Round eyes after upper eyelid surgery. Any suggestions? (photos)

Question

I am one week after upper eyelid surgery and my eyes appear to be very round. I had my stitches taken out two days ago by the nurse and she just said that everything looked fine and that it would take some time before I could see the final results. I am going back for a final check up in six months. I still have swelling and I also have a patch on the right eyelid. I know it is early but I am really worried that my eyes will look this round forever. I have a very "surgical" look. Can it still change?

John J. Martin, Jr., MD · Answer

In the before picture you can see that the eye is actually too open - you can see the white above the iris.  This means that you have eyelid retraction.  This can often be caused by some thyroid abnormalities.  It doesn't look like you have any excess skin in the upper lid so not sure why you had an upper lid bleph.  The swelling will not cause the lid to open more - if anything it will pull it down.  So you may actually open even more as you heal.  You will probably need an upper eyelid muscle recession to allow the lid to fall to its' normal position.  See an oculoplastic surgeon for an evaluation.

Kenneth D. Steinsapir, MD · Answer

You are worse now.  I am not going to say your surgery was inappropriate but you needed to be assessed for a possible metabolic disease before surgery.  I recommend to see you speak to your surgeon today and get a referral to an oculoplastic surgeon today.  You will need help for corneal exposure and drying which will be inevitable with this amount upper eyelid retraction which definitely looks worse today.  Management beyond this is to complex for this forum but I am very concern.  Eye comfort and measures to reduce inflammation need to be tailored base on detailed findings from your examination.

James R. Gordon, MD, FACS, FAAO · Answer

Thank you for sharing your concerns. It is much too early to make any judgements about the results of your blepharoplasty. See your surgeon in a few weeks for evaluation. Discuss your concerns at that time as well. You will likely improve significantly with time. Good luck,

Rigo J. Mendoza, MD · Answer

Thank you for your question.  At one week you are still swollen and bruised.  That is why your eyelids are retracted up and down.  As the swelling goes down, it will get easier to close your eyes and you will have a less "rounded" look.  If you still have concerns after a few weeks, you should go see your doctor and not wait until 6 months for your next visit.

Flora Levin, MD, FACS · Answer

Do you have any known thyroid problems? Did your eyes always look like the "before" photograph? Do you have any issues with inability to close them now? Dryness? Consultation with an oculoplastic surgeon maybe if value. Would discuss this with your surgeon much sooner than your appointment in 6 months.

Elbert T. Cheng, MD · Answer

Hello Catherine,You appear to have some mechanical ectropion of the lower eyelid.  From your before pictures, you had ectropion (sagging of the lower eyelid) prior to surgery and the lower eyelid surgery accentuated this.  I would support your lower eyelids with tape to hold up the skin and muscle upward during the healing process.  Talk with your surgeon about how to help the healing process.  I think a lot of what you see will resolve over time, but I would stay in closer contact with your surgeon.  You had round eyes to begin with and I think it is very natural to enhance your naturally round eyes too.  Best of luck!

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