Droopy Eyes After Lower Blepharoplasty

I had a lower Blepharoplasty two weeks ago, and both of my eyes look a little droopy, especially the left one, giving me a tired look. Is it possible to correct it? How and when? I had a previous blapharoplasty four years ago.

Doctor Answers 13

Slow down and relax

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Lower lid blepharoplasty, depending on how much work was done, can cause significant swelling and hence drooping of the eyelids for quite some time. This is especially true is the periosteum or layer of tissue over the bone was elevated for fat redraping.

The best thing you can do is continue to massage the lower lids in a upper and out direction to both help the swelling the direct the tissues to their correct position. If you still have issues after 12 weeks then it's worth discussing with your surgeon. In the mean time continue to see your surgeon frequently.

Massage and squinting exercises

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Lower lid surgery can have a longer recovery time and more complications than upper lid surgery. Surgeons nowadays tend to remove minimal lower eyelid skin in order to prevent the lower eyelid from retracting the patient developing what's called ectropion, which is where lower eyelid everts. I have my patients start performing upward massage along the lower eyelid bone as well as doing a squinting exercises where they squint real hard and hold it for three seconds. I'll have them do this four or five times and repeat this process three times a day.

At two weeks you are still early in the recovery process so be patient keep your regular postoperative visits. Let your physician know your concerns.

Joseph M. Perlman, MD
Houston Plastic Surgeon
4.3 out of 5 stars 27 reviews

Doopy lower lids are usually temporary but could be a reason for concern

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One of the most significant risks associated with lower eyelid surgery is ectropion. This is when the lower eye lids are pulled down. (could be everted in more sever cases)

The reason is that the lower eye lid supporting ligaments can not handle the down ward pull of the skin of lower eyelid or the cheeks.

Most of the time this is due to swelling and is temporary. But it could also be the result of scar retraction or excessive skin removal.

Your surgeon needs to know about this.

Amir Moradi, MD
San Diego Facial Plastic Surgeon
4.0 out of 5 stars 8 reviews

Be patient - you will be surprised with time

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 If you post a picture, we may be able to give you more specific advice.  However, this early after surgery, it is best for conservative treatment (massage and taping).  You should discuss this with your surgeon.  Good luck.


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You are still experiencing swelling, and reduced eyelid function.  At this time, it is early in the recovery.  Talk to your doctor about taping the lower lids, and perhaps massage.  Now is not the time to do anything but conservative treatment.  Hang tough.


Don't panic. This isn't that unusual.

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I assume you are talking about your lower eyelids. The upper can look “droopy” because of swelling right after any procedure on the eyes. The usual cause of “droopiness” of the lower lids at this point is residual swelling of the lids and some lack of support of the lateral lid, especially after a redo procedure. Although this can be a problem that may eventually need correcting, it will frequently resolve with a little time and TLC. You need to do several things. First, you need to make sure your eyes are not dry. This can be accomplished by using Refresh Tears during the day and Refresh Liquigel at night. These can be purchased at almost any pharmacy. Secondly, you need to massage the lower lid frequently during the day by pushing up and lateral with gentle pressure. This helps resolve the residual swelling and keeps the scar pulling the lid down from becoming set in that position. If it is going to, the drooping will generally resolve in another 2-4 weeks. I would not, however, if it does not resolve, consider reoperating for another 6 months to a year.

Robert T. Buchanan, MD
Highlands Plastic Surgeon

Droopy lower eyelids after second Blepharoplasty

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I agree that you need more time to heal. It sounds as though your lower eyelids are drooping or pulled down creating what we refer to as a sad eyed look.

An external lower eyelid incision does interfere with the support of the lower eyelid, and drooping is particularly common if the lower eyelid is lax and does not have good support.

A secondary lower blepharoplasty is particularly prone to drooping and in some cases can progress to an ectropion, especially if extra lower eyelid skin has been removed.

I recommend massage of the lower eyelids, pulling the lower eyelid skin up and out towards the corner of the eye to stretch the lower eyelid skin which is pulling downward on the lower eyelid as it is healing.

Be sure to moisturize the eyes during this time as lower eyelid droop can expose the eye to dryness whiuch can be a problem.

See your doctor and ask if he/she can apply steri strips to pull the lower eyelid skin upward and out to the corner-this added support can help.

If your doctor feels that you are developing an ectropion, he/she may also elect to perform a temporary tarsorraphy with a simple stitch in the outer corne to tighten the lower lid and prevent further drooping. If this is needed the sooner it is done the better.

If you do develope a sad eyed look or ectropion then surgical revision may e necessary, however i would not consider this until you are 4-6 months out from surgery.

Hopefully, this is a temporary problem and simple massage will do the trick; however, lid drooping past 6 weeks is a concern.

You need time to heal.

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Dear Scared

Gladwell got the concept of thin slicing on the money in his book Blink. Your impressions are probably correct.

However, it is not clear to me if you are referring to your lower eyelids or your upper eyelids. You state you had lower eyelid surgery and now your eyes look droopy. You could be referring to a sag in the lower eyelid position or a heaviness in the upper eyelids. When the upper eyelids swelling which can occur with lower eyelid surgery, they will look heavy. This type of situation generally improves with time. When the lower eyelids look droopy after surgery, this type of problem gets worse as it heals more. However, in either case, you need time to let the dust to settle.

It is generally a mistake to assume that a problem this early will need surgical repair or revision. Focus on healing. If you become depressed thinking about your surgery, consider seeing a psychotherapist or neuropsychiatrist. Occasionally, antidepressants are needed. The reason for this is that healing from surgery and dealing with uncertainty can be stressful. How we cope with that stress is different for everyone. Try to be aware of these feelings and take care of your emotional well being while you heal from surgery. Being patient and letting yourself heal can be very difficult under these circumstances.

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

Droopy eyes after lower Blepharoplasty

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Dear Scared Florida

Your concerns are reasonable and should be addressed by your surgeon. There are many steps at this time which will help keep the lower eyeid from pulling down more-

massaging the lid in an upward direction several times a day

temporary partial closure of the lower eyelid to the upper eyelid

steroid injection into the healing tissue(if needed)

Theratears - eye lubrication if you have dryness and/or patching the eyes at night or goggles for dryness

taping of the lower eyelid for support

Please follow up with your surgeon so that your progress can be monitored and i am sure that things will be fine.

With Warm Regards,

Trevor M Born MD

Trevor M. Born, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 126 reviews

Droopy eyes from Blepharoplasty will likely resolve with massage

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Lower lid malposition is onr of the most common sequela following lower blepharoplasty. Most cases will not require any further managment. Massage and taping will help in the early stages. If you develop any signs of corneal irritation, please seek the advice of your surgeon and start using eye drops during the day and ointment at night.

Hisham Seify, MD, PhD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 19 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.