I Have a Left Lower Lid Ectropion After Initial Blephoplasty..how Can This Be Fixed?

I am 1 week post op from a lower lid blephoplasty. I had skin removal, fat repositioning and tightening of muscle. I have severe swelling on left eye. The right eye is beautiful. The lower left lid is drooping( ectropion). I am keeping it taped and using cold compresses. Will this go away? My surgeon told me to keep it taped and to push up and out on it for 2minutes every hour. Could this be caused by the swelling alone?

Doctor Answers 5

Yes of course this can be fixed.

Of course this is all the worse because the other side is perfect.  Cutting the lower lower eyelid skin to perform lower eyelid surgery can and frequently does damage the motor nerves that innervate the orbiculularis oculi muscle the helps hold the lower eyelid against the eye.  The lower eyelid malposition is not caused by swelling and it is not caused by chemosis (conjunctival swelling).  Massage and taping do not fix this issue.  As you heal, the lower eyelid appearance may improve to the point that the issue does not bother you.  However, a certain percentage of these do require or benefit from repair.  Generally it is best to give the eyelid time to heal.  If you are having dry eye symptoms, see your general ophthalmologist for dry eye care.  As early as 4 months after surgery, it is appropriate to be assessed by an oculoplastic surgeon who offers the specialized repair of this issue.  Do not be talked into having lateral canthal tightening surgery to address this problem ( sometimes referred euphemistically as "tucking" the eyelid).  It will not work.  Tightening the lower eyelid will actually further pull the lower eyelid under the curvature of the eye making the problem worse.  The surgery also uses up precious lower eyelid tissue that can be put to better use with definitive reconstructive methods.  With any luck this all settles down and nothing further is necessary.  By the way taping does help at night because it helps you close your eye while sleeping.

Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

Lower lid position issues should be treated conservatively early after lower eyelid surgery.

Swelling can contribute to malposition of the lower lids after eyelid surgery. Therapy to combat swelling and promote good lid position almost always corrects the problem.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.7 out of 5 stars 35 reviews

Ectropion and blepharoplasty

If you have significant eye swelling and chemosis, ectropion may develop. The key is to follow your surgeon's advice and  keep the eyes very moist.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 28 reviews

Ectropion after blepharoplasty

Hopefully the ectropion will improve as the swelling calms down - it is definitely too early to know what your final result will be. Follow your surgeon's instructions and try not to get too discouraged. It is very common for one eye to heal more slowly than the other. Best wishes for your recovery.

Mitesh Kapadia, MD, PhD
Boston Oculoplastic Surgeon
5.0 out of 5 stars 164 reviews

Lower eyelid after blepharoplasty

The lower eyelids are very delicate and things like swelling and bruising after surgery will cause them to pull away. In many cases, this gets better with time as the swelling decreases, which can take a few weeks.  Once in a while, scarring will pull the eyelid down and it must be tightened up, but you are still very early for this.  Keep following your doctor's recommendations and be patient.  

Matheson A. Harris, MD
Salt Lake City Oculoplastic Surgeon
5.0 out of 5 stars 6 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.