Lower Lid Drooping After Lower Lid Blepharoplasty, If This Doesn't Resolve Itself, What Are My Options?

I am 40-years-old and 10 days post op from a lower lid bleph that included a transjunctive approach and skin pinch incision below the lid.The lower lid is still retracted from the eye. My board-certified facial plastic surgeon recommended upward massage but not taping at this point. My questions are: 1) How long should it take to resolve 2) Statistically what are the chances this won't resolve; 3) What are the options to fix it should it come to that? Many thanks for your time.

Doctor Answers 5

Lower eyelid malposition after eyelid surgery

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I have performed Blepharoplasty (eyelid surgery) for over 20 years and the lower eyelids appear to have significant malposition at 10 days after the lower Blepharoplasty. You should see your surgeon and possibly an occuloplastic surgeon for early intervention to prevent further lower lid retraction.

Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 28 reviews

Ectropion post op

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a skin pinch with a transconj approach is designed to be forgiving because it prevents scarring in the middle lamellae or septum which is a potentially big problem. I expect you to be fine with conservative measures. hang in there.surgery will not be needed in most cases. good luck

Rafael C. Cabrera, MD
Boca Raton Plastic Surgeon

Lid pull after blepharoplasty

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The lid retraction in the lower lid is also called ectropian and can be quite uncomfortable. There is a chance that the situation will improve with massage in an upward direction in the next several weeks. Drops during the day will help as will ointment at night to keep the eye moist and free of irritation. We would suggest waiting about three months to see if massage will resolve the situation. Odds are70%, without further surgery, and there are procedures which can 'fix' things if you continue to be unlucky.

Best of luck,


Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 44 reviews

I am so sorry you are in this situation.

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This was the result of a very aggressive skin pinch.  A skin pinch is supposed to be just that.  This looks more aggressive than that.  10 Days is early and it is likely you will have some softening of these eyelids as you heal.  However, I would encourage you to get a second opinion. This is primarily for practical interventions right now like steroid injection, massage, use of artificial tears and ointment.  If you need a revisional surgery for this, it will be 6 to 12 months from now.  Consider seeing Tarmara Fountain, M.D. or Noel Saks M.D..  They are both well respected oculoplastic surgeons who practice in the North Shore.  They are very kind clinicians and I believe either will help support you while you heal from this surgery.

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

Retracted lower lid after skin pinch

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Generally skin pinch is done conservatively as there is only mild skin excess. In your case, you have developed ectropion or down ward pull on your lower lids in the immediate post-operative period. Conservative measures such as massaging and taping will improve this markedly but it will take a few weeks. In young patients with good skin elasticity adequate recovery is likely in 2-3 months. You are likely still swollen and that may be worsening the ectropion. A short course of oral steroids may expedite the resolution of swelling or this will likely resolve spontaneously within the first 3 weeks. If a significant ectropion persists, your surgeon can use very small steroid injections to relax the lower lid skin or even reoperate and take the tension off the lower lid by suspending the cheek tissue to lateral ordital wall covering. I would advise patience and diligent massaging several times daily for the next several weeks. I would also recommend making regular follow up appointments (weekly) with your surgeon to monitor your progress and intervene as needed.

Edwin Ishoo, MD
Cambridge Facial Plastic Surgeon

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.