Muscle Damage Due to Blepharoplasty - Can It Be Repaired?

I have a permanent frowning after upper and lower blepharoplasty 11 months ago. I am very concerned about muscle damage. How can this be repaired? I do not want to use fillers.Please help. I am devastated with the results. Thank you for your help!

Doctor Answers 10

Muscle damage can be repaired

Depending on what it is and whether it’s muscle or skin, muscle damage can be repaired.  Sometimes surgery is needed and sometimes filler can help.  If, however, there’s still a problem after 11 months you should see a specialist in this area.  It’s particularly important to see a specialist who does a lot of eye surgery because a secondary surgery can often be more complicated. 

New York Oculoplastic Surgeon
4.7 out of 5 stars 66 reviews

Blepharoplasty complications

Without examining you it's difficult to make specific recommendations

General considerations are:

  • Go back to your surgeon for evaluation and discuss your concerns
  • Ask your surgeon about possible revision surgery
  • Ask whether a neuromodulator can improve your appearance

Paul Carniol, MD
Summit Facial Plastic Surgeon
5.0 out of 5 stars 7 reviews

Frowning is almost always caused by action of forehead muscles

Frowning after upper and/or lower eyelid surgery doesn't add up to me. There is no connection between the two that I know of. Could be your previous eyelids were so heavy that they shaded your eyes so much that you got used to that amount of light entering your eyes. Now that the eyelid skin reduction unshades your eyes you may be reflexively squinting your eyes to shade them and consequently are getting frown lines from this squinting?

Without before and after photos we are somewhat handcuffed giving reasonably good responses.

Harlow Hollis, MD
Victoria Plastic Surgeon
4.3 out of 5 stars 4 reviews

May well be related to your brow position

Brow position often changes after upper eyelid surgery - you no longer have to "work" to elevate your brows to compensate for the excess skin.  You should discuss this with your operating surgeon.  I would not recommend seeing another surgeon (even one who "specializes" in revisions) unless you and your first surgeon cannot agree on what should be done next - something as simple as Botox may well be your answer.  Dr. Hankins

W. Tracy Hankins, MD
Las Vegas Plastic Surgeon
4.9 out of 5 stars 292 reviews

Frowning after blepharoplasty

It is difficult to tell what exactly is going on from your description.  Frowning occurs when the muscles that pull the brows together are contracting.  This leads to vertical lines between the brows.  Is this what you mean?  A picture would be helpful.  I believe you should consul ft an experienced eyelid surgeon who has performed many revision cases to get the best evaluation before proceeding with any treatment.  I hope this helps

Guy Massry, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 47 reviews

Based on your description, it is hard to understand your concerns.

You should know that eyelid surgery can cause permanent changes in the function and appear of the eyelids that are not necessarily desirable.  Many of these changes can be improved or corrected with reconstructive surgery.  However, you must first find a surgeon who understands your concerns and has the training and experience to improve the situation.  Generally we ask that people wait 6-12 months before undertake this type of repair work.  At 11 months after surgery, it is appropriate for you to look for this type of help.

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

Post-blepharoplasty problem

Hi.  I do not understand what you mean by permanent frowning. A photo would be helpful.

You need to obtain a few consults (from oculoplastic surgeons).  Further surgery can make things worse, or better, depending on the problem.  The function of the eye/eyelids are most important, followed by the aesthetic concerns.

Dr Taban

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

Frowning after an eyelid procedure

Without a picture, I am not 100% sure where the area of frowning is. If it is between the eyebrows, then that can be treated with Botox or Dysport.  Not sure what other area would be affected after an isolated eyelid surgery.

Julio Garcia, MD
Las Vegas Plastic Surgeon
4.8 out of 5 stars 27 reviews

Frowning after Upper and lower eylid surgery.

  Before and after photos to compare would be very helpful in defining what exactly is your primary concern.  I have performed Eyelid Surgery for well over 20 years and IMHO, you should not jump into another surgery until you have a few consults and examinations to discuss what is causing your increased frowning. 

 Although removing upper eyelid muscle and skin can relieve the forehead muscles of constantly contracting, to decrease this excess skin as it did before the Upper Eyelid Surgery, I really fail to see how that can cause your Glabella and forehead muscles to be stronger after the procedure.  Frowning is caused by three sets of muscles, the upper portion of the eyelid muscle, the glabellar muscles and forehead muscles.

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

Frowning After Blepharoplasty

Photos would be helpful to evaluate your situation, but there is no substitute for an examination.  I recommend you find an oculoplastic surgeon and get a second opinion.  If overaction of your brow depressors is causing the appearance of frowning, Botox injection would provide a rapid solution.

Michael McCracken, MD
Lone Tree Oculoplastic Surgeon
5.0 out of 5 stars 12 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.