Lower Lid Retraction Immediately After Eye Surgery, is This Normal? (photo)

It has only been 6 days since my lower eyelid surgery to remove excess skin under my eyes, but I noticed right after surgery (like 2 minutes) my left eye was already pulled down ie. retraction. This eye was also the one with more excess skin before surgery. I asked the Dr. if he did more to that eye and he said no. It is also bruised & swollen more than the other. I am so worried about this, My Dr. said don't worry it will heal fine and told me to do a blinking exercise and anti-inflam. drops

Doctor Answers 6

Lid retraction after lid surgery is not normal

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Some tightness in the lower lid is normal after lower lid surgery and some irritation called chemosis can be typical. Your photo shows an ectropian of the lower lid with quite a bit of scleral show in a fairly young face. We would be worried as you are. Use drops to prevent dryness, and see your surgeon, or another if necessary.

Lid retraction is not normal after blepharoplasty

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This condition is called ectropion and is a known complication of blepharoplasty.  Fortunately, most of the time it resolves on its own with massage and time.  Keep using the drops and keep massaging.  Reassess the result in 6 weeks.

Too much retraction

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After lower eyelid surgery, a slight amount of retraction is not unusual. Your case however is a frank "ectropion", that is the eyelid is being pulled away from the eyelid.

When doing a lower lid blepharoplasty, often a tightening of the attachement of the eyelid to the bone [canthal ligament] needs to be done or supported in a different fashion.

This is something that may need to be done for you. In addition, injections with steroids and/or 5FU [an anti-fibrosing agent] may be needed. You should followup with your surgeon immediately, and if he/she feels that nothing needs to be done, I would seek a second opinion from an oculoplastic surgeon.

I would recommend consultation with an ASOPRS trained Oculoplastics surgeon. You can find one close to you on the ASOPRS dot org website.

A.J. Amadi, MD
Seattle Oculoplastic Surgeon
5.0 out of 5 stars 41 reviews

You need treatment now

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Your skin retraction and sclera show is too much and will cause more issue by skin retraction and dry eyes. You should see your doctor for evaluation and possible early revision. You may need to have canthoplasty/canthopexy.

There is nothing normal about how your eyes look.

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Generally I like tincture of time after surgery.  However, there are instances where early intervention is warranted.  This may be one of those instances.  It is hard for me to recommend having your surgeon perform this intervention.  It is generally my experience that surgeons whose surgeries are associated with these types of early outcomes often lack the depth of experience need to do a satisfactory intervention.  You may actually need more surgical help than can be mustered in your own local community.  I encourage you to seek an early second opinion.  The challenge is finding the right person for that second opinion.  Try not to put your surgeon on the defensive ask him for a referral to an oculoplastic surgeon in your area. Despite your current situation, it is best to heal and then have reconstructive surgery.  However there are instances where early intervention can be beneficial.  Can nonsurgical treatment make the difference here?  While the eyelid will look better with time, I foresee that you will need further surgical help. 

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

Lower lid ectropion

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It sures looks like you have ectropion and one eye is worse than the other.  With mild post-op scleral show often eyedrops and gentle massage help. For the eye that appearas worse, it would be important to know if a canthopexy or canthoplasty was performed. Sometimes early intervention is recommended. An exam in person would be essential.  I would suggest following very closely with your 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.