Lateral droop after upper blepharoplasty? (photo)

Question

upper and lower blepharospasm done 6/2013 . approx 4 months later lateral droop both upper eyes. chemical brow lift helped. didn't have this prior to surgery.. what happened??? thanks for your time !!  Update: details to my first question on lateral droop.. here's a picture when I first awake.. no droop.. later in day my laterals droop as seen in pictures on initial question thank you soo much for your time spent answering

Kenneth D. Steinsapir, MD · Answer

I think if you solely focus on the eyelid fold, you will end up with all of this skin removed and your eyelid skeletonized and a buggy look.  I suspect that much more is going on that just a poorly performed upper and lower blepharoplasty.  I think a big confounding factor here is that you have been botoxed in the forehead at a time when you are trying to determine what type of eyelid surgery result you have.  There is no substitute for an in person consultation.  Stop doing botox for 4 to 6 months so an accurate assessment of your eyelid surgery will be possible.

Toby Mayer, MD · Answer

Lateral drooping after upper blepharoplasty is best treated with a browlift instead of upper blepharoplasty in my 35 year experience. Have your surgeon do a lateral browlift under local anesthesia.

John J. Martin, Jr., MD · Answer

Even when your brow is higher with the Botox, you have some residual skin.  This can be easily removed.  However, you may want to also consider a lateral browlift.  You have a fairly heavy outer brow, and if you like the way it looks after Botox your surgeon could surgically elevate this area as well.

Mitesh Kapadia, MD, PhD · Answer

People with excess upper eyelid skin often use their forehead muscles to pull their eyebrows up. The brain often does this involuntarily without the person even realizing it. If the drop in brow position happened several months after surgery, the most likely explanation is that you are no longer using your forehead muscles to lift your brows. Your brain became used to the fact that there is less upper eyelid skin and no longer feels the need to pull the brows upward. This can be corrected with a revision surgery where additional skin is removed.

Barry L. Eppley, MD, DMD · Answer

The lateral hooding that remains after your upper blepharoplasty is the result of the design of the upper eyelid skin excision. The design needs to incorporate more skin removal in the lateral or temporal area. Usually more skin needs to be removed in this area to avoid this lateral droop. This can be remedied by additional skin removal in this area which can be done under local anesthesia.

Steven Wallach, MD · Answer

The brow and eyelids have a delicate balance. An exam in person is critical, but sometimes a lateral brow lift is necessary or even a little filler can help to lift the lateral brow a bit.

Robert E. Zaworski, MD (retired) · Answer

Based on your photos, your surgeon did not take enough skin off your upper eyelids.  Follow up with him, and express your concerns.  A revision may be needed.

Lateral droop after upper blepharoplasty? (photo)

Answers (7)