Lower lid bleph. Eyes cut in outer corner instead of transconjunctuval. Does this look normal? How long till revision?

Question

Doc BS 24yrs. He failed to say he was going to cut the corners of my eyes for this or I would not have done it. 8 wks post op. My L eye still looks terrible. The R eye no problems. This doesn't seem normal to me. Upper lid lashes dig into lower lid. Low lid feels muddy inbetween inner and outer lid. Doc says give it time. Was not expecting it to take this long. L eye definitely experienced more trauma. Entire reconstruct seems off.

Vasdev Rai, MD · Answer

Most of lower blepheroplasties do require incision on eyelid to get good results. Transconjuctival approach is used infrequently. Thus your surgery was done right.

John A. Standefer Jr., MD, FACS · Answer

Dear mommygal: Rest assured that your eyelid swelling will improve with time. Even when a transconjunctival blepharoplasty is performed to remove the fat, many patients require a pinch of skin be removed externally for complete restoration of the lid. Removal of a pinch of skin does require an external incision. The combined approach gives you the best of both worlds. It removes the fat and preserves the middle layer of the lid which is the muscle. The muscle is not very strong, so a transconjunctival approach is safer for the muscle, since the approach is on the inside of the eyelid. The skin pinch is external to the muscle so once again, the muscle is preserved with less chance of lower lid weakness postoperatively.  The swelling in your left lower eyelid is most likely the muscle swelling and should resolve with time and gentle massage. Total healing will be apparent in 3-6months. The external scar is in a natural laugh line and will fade with time as well. If the swelling doesn't subside, a steroid injection with 5FU can help soften it, or as a last resort, a conservative trim of the muscle can be considered. Good luck. John Standefer MD

Samuel Baharestani, MD, FACS · Answer

Thank you for sharing your case and photos.  I'm sorry to hear that you have had a slow recovery after lower blepharoplasty.  Overall, you look pretty good and the symmetry should return with time.  I'm glad that your surgeon is aware of your concerns.  They will know your anatomy best.  Good luck!  Keep us in the loop with your progress.

Lower lid bleph. Eyes cut in outer corner instead of transconjunctuval. Does this look normal? How long till revision?

Answers (3)

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