I Had Lower Eyelid Surgery 4 Months Ago and Right Eye Still has Droopiness, Options? (photo)

Question

My right eyelid still has some droopiness. My doctor is says he could put another stitch to hold it up. Is this the best option?

Jeffrey M. Darrow, MD · Answer

Your photos are helpful and do show more scleral show on your right side.  An exam would help clarify if the healing in your lid is still active and is holding the lower lids down from the internal scarring.  You appear to be young and your tissues good.  Some gentle upward eyelid stretching, to lengthen the scar, and some active eye squinting exercises to strengthen the lower lid muscles may raise the lower lid over the next few months so as to avoid any new procedures.  Your plastic surgeon knows exactly what was done at surgery and would be in the best position to examine and advise you

Steve Laverson, MD, FACS · Answer

My personal routine in this situation is for office revision of both lower lids, right more than left, to mobilize the lower lids upward and re-do the canthopexies.  you are looking slightly upward in the submitted photo, so if the left lower lid is in good position in forward gaze, best leave it as is.

Kenneth D. Steinsapir, MD · Answer

Four months after surgery is a good time frame to judge the effects of surgery.  Transcutaneous lower eyelid surgery damages the muscle that helps hold the lower eyelid margin in place against the eye.  Removal of skin and scaring from surgery has created a vertical height issue in the right lower eyelid.  Surgeons lacking post-blepharolasty reconstructive surgery experience commonly err thinking that this type of situation can be improved or cured by "putting a stitch in the corner of the eyelid."  They believe this because they have sat through numerous lectures suggesting that a canthopexy will strengthen and support the lower eyelid.  Unfortunately this is largely wishful thinking.  The laws of topology dictate that the shortest path on a curved surface is not a straight line but a curved path called a geodesic.  In ordinary life we most commonly encounter this type of mathematical relationship when we take a polar flight from a North American City to a City in Europe.  When the plastic surgeon attempts to horizontally shorten the lower eyelid with the stitch which effectively tightens the lower eyelid, the surgeon is surprised when after the procedure the lower eyelid is actually worse than before.  This is because the cathopexy effectively shorten the lower eyelid which must now follow an even shorter path around the eye.  This shorter geodesic is even lower on the eye.  Like Dr. Taban, I recommend that you find an expert in the correction of this type of lower eyelid issue and pass on a repair you have been offered.  Your surgeon means well but the proposed procedure can make you worse rather than better.  You need an oculoplastic surgoen who offers specialized methods for fixing the lower eyelid contour and position after aesthetic blepharoplasty.

Mehryar (Ray) Taban, MD, FACS · Answer

You have right lower lid retraction, postblepharoplasty. It is unlikely that just putting a stitchalone will hold it up, as there is tightness and traction on the lower lid.  There may be other factors involved as well.  You should consult an oculoplastic surgeon for options.

Sam Goldberger, MD · Answer

As others have stated, you have right lower eyelid retraction.  A stitch does not fix this.  You will need some type of reconstructive lower eyelid surgery to raise and support the eyelid.  The best time to operate is at least 6 months after your last surgery.  Please see an Oculoplastic surgeon who has experience in this type of surgery.  Good luck.

I Had Lower Eyelid Surgery 4 Months Ago and Right Eye Still has Droopiness, Options? (photo)

Answers (9)

Answer: Postblepharoplasty lower lid retraction

Answer: Postblepharoplasty lower lid retraction

Answer: I Had Lower Eyelid Surgery 4 Months Ago and Right Eye Still has Droopiness, Options? (photo)

Answer: I Had Lower Eyelid Surgery 4 Months Ago and Right Eye Still has Droopiness, Options? (photo)

Recommended reading

Everything you need to know about Eyelid Surgery

Our mission is to create a world where every investment in modern beauty is Worth It.

I Had Lower Eyelid Surgery 4 Months Ago and Right Eye Still has Droopiness, Options? (photo)

Answers (9)

Answer: Postblepharoplasty lower lid retraction

Answer: Postblepharoplasty lower lid retraction

Answer: I Had Lower Eyelid Surgery 4 Months Ago and Right Eye Still has Droopiness, Options? (photo)

Answer: I Had Lower Eyelid Surgery 4 Months Ago and Right Eye Still has Droopiness, Options? (photo)

Browse related questions

Recommended reading

Everything you need to know about Eyelid Surgery

Our mission is to create a world where every investment in modern beauty is Worth It.