Lower rim eye waterline downturn - options to reshape the lower eyelid area and rim? (Photos)

Question

Hi There, I had a lower eye skin pinch and upper blepharplasty. I’m a bit unhappy or unsure of the lower eyelid area and the waterline being a bit downturned. Is there anything you suggest to lift and possibly reshape the lower eyelid area and rim. Thankyou

Kenneth D. Steinsapir, MD · Answer

The infracillary incision associated with the skin pinch is not as benign a surgery as presented. You do have a mild lid margin roll that present the waterline to view. I also believe that your eyes are somewhat rounded in shape as a consequence of your blepharoplasty. I would recommend a vertical midface lift supported by a custom carved ePTFE rim implant with an open canthoplasty to help reestablish a more almond eye shape. An in-person assessment is needed to determine if you need some type of spacer graft behind the lower eyelid. This type of reconstruction allow the recruitment of more skin and soft tissue into the eyelid which will be necessary to relieve the waterline ectropion.

Lower rim eye waterline downturn - options to reshape the lower eyelid area and rim? (Photos)

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