Lagophthalmos 6 wks after upper &lower (transcutaneous) bleph. How likely am I to recover without surgical intervention?(photo)

This condition can occur with over aggressive surgery and may require further surgery to be fixed.  I usually leave at least 18 mm of skin between the edge of the eyelid and start of the eyebrow to avoid lagophthalmos after blepharoplasty.  As most oculoplastic surgeons know, any less than this can lead to temporary (if not permanent) problems with eyelid closure.  Consistent lubrication - especially at night - can help to keep the eyes safe and comfortable.  Usually, the skin will stretch with time to help with closure, but occasionally skin grafting is necessary to make up for the deficit.  Your surgeon should be able to check the health of your eyes and make sure you are headed in the right direction.  Wish you a speedy recovery!

I suspect that the lower eyelid will remain somewhat pulled down.  The upper eyelid issue can be from motor injury affecting the blink.  This is common after upper blepharoplasty and many of these do recover with time.  Generally the combination of lower and upper eyelid compromise will produce a symptomatic dry eye.  The severity of this issue often dictates what needs to be done regarding the need for revision surgery.  I would recommend that you are closely followed by your surgeon to make sure the cornea is tolerating this situation.  

 The appearance of your eyes is not unusual considering when you're blepharoplasty was done. General traction on the lower lids and a cephalad direction can be used for physical therapy  To help position of the lower lid. It's doubtful you will need revisionsurgery when you're totally healed.

This condition can occur with surgery and can require surgical intervention.  However prior to surgical intervention, a number of conservative measures can be tried.  First, the eye should be protected from dryness with lubricating and moisturizing drops, next the eye should be protected at night with taping, or a moisture chamber.  Early massage can help.  One can perform this with an upward motion on the lower lid.  Essentially the goal is to stretch and soften the lower lid.  The technique entails putting some upward pressure with two or three finger on the skin of the lower lid, below the lashes and holding it upward with gentle pressure for 10 to 15 seconds.  Patients can do 10 to 15 reps several times per day.  A temporary tarsorraphy can also help patients with this condition,  this is a removable suture placed in the corner of the eye to suspend the lower lid and narrow the lid opening.  Time may also help, but worsening would indicate that earlier surgical intervention is needed.  Typically this condition is more commonly caused by shortening and scarring in the lower lid rather than in the upper.  Continue see your surgeon.  Your case will need careful, regular follow up to ensure resolution.  While your description and photos help, only a physician who can exam you and get a detailed history can make a proper recommendation for your particular case.  

Hi  Anon  ! From  my personal  point of view,  the healing problems, (  lagoftalmos, blink, eyelid retraction  etc . )  after surgery of the eyelids,  improve in  amazing  way  after a few weeks only with  masagge, with your  fingertip pull up the corner of your eyelid,  without  giving  pressure on the eyeball, just in the  skin. Ask your  Doctor if this kind of maneuver can help you,  and the proper  way to do, in you will see  an  big improvement  after a few  weeks, leaves the  secondary surgery for the very last option .  Get  well  and good look.

While there are surgical procedures to correct your lagophthalmos, you are likely to recover without surgical intervention, but your actions during this time are critical. The good news is that skin stretches (why women can get pregnant) and similarly, with aggressive massage, you should be able to massage your eyelid skin. I tell patients that they cannot overdo the massage. 100 times a day if you can, as 4-6 weeks post op is the tightest time for scars. Additionally, you need to be careful during this time to prevent corneal damage. Lubrication at night is key. Best of luck to you!

You probably have some incomplete blinking and some lagophthalmos when sleeping. This will get better with time, especially if you start hourly forced eyelid closures (x20) and hourly downward upper eyelid massage. You appear to have bilateral lower eyelid retraction (lowering) which can also respond to the hourly forced eyelid closure exercises and upward massage of the lower eyelid.  Use lots of drops and ointment to lubricate the eye. You might try temporary punctum plugs to further help with the dryness.  Try this for 2-3 weeks and if there is no improvement at all in your lower eyelid position, you probably would require a procedure to lift and tighten the lower lids. Good luck