Lagophthalmos After an Eyelid Surgery? (photo)

Hello, I really need your help. I had a n eyelid surgery 2 years ago and after that i have been experiencing painful dry eyes. After a while I noticed that my eyelids didn't closed fully when my eyes are closed. I don't know what to do and would really appreciate your help.

Doctor Answers 7

Dry eye can be unmasked by blepharoplasty.

The photographs do not give enough information to make a credible opinion. However some patients can have dry eye syndrome unmasked by blepharoplasty. Usually this is managed with medication.

Atlanta Plastic Surgeon
4.7 out of 5 stars 35 reviews

You need injections... or surgery

Try first having a Restylane (hyaluronic acid) injection in front of the tarsus (the area between your lashes and the crease of the upper lid). If this is not helpful, you can try to live with it (keep eyes lubricated with eye ointment and taped at night). If you cannot live with it, you will need a skin graft above the eyelid crease.

Nabil Fanous, MD
Montreal Facial Plastic Surgeon
4.2 out of 5 stars 6 reviews

You may benefit from a consultation with an oculoplastic surgeon familiar with the treatment of lagophthalmos.

You appear to have a paucity of skin in your upper eyelids more so on your right. Depending on your examination, you may benefit from a skin graft to one or both of your upper eye lids to allow closure. Skin may be harvested inconspicuously around your ear.

Your examination is critical for determining your next step, but in the right hands, you may achieve improvement.

Hope this helps, and all the best to you.

Dr. Joseph

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon
4.9 out of 5 stars 418 reviews


Without an exam, it is hard to answer your question. Your condition may be related to tightening of the levator following the surgery. To get a good ptosis correction, many patients will get this due to the need to correct your eyelid position. You are better served to discuss this with your surgeon. All the best.

Thomas A. Narsete, MD
Denver Plastic Surgeon
5.0 out of 5 stars 10 reviews

Lagophthalmos (inability to close eyes)

An oculoplastic examination is needed to understand the reason you can't close your eyes. It could be due to weak orbicularis muscle (which helps close eyes, blink), lack of skin, scarring, or combination. See an oculoplastic surgeon for evaluation.

Mehryar (Ray) Taban, MD, FACS
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 72 reviews

You had a very aggressive upper eyelid surgery.

It is why your eyes do not close properly.  However, it is not just that you are short of skin.  The orbicularis oculi in the upper eyelids is atrophied from denervation (damage to the motor nerves that supply the upper eyelid).  This is actually relatively common but just more extreme in your case.  Seeing a cornea specialist for dry eye treatment is beneficial.  Regarding surgical options to make things better,  you need a detailed oculoplastic assessment by a specialist who provides post blepharoplasty aesthetic reconstructive surgery.  That often means traveling to get the best possible care.

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

Lagophthalmos 2 years after eyelid surgery

Did you just recently notice that your eyelids were not closing completely or was it something you had right after the surgery?  It would be unusual to develop lagophthalmos many months after upper eyelid surgery.  In any event, you need to see an eye doctor (ophthalmologist) so that your eyes can be examined and treated.  There are some medical treatments that can help.  It would also be a good idea to return to your eyelid surgeon to be examined.  Sometimes, a revision procedure can be done to help as well.  

Michael I. Echavez, MD
San Francisco Facial Plastic Surgeon
4.5 out of 5 stars 18 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.