Scleral Show 1 Weel After Blepharoplasty, Should I Wait to do Anything? (photo)

Question

I have developed scleral show after several days of lower lid blepharoplasty. Now it is 8 days since the surgery. Anything I should do right now, or should I wait? Scleral show is not extreme, but my eyes are different.

Kenneth D. Steinsapir, MD · Answer

You do appear to have a pulled down right lower eyelid with scleral show. The doctors here are correct to point out that this appearance will improve with time. However, there are some steps your surgeon can take to attempt to improve the situation: taping, finger winking, and possible antiiflammatory injections such as kenalog and 5FU. If this malposition does not respond to intervention, then tincture of time can be very helpful. It is this reason that revisional surgery is not seriously consider until you have healed for 6 to 12 months.

Stephen Prendiville, MD · Answer

The first thing I would recommend is that you maintain close contact with your Surgeon. This early lid retraction may be related in part to swelling of the conjunctiva, or chemosis. Although this is disconcerting, it generally resolves without sequellae. Support for the lateral canthus via taping can be helpful, but time is likely to be the determining factor.

Lawrence Kass, MD · Answer

The results of your surgery are best judged 6 months after surgery, not eight days after. If you trusted your doctor to do your surgery, I would advise asking him/her these questions, rather than asking the doctors on this forum as he/she is a better judge of your results. I would also advise staying away from a mirror for the next couple of weeks. Good luck!

Kamran Khoobehi, MD · Answer

You lower lid tissue is loose and will not improve a lot. I would recommend canthoplasty and I would do it early than late to avoid scaring . Your before picture would be helpful.

Steven Wallach, MD · Answer

Scleral show can develop after blepharoplasty. Massage and good lubrication often improves the situation, but I would discuss this with your doctor.

Barry L. Eppley, MD, DMD · Answer

Scleral show after a lower blepharoplasty can and will improve over time to some degree. Whether it will completely resolve itself is an issue of more time and healing. But there are several things that you can do now that can really help such as taping the corner of the affected eye upward and some massage. This will not only help in pulling up and stretching the lower eyelid in the right direction but will also assist with decreasing sensitivity and tearing. This is going to be an issue of at least several months before you know whether a revisional procedure will be needed.

Andrea Nowonty Hass, MD · Answer

Because of swelling and bruising, it is not unusual to see some early scleral show that resolves readily with time. 1st - address your concerns with your surgeon - he/she may discuss somoe options with you.

	I will often instruct my pateints to do what I call 'eyelid pushups' several times a day starting about 10 days after surgey and continuing for up to a month. While looking in the mirror, gently place a ring finger on the lower lid very close to the lashes. Without bunching the skin, give a gentle stretch toward the eyebrow and hold for 3 seconds and release. You will likely see an immediate improvement in lid position that will drop again. However, each time you do this you will be slowly improving the lid position untill you no longer need to do so (as determined when you no longer see a drop)

Robert L. Kraft, MD, FACS · Answer

Scleral show can resolve with time and it is too early to conclude that this is permanent. Many instances of scleral show go on to resolve as the healing progresses. If revision is required, this should not be performed until the wound has settled down and, at a minimum, no earlier than 6 months postoperatively.

Mohsen Tavoussi, MD, DO · Answer

Most scleral show will resolve after healing process is complete i.e. 6 months. I recommend to be patient for the completion of healing process.

Scleral Show 1 Weel After Blepharoplasty, Should I Wait to do Anything? (photo)

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