operative massage is often important after the first week or 2. If a revision is required this should be done after waiting at least 6 months. See your surgeon, review your concerns, and if you want a second opinion see who s/he would suggest.
Best wishes,
Alexander Anzarut, MD

Victoria Plastic Surgeon

I advised you in December 2015 to avoid more surgery with folks who do not know what they are doing.

Please first understand that you are in trouble.  You may not be fixable.  Fixing these types of issues requires resources that are used up by well meaning surgeons who do not understand that lateral canthal surgery can not fix these problems.  You now have a tight, insufficient lower eyelid because these surgeon have been nipping away on your eyelid.  You also have chronic corneal exposure and inflammation.  I strongly recommend getting assessed by a corneal specialist who is only interested in the health of your eye and not their fee for doing more eyelid surgery on you.  It is critical to let things heal.  It is critical to get real second opinions from surgeons who are true experts in fixing the work of other surgeons. A reasonable time frame would be a full year but chronic corneal exposure unresponsive to medical management sometimes forces surgery at a much earlier time frame. Please study my free ebook on eyelid surgery which has a lot of information on what is required to help these issues.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Poor result after cathoplasty

It appears from pictures that you have a condition called chemosis(swelling of the conjunctiva, it looks like a tear but you can't wipe it away) with secondary inflammation on the left worse than right. This is somewhat common after this procedure. I usually treat it with oral and ophthalmic steroids which will help it resolve. Then it can be re-evaluated, hopefully improving the eyelids not needing to revise them. But if not I usually wait at least 3-6 months to do a revision surgery.

Byron A. Long, MD
Marietta Oculoplastic Surgeon
5.0 out of 5 stars 3 reviews

Canthoplasty issues

Dear Anonymous,It's early in the recovery process for you.  From your pictures you still look red and irritated - which is normal in the post-operative period.  Some eyes are more sensitive than others and take longer to settle down.  Does your plastic surgeon have you using any drops or ointment and massage?  The bottom line is it's too early to tell.  I get that you're panicking at the moment because your eyes look so different and red and irritated - but as things settle down the position of the canthus really will change.  (seems hard to believe but trust me).  Even if you're still unhappy after everything settles down (think two months from now) - you won't want to plan any revisions until the swelling and irritation has resolved from the first surgery and you see what the final result is.  It's a tough waiting period, but there's no way around it.Meanwhile - stay in close contact with your plastic surgeon.  Does he/she know you're still red and irritated and unhappy?  There may be some low grade infection causing the redness.  Are you having a lot of discomfort?  He may be able to add some steroid drops to help things along.Best of luck.M. Renee Jespersen MD

M. Renee Jespersen, MD
Arlington Plastic Surgeon
5.0 out of 5 stars 5 reviews

How long ago

There are a number of ways to perform a canthoplasty. Some involve stitch material very close to the lateral canthus where you seem to have some redness and irritation.The stitch material may be the cause. Either you could be allergic or it could be irritating your eye. Go back to your surgeon, who I assure would be happy to offer you some advice. It may just be a case of antibiotic ointment until the suture material stops irritating. Hope that helps.
Adam Goodwin

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