2 Weeks Post Blepharoplasty Scleral Show, Used Steri-strips to Tape the Eye, but Its Still Irritated and Teary, Options? (photo)

Dear Ann

It is way to early after surgery for you to worry about asymmetry. There is significant swelling in the first two weeks after surgery, and sometimes even longer than that. Furthermore, surgical scar will evolve and soften over a period of months. I would not consider revision surgery on anyone until the at least 6 month post operative visit, and sometimes even longer than that. Scars can mature for up to a year after surgery. Please be patient with your body and let it heal.

As far as lid taping is concerned, my favorite tape to use on the eyelids is actually the "Breath Right" strips that are made for nasal application. Its strong adhesive, but gentle on the eyelid skin, and easy to apply. Don't forget massage.

Furthermore, 5FU injections can help scar softening. Discuss this with your surgeon.



If you decide to explore this further, I would recommend consultation with an ASOPRS trained Oculoplastics surgeon. You can find one close to you on the ASOPRS dot org website.

Ectropion, or lower lid pulling away from the eye, in general is not uncommon and usually resolves on its own. Because yours is mild I suspect this will be the case but it will take several weeks to months to resolve in most. It is often caused by the initial edema which adds weight to the lower lid. The edema can become firm (induration) and this will be improved with massage  and taping at night, if severe during the day too. I usually use paper tape as "less rough than steri strips" Make sure your surgeon instructs you how to do both of these if he/she thinks it helpful. If however it is because of deep scarring also called ciccatricial ectropion, then other measures are helpful such as injections of steroids with or without 5-FU, or a temporary stitch to close the lids (lateral tarrsorrhapy suture). The key here is close followup and good compliance with your surgeon's advise. 

With the tape your scleral show appears to be minimal.  You are only 2 weeks out from surgery.  Usually scleral show will improve over 8-12 weeks if not before.  Both of your upper and lower lids appear irritated: allergies? irritation secondary to steri strip adhesive?  With moderate scleral show recommendations of tapping the eyelids with ointment at night to prevent drying of the cornea would be prudent.

Dr. ES

I know you do not feel like this will ever get better, but it is amazing how things can improve with a little time.  Generally if you do need revisional surgery, this decision should be make 6 to 12 months after the original surgery.  The American Society for Ophthalmic Plastic and Reconstructive Surgery maintains a geographic website that can help you find oculoplastic surgeons in your area (asoprs dot org).  Please understand that post aesthetic lower eyelid surgery is specialized and not every oculoplastic surgeon offers this type of service.

In most cases this problem will resolve in a fairly short time (a few weeks or months).  Stay in contact with your surgeon to help manage the problem.

Usually mild sclearal show improves with time.  Taping and massage and good lubrication usually does the trick. I would suggest maintaining regular visits with your surgeon to keep a watchful eye on this.

Photo demonstrates the correct taping but why are you not seeing your chosen plastic surgeon? Allow at least 4 to 6 months for relaxation of the tissues before thinking about a revision.