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Posted underEyelid Retraction Repair q&a

Congenital Large Eyes and Inferior Scleral Show (photo)

Do I have lower lid retraction? If so, is retraction repair with a graft sufficient to reduce the bug eye appearance or do I need an infraorbital implant, orbital decompression, etc

Answers (1)

From board-certified doctors and trusted medical professionals
Dr. David K. Isaacs, MD, FACS
David K. Isaacs, MD, FACS profile photo
Dr. David K. Isaacs, MD, FACS
Oculoplastic Surgeon, Board Certified in Ophthalmology
5.0 | 95 Reviews
Answered on Feb 12, 2025
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Canthoplasty or Canthopexy to fix mild lower lid retraction? (photo)

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David K. Isaacs, MD, FACS

Neither canthoplasty nor canthopexy will help. I trained with Dr. Norman Shorr, the inventor of the Madame Butterfly procedure, a revolutionary approach to lower eyelid retraction. People from all over the world would fly in to have surgery. Since then we have modified this procedure to address...

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Mehryar (Ray) Taban, MD, FACS

You have a complex problem and may need lower eyelid retraction repair. See an expert for evaluation and treatment.

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Kenneth D. Steinsapir, MD

The steroids are effective at reducing inflammation but they also kill fat and unnecessarily hollow the eyelids. There are better options if you in fact need inflammation managed. However, sometimes less is more. You are two months out. You could have reconstructive surgery as early as month 4...

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C. Blake Perry, MD

Eyelid retraction is a complicated condition. This often is caused from over-resection of skin. Correction often involves a lower lid spacer graft (hard palate or alloderm) and canthoplasty. Best to see an eyelid expert.

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Kenneth D. Steinsapir, MD

You are right that the lower eyelid retraction seems mild by the pictures but it is not. Your eyes are functionally dry and a careful analysis of the lower eyelid position shows they are retracted many millimeters compared to their preoperative position. An actual physical examination would be...

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