Lower Eyelid Still Drooping 6 Months Post-Op, Are These Most Likely the Final Results? (photo)

I am 6 months post op from lower bleph/subperiosteal mid face lift. both eyes had a stitch put in the medial corner and are healing with a rounded droop. i was told (after surgery, not before) to wait a year for complete recovery. is there a chance my eyes will still come up? the right one appears larger when i am not smiling. also have loose skin under the eyes. i had been doing massages but wonder if there is anything more i can do?? is it too late? still have discomfort/swelling in cheeks

Doctor Answers 9

Drooping after lower eyelid surgery

Lower blepharoplasty can initially have slight "droopy look" especially on the outer corner as healing takes place. This is often due to chemosis and swelling and should be normal in appearance by 2-3 weeks post surgery. When excess skin is removed or excess laser procedure is done under the eyes, you can get rounding (mild) or ectropion (severe). Having a midface lift should help prevent these and not cause them. Your picture appears as though you have a mild case of rounding. I would suggest a lower lid massage where you push up on the edge of the lower lid and while you have it pushed up, you open your mouth to stretch the skin. I would not necessarily wait one year as this exercise can help you now.

Virginia Beach Facial Plastic Surgeon
4.7 out of 5 stars 37 reviews

Revisional lower lid surgery

Lower eyeid retraction after lower lid surgery can be due to a variety of factors, including scarring, muscle weakness, and/or lack of skin pulling the lid down.  Scarring and muscle weakness can improve up to a year so if the eyes are relatively comfortable, it is advisable to wait up to a year.  Consult an oculoplastic surgeon.

Mehryar (Ray) Taban, MD, FACS
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 72 reviews

Why Didn't Radiesse Last for me As Claimed by the Producer Mfr?

Yes, at 6 months post op from a lower Blepharoplasty, these are the final results.  You can always discuss any lower eyelid rounding or malposition with the plastic and cosmetic surgeon that did your lower Blepharoplasty.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.6 out of 5 stars 24 reviews

Revising eyelid surgery

It's difficult to assess the "after" without seeing the "before".  Generally, the result looks good and you must be patient as the final outcome of the procedure you described may take a year for all the tissues to settle down.  If there is an area of bulging at that point, it can always be surgically revised but patience is sometimes the best treatment.

Robert L. Kraft, MD, FACS
New York Plastic Surgeon
5.0 out of 5 stars 40 reviews

Lower eyelid "droop" after surgery

The "droop" you are referring to is not apparent on your submitted photos.  The suture to secure lower eyelid position is a lateral canthopexy, not placed medially.  In the photos, the lower eyelid margins are above the lower border of your corneoscleral limbi, which is their appropriate and normal level.  Some asymmetry is normal, yours doesn't appear dramatic or abnormal to me.  It is not too late;  Revisions can always be performed if indicated.  If there is still edema (swelling) of your cheeks, then you are not seeing your final result yet.

Steve Laverson, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 46 reviews

Be Patient with healing from lower eyelid blepharoplasty and subperiosteal midface lift

Dear Djr

The  subperiosteal midface lift can be very effective, but has one of the longest healing times.

Please keep your eyes healthy and moisturized, massage the corners gentle and protect the incisions from the sun.  (the hat is a good idea)  Reapply the sunscreen ever few hours. 

I know it is hard to be patient, I assume that you are meaning that "is it too late", for your eyelids to improve, and the answer is no.

Keep in touch with your surgeon, you are doing the right things.  Best Wishes 

Travis T. Tollefson, MD, MPH
Sacramento Facial Plastic Surgeon
5.0 out of 5 stars 5 reviews

Wait before considering more surgery!

  You ask a very good question.  I agree with the last doctor that I would not suggest that you have any further surgery at this time and I also agree with his recommendations.  Did the surgery help?  What did you look like before?  Without weeing preop photos, it is hard to say but realize that you do not look bad at all and that further improvement without surgery is still likely.

Lawrence Kass, MD
Saint Petersburg Oculoplastic Surgeon
4.8 out of 5 stars 131 reviews

Revising ptosis surgery

First of all, is that a Southern Illinos Univ. cap!?  I spent 5 years in central Illinois.  Had a lot of patients from SIU. 

Anyhow, I see what you're talking about.  If you're talking about some rounding of the lower lateral parts of your lower eyelids, this can improve somewhat with more time.  Massage is good.  Injection of the lower eyelids with some 5-flurouracil may help it loosen a bit.  Don't inject steroids.  Not helpful at this point and slightly risky.

For some loose skin of the lower lids I would recomment either fractionated CO2 (gentle) or Affirm laser therapy (likely a series of 3 treatments).

I would not revise anything surgically for another 6 or more months.  To correct this rounding you have to repeat the lower eyelid surgery and perform a lid tightening procedure.  Ideally you want to look over corrected, with your lower eyelids looking high and a bit funny.  As they settle they would go back to a normal position. 

Another thing, an implant to the inferior orbital rim can lift your lower lid tissues and cheek tissue so they are better supported and not pulling down on your eyelids so much.  That would be done at the time of your lower eyelid surgery.

Hope that helps.  

Chase Lay, MD

Chase Lay, MD
Bay Area Facial Plastic Surgeon
4.9 out of 5 stars 75 reviews

Lower eyelid swelling after Blepharoplasty and Midface lift

Hi djr,

Thank you for your question. As others have stated, it might be too early to judge final results from your cosmetic surgery. Swelling of the skin and tissue can last a variable amount of time. While most of the healing occurs within the first couple weeks, it may take much longer to the rest of the healing to occur.

Eyelid swelling may improved with gentle massage, eye exercises, ice, and time. Reducing salt intake may also help. Other medical conditions such as allergy or thyroid condition will prolong or exacerbate swelling.

Lastly, based on the photographs alone, you appear to have reasonable results at this time in the healing process and it's difficult to determine a droopy. Only after a comprehensive evaluation can a specialist help determine appropriate options for you. Best of luck.

Dr. Chaboki


Houtan Chaboki, MD
Washington DC Facial Plastic Surgeon
4.9 out of 5 stars 86 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.