Lower Eyelid Drooping After Blepharoplasty

I had upper and lower eyelid surgery. My lower lid on one eye is drooping. The doctor tightened it, but it's still away from the eye and causing extreme dryness. My vision is also horrible. Should I go back for corrective surgery? I am afraid he will not fix it but make it worse.

Doctor Answers 20

Pulled Lower Eyelid Is A Tough Complication To Fix

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A pulled out (ectropion) or pulled down (rounded) lower eyelid after a skin removal lower blepharoplasty is a problem that is far too common and difficult to correct.  Skin removal in the lower eyelid is something I avoid as it rarely produces benefit and is high risk for complication.

Without knowing the exact time course of events it is hard to say what should be done.  Initially the eyelid should be taped or a special stitch put in between the eyebrow and lower eyelid to pull it up (Frost suture).  Also massage and steroid injections should be done.  If in time the problem persists, a surgery to tighten and reposition the eyelid's attachment to bone (lateral canthoplasty/tarsal strip) procedure is usually done.  If this should fail, a mid face lift may help.  Finally, skin grafting the lower eyelid may help but is quite unattractive.

Austin Facial Plastic Surgeon
4.8 out of 5 stars 37 reviews

Revision lower eyelid surgery

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Revision lower eyelid surgery is complex. It involves midface techniques (i.e. cheeklift), possibly grafts into the lower eyes, and complex canthal surgery. The skillset and paradigm required for the revision surgery of the lower eyelid is entirely different than for the primary surgery.

Surgeons undertaking this surgery should have an interest in these areas before attempting a third time redo lower eyelid surgery.

There was no time limit specified in your post. Shortly after surgery, the lid can pull down and this can often be treated with conservative means.

With any problem with vision, it is a good idea to see an ophthalmologist. He or she will also check for excessive dryness of the cornea, the lining of the eye.

Brent Moelleken, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 195 reviews

Work with your Doctor if you can

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This is not an uncommon problem and there are many ways to fix this problem. To answer if you must go back to the surgeon, that depends on many factors:

  • your relationship with him or her;
  • his or her skill level;
  • and the degree of the problem, etc.

Generally, it is best to return to the original surgeon and express your concerns. Be honest with your doctor and tell him or her that you are worried that he or she may not be able to correct the problem. Do it in a kind and polite way because all surgeons, myself included, have delicate egos.

If your doctor feels confident that he or she can fix the problem, you might want to give him or her another chance. Usually if there is a problem, the original surgeon will attempt to correct the problem for free or at a greatly reduced price.

If your doctor is hesistant, ask your doctor for a referral to another physician who may be able to correct the problem. It is usually best to try to work with your doctor even if there is some conflict or disagreement. Most definitely, your original doctor wants you to have a good final result and will do his or her best to help you.

Lane Smith, MD
Las Vegas Plastic Surgeon
4.6 out of 5 stars 98 reviews

TLI. too little information

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It would be nice to know your age, how long ago your surgery was and what the tightening procedure was. Without this information we can only speculate on your condition and its treatment. The findings that you describe may be caused simply by the expected post surgical swelling and may be amenable to massaging and eye lubrication. They might also represent a condition known as ectropion, which may require further surgical intervention. Hopefully, your surgeon is guiding you through the recovery period with advice and consolation. Good luck!

Healing after #lowerEyelidsurgery

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Healing after #lowerEyelidsurgery
ectropion is not uncommon in the first 6 weeks after lower lid surgery.
this can improve with taping, massage, injection with 5fu.
the eye must be protected from drying while this heals

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 116 reviews

Lower Eyelid Drooping after Blepharoplasty

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Thank you for posting your concerns. Unfortunately we do not have pictures to evaluate. In general, lower eyelid malposition is the most common problem after lower eyelid surgery. The eyes take on a rounded shape, and the white under your eyes starts to show. This problem is hard to fix, but it is possible. Canthoplasty or canthopexy is usually all you need to fix the problem. This is best done immediately after surgery or after 3 months. Hope this was helpful. Good luck!

PostOp Eyelid Drooping Following Blepharoplasty Surgery

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                  In the immediate post-operative period, lower eyelid drooping is not an uncommon finding in blepharoplasty patients. In the vast majority of patients, lower eyelid drooping resolves with conservative management. In a small percentage of patients, this problem persists and surgical intervention becomes necessary.

                  It’s difficult to make a treatment recommendation without knowing the surgical time line of your procedure. In addition, it’s difficult to know what option is best for you without performing a physical examination.

                  In general terms, the vast majority of patients can be managed conservatively. This usually involves massage and suspending the lower eyelid with steristrips. In most cases the lower eyelids will snap back and patients will have total resolution of their problem. When lower lid drooping persist after a suitable period of time has elapsed, surgical correction may be necessary.

                  This problem requires close monitoring by your surgeon. In some cases consultation with an expert in eyelid reconstruction may be necessary. 

Lower Eyelid Drooping After Blepharoplasty

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This is not an uncommon problem can present in a variety of ways.  If surgery was recent then massage from inner to outer  areas of the lower eyelid and the use of steristrips will sometimes completely correct the problem.  Other times there may be more precise surgical repair to be done.  I would see my surgeon and see what he recommends.

Paul Vitenas, Jr., MD
Houston Plastic Surgeon
4.8 out of 5 stars 118 reviews

Lower eyelid drooping after blepharoplasty

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Eyelid surgery, and surgery on the face is some of the most delicate surgery in all of plastic surgery.  Correction of the drooping after blepharoplasty mandates advice from an expert in facial or eyelid plastic surgery.  Myself and a colleague have recently written an academic paper (see below link) on avoiding this complication after blepharoplasty.

Anil R. Shah, MD
Chicago Facial Plastic Surgeon
4.8 out of 5 stars 181 reviews

Lower eyelid repair in Denver Colorado

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Jerry Popham at Park Avenue Oculoplastics is a good surgeon  in Denver. I would give it some time first and see how things are in 6 months. The best thing to do is first try massage to help elevate the lower eyelid. You may need some future procedures to get the lower eyelid where it needs to be. You probably wouldn't hurt to see your original surgeon and see what they have to offer. If you are not happy you can ask for a second opinion. You surgeon does not want you to have complications just as you do so I would give them a chance to make things right. 

Chris Thiagarajah, MD
Denver Oculoplastic 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.