Can rounding of the outer eyelids after surgery be improved?

Question

I had a lower bleph and my eyes appear much shorter horizontally. It seems the outer corners have been blunted slightly, but just enough to make a big difference in my appearance. Is there a procedure in which to lengthen and sharpen the outer corners? If so, does it have a high or low success rate (assuming it is being performed by skilled hands)? Will it last or need to be fixed again later on? Thank you in advance for all the help and advice.

Kenneth D. Steinsapir, MD · Answer

The easy answer is sure it can be improved.  The true is more complicated.  The type of repair you may need will very much depend on the actual anatomic basis for your issues.  Generally speaking, the most common situation is after transcutaneous lower blepharoplasty.  The post-surgical defect represents several injuries caused by the surgery.  This included denervation of the pre-tarsal orbicularis oculi muscle.  Unfortunately, cutting the skin and muscle under the lower eyelid lashes damages the motor nerves for this very important muscle.  This effectively weakens the lateral lower eyelid.  This muscle helps hold the lower eyelid up.  This means that the scar tissue that forms after surgery is not resisted by the normal anatomic factors that would ordinarily hold up the lower eyelid.  Excess skin that is removed by your surgeon effectively shortens the lower eyelid and this pulls contributing to the rounding of the lower eyelid.  So if a surgeon tells you without out examining you that all you need is a "tuck up" of the corner, or a lateral canthoplasty, these surgeons are over simplifying what is needed to repair the lower eyelid.  Unfortunately, this may actually represent the surgeon's mechanical understanding of the problem.  This can lead to a bad situation because many surgeons actually believe that this is the basis for the problem.  They become confused with these measures fail to repair the problem and actually make lower eyelid retraction worse.The answer is a detailed assessment of your current situation and a very careful surgical plan that addresses your particular anatomic situation.  Don't let anyone cut corners on addressing this.

John Bitner, MD · Answer

Rounding or pulling of the lower eyelid after blepharoplasty is a well described complication. There are several techniques that should correct the problem, but depends on a few different factors (how far your eye comes forward, skin deficiency, conjunctival deficiency, muscle strength, scar tissue, etc...).  Of course, I would need to see a picture or see you for a consultation in my clinic to give you my opinion on any solutions.  I hope that helps.

Mehryar (Ray) Taban, MD, FACS · Answer

Revisional eyelid surgery may be possible. It may require lower eyelid lift (with possible internal spacer) with canthoplasty. It may also require midface lift/support. See an oculoplastic surgeon.

Toby Mayer, MD · Answer

Repair of the round eye after eyelid surgery can be done but I would need to see photos to make a proper assessment of what the problem is and therefore what the treatment would be.

Devinder S. Mangat, MD, FACS (retired) · Answer

rounding of the eye is not an uncommon outcome after lower eyelid surgery if too much skin was removed or some scarring occured under the skin after the procedure.  This can be improved with revision surgery but may not be restored to a completely normal appearance.  You should consult an experienced surgeon who performs lots of eye Plastic Surgery or submit photographs so we can advise you better.

Can rounding of the outer eyelids after surgery be improved?

Answers (5)

Answer: Repair of the round eye after eyelid surgery.

Answer: Repair of the round eye after eyelid surgery.

Answer: Rounding of the eye after lower eyelid surgery

Answer: Rounding of the eye after lower eyelid surgery

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Can rounding of the outer eyelids after surgery be improved?

Answers (5)

Answer: Repair of the round eye after eyelid surgery.

Answer: Repair of the round eye after eyelid surgery.

Answer: Rounding of the eye after lower eyelid surgery

Answer: Rounding of the eye after lower eyelid surgery

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Everything you need to know about Eyelid Surgery

Our mission is to create a world where every investment in modern beauty is Worth It.