Can a Lower-lid Retraction Be Improved by Performing a Mid-face Lift Through the Mouth?

You need to be careful about midface lifts that depend on suspension to the bone around the eyelids. Talk to your surgeon about the risks of lower lid scarring and pulling down. A safer route may be through more of a facelift approach with incision in the hairline.This approach will not impair the eyelid.

Yes and yes.  The trans-oral approach is a great one and this mid-face lift can support he lower eyelid complex.  Can't tell you much more than that without a little surgical history and a photo.  I'll still need some suspension of the mid-face complex once it's elevated through the mouth and that can be done without cutting the lower eyelid skin.  It can be done via an upper lid incision or the temporal hair tuft.

 

Best of luck

Chase Lay, MD

Lower lid retraction can be caused by several mechanisms.

The lower lid is composed of three layers:

1: Skin or anterior Lamella

2: muscle or middle lamella

3: conjunctiva and lid retractors or posterio lamella.

Any shortage of these layers or scarring of these layers can cause lid retraction and the treatment is different for each cause.

The treatment is very complex and depend on appropriate diagnosis, and may require multiple steps to correct the original cause and another procedure (done at the same time) to support the repair.

The surgical execution is also very important for a successful repair. May require a skin graft , or an acellular graft or in complex cases a cartilage graft. Plus a canthopexy or even a canthoplasty.