I had a lower blepharoplasty now have ectropion would a filler help correct it? (Photos)

Question

Gad a lower blepharoplasty done 3 months ago, my eyes are very irritated and it's so uncomfortable, I was told by an ophthalmologist that I had slight ectropian in both eyes, I've taped my eyes, did massages and nothing helps them. I read that a solution is to inject fillers to stretch the skin, to fix the issue, do you guys think it would help me? their is a place that injects fillers in my area and I was gonna go there for a consult. Also Would stitching the eyes on the corner help?

Dallas Buchanan, MD · Answer

Thank you for your pictures and questions. I would agree with others that this is not classic "etropion" and I would be very cautious about how you proceed. It would be helpful to know the details of the procedure you had and to do a thorough physical exam. Some problems can be addressed with volume replacement and support and others need more invasive measures. My best piece of advice is to wait and do nothing right now. Try conservative measures and see if this improves with time. If not, then consider seeing a surgeon who specializes in revision eyelid surgery and be very careful about that choice. Best of luck!Dallas R. Buchanan, MD, FACSOwner & Board-Certified Plastic SurgeonVIVIFY plastic surgery

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

Thank you for sharing your question and posting your photos. Sometimes, fillers can improve the ectropion following lower blepharoplasty. In more pronounced cases, surgery is required. See an experienced oculoplastic surgeon for comprehensive evaluation and discussion of potential treatments. Good luck!

Mehryar (Ray) Taban, MD, FACS · Answer

I do not believe filler would help significantly or permanently. You likely need lower eyelid retraction surgery with possible other adjunctive procedures. See an expert.

Camille Cash, MD · Answer

I'm sorry to hear of the issues you are having since your surgery.  Unfortunately I don't think filler is the answer to correct the issue.  As others have expressed it appears the you have some eyelid retraction.  Visit with your surgeon to discuss options for correction.

Kenneth R. Francis, MD, FACS · Answer

Dear ByeBye,
Your photos do demonstrate some eyelid retraction rather than ectropion.  You need to closely follow up with your surgeon and follow his/her instructions carefully.  They will likely recommend aggressive daily massaging, which, in the majority of patients will correct the retraction by 6 months or so.  If you were my patient I would strongly recommend against putting fillers in.  It would further complicate the issue.  Good luck!

Leonard Grossman, MD · Answer

Unfortunately not all doctors use the proper technique for lower blepharoplasty and not many people know what needs to be done in the least invasive manner to correct the ectropion. I have performed hundreds if not thousands of such procedures that are used in correction of the ectropion and they are all done with the use of the patient's own fat. By filling out the hollow eyelids and upper cheek area you provide support that holds up the lower eyelid and the ectropion is corrected immediately and forever with no downtime. I hope this helps and good luck from New York City plastic surgery

Karan Chopra, MD · Answer

Hi Friend, I’m sorry you’re having this complication after blepharoplasty. 
Upper eyelid blepharoplasty is fairly straightforward but lower eyelid blepharoplasty is more complex. 
When too much skin is removed from the lower lid, or its sutured incorrectly, it can “shorten” the height of the eyelid. This leads to exposure of the sclera (white part of the eye) like you have in the picture. This results in poor cosmetic results but also put you at risk for irritation due to inability for your eye to completely close and protect itself.
Your doctor was correct to suggest taping and massage but if you’re still having this at this point, then a simple canthopexy or canthoplasty may help. Not suturing the corner of your eye shut that is called a Tarsorrhaphy Which would treat the symptoms of irritation but not fix the actual problem. Filler would just add more weight to the lower lid and make it worse.
Be sure you are properly performing eye massage because if you do it incorrectly it wont help. The best is  is a method called “20 20’s” it is a highly effective method for restoring lower eyelid position. 
Goodluck!

Mayli Davis, MD · Answer

Hi,
I have used filler with limited success for lower lid ectropion.   I suggest it be used in very small amounts.  I would recommend consultation with a surgeon or someone very experienced in tear trough filler.   For ectropion. I usually place the filler higher (closer to the lid margin) than traditional tear trough injections. 
Further surgery may also help but I recommend waiting at least 6 months after your last surgery. 
Good luck !

Robert T. Buchanan, MD (retired) · Answer

Your lower eyelid is is good contact with the eyeball, just pulled down. Therefore, what you have is a shortened lid or scleral show, not an ectropion. What you need is an examination, when the quarantine is over by an expert in eyelid surgery. This exam will reveal where the shortness is and what needs to be done to repair it. Occasionally you can improve it with fillers, but only an in person will determine this. Worst case, you will need release of the tissue between the orbit and lid margin and a graft, a rather involved procedure. Though it does not matter now, from your before picture, you were never a candidate for a blepharoplasty. Be very careful with anything else you do.

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