Odds of Lower Lid Retraction Resolving Spontaneously? What Does Literature Say About Time Frames, Conservative Measures Etc?

Question

Had lower lid bleph, with outside incisions 12 days ago. One eyelid retracted significantly (5mm) with slight outward 'roll'. Ps initially said 'swelling' but now have feeling based on his body language and tone that he too is concerned. Lid offers minimal resistance when pushing up digitally and am hoping this is indicative of conservative skin pinch. Swelling of affected eye less than other eye. Leaves me confused and frightened as to outcome. What are the odds this will 'resolve'.

Joseph Mele, MD · Answer

The odds of resolution are good. Continue with gentle upward massage, and as long as your eye is protected and moist, time is on your side. This is more common when the cheek is behind the front of the eye, when large amounts of fat are removed and less commonly when too much skin is removed.

	The fact that you can easily push the eyelid up to, or even past its ideal position is a good sign. Your surgeon, obviously has the best information on prognosis.

Mehryar (Ray) Taban, MD, FACS · Answer

It depends what the problem is and how bad. For the most part, eyelid is resilient and recovers after few weeks to month, especially if first ever surgery on it. There are things to do to help the eyelid recover in the meantime. It is also important to lubricate your eyes. Discuss with you surgeon and consider seeing an oculoplastic surgeon if the problem persists.

Dana Goldberg, MD · Answer

It is very common for the eyelid to pull away just after surgery, and usually this will resolve within 3-4 weeks (if not sooner). Even a small amount of swelling in the lid or the conjunctiva (lining of the eyeball) can make the eyelid look pushed away. Massage will help in about 70-80% of cases and carries minimal risk. For the few cases that do not resolve on their own in that time period, steroid injections may help. Surgery is needed in a few cases, but it's best to wait as long as possible (at least 6 months) because operating sooner could cause even more scar tissue to develop, which may pull the eyelid even more.

	In the meantime, make sure your eyes are protected by using drops in the day and ointment or taping at night to prevent excess dryness, which can cause damage to the cornea.

A.J. Amadi, MD · Answer

Often, mild lower eyelid retraction will resolve with time and conservative management. Sometimes this can be helped with gentle massage and/or injection of steroids or other anti-fibrotic medicine [5FU].

	I would recommend close follow up with your surgeon so that he/she can decide where you fall in this continuum.

	The one thing I would recommend is fight the urge to request revision surgery early. One thing I always stress to patients when they come in for revision surgery is that you can almost NEVER go wrong by operating later [there are a few exceptions to this rule], but its certainly possible to worsen things if you operate too early.

Algird R. Mameniskis, MD · Answer

This slight droop or lid pulling away from the sclera(white of eye) is something that occurs frequently after blepharoplasty with external incisions. As others have stated gentle upward, outward massage will usually improve or resolve this problem. It is best to wait and be patient, although I know that this can be difficult. Sometimes steroid injections after 2-3 months can help ,rarely repeat surgery after 6 months or more is needed

Odds of Lower Lid Retraction Resolving Spontaneously? What Does Literature Say About Time Frames, Conservative Measures Etc?

Answers (5)