Rounding of eyes after blepharoplasty

Question

Approx. 3.5 weeks ago I had upper and lower blepharoplasty done along with a facelift. I initially liked the look of my eyes during the first 1.5 weeks. However, my eyes are now taking on a rounded appearance now that I'm farther out from the surgery. What could this be due to? Will it go away, or can it be fixed?

Earl Stephenson, Jr., MD, DDS, MBA · Answer

This rounding up your eyelids may be due to drooping of the lower eyelid secondary to swelling and surgery. It is termed ectropion. Typically it will resolve with time and tissue massage. Periodically it will require a small dose of steroids to help soften the lower eyelids so that it regains its normal position.  When I perform my lower lid  I am very aggressive and I typically perfirm a canthoplasty which tightens the lower lid and prevents this phenomenon from occurring after surgery.

Kenneth D. Steinsapir, MD · Answer

You are very early from your recent surgery.  Things will continue to settle and improve.  However, the distortion than can follow after lower blepharoplasty generally does not resolve and can become more visible in time.  Some surgeon feel that this change in shape can be prevented with a canthal strengthening procedure.  That is not accurate and in fact, canthal procedures can contribute to unwanted changes.  I would strongly advise you against having your surgeon "tuck the eyelid up."  While the surgeon may be motivated to try something to help you, these often amounts to a half measure than can make the situation worse.  Caution is advised therefore.  It is helpful to get about 4 months out from surgery before shopping second opinions for help for the situation.  It is certainly possible that things may soften enough that you are not so bothered by the change.  You can study my website to understand what options are available to help these situations.

Michael I. Echavez, MD · Answer

Pictures of your eyes would be very helpful to give you the best advice.  Rounding of the eyes after blepharoplasty can occur in some cases when excess skin is removed from the lower eyelids.  Sometimes this rounded appearance may just be temporary as the skin is healing as well.  You should discuss your concern with your surgeon and be evaluated to determine the cause.

Matheson A. Harris, MD · Answer

This is generally due to scarring of the lower eyelids, causing them to pull down and bringing the outer corner of the eyelids inward. It is still very early, but share your concern with your surgeon and it is likely something that can be corrected with a lower eyelid tightening procedure, if necessary.

John J. Martin, Jr., MD · Answer

Photos would be helpful here.  Did they do a canthoplasty or canthopexy with the lower eyelid surgery?  As you heal from a lower eyelid  blepharoplasty, the skin may start to tighten and pull on the outer corner - especially if a lot of skin was removed, and if there was no tightening done at the outer corner tendon.  Sometimes as the inflammation resolves, the shape may continue to change, so see what happens over the next couple of months.  There are some options that can be explored to help with the shape if you are unhappy after about 6 months.

John R. Burroughs, MD · Answer

With no pictures it is hard to say what may be occurring, but if lower eyelid skin was removed then some rounding can occur.  Generally this can be repaired if necessary with a lateral anchoring procedure.

Ross Stutman, MD · Answer

Your initial results were probably more from post operative swelling and the results you are now seeing are probably more representative of what your long term result will be. Without photos and a detailed exam, as well as knowing what was done in the blepharoplasty it is hard to comment on your particular case. However, if the lateral eyelid was not anchored properly, as your body heals it may cause the lower eyelid to fall from a normal position giving it a more rounded shape. It is important that you discuss your concerns with your surgeon.Best Regards,Dr. Stutman

Michael Hueneke, MD (retired) · Answer

It is too early to make any conclusions about your results. Without seeing you we can not either. In most cases minor problems like this can be corrected if needed.

Rounding of eyes after blepharoplasty

Answers (8)

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