Thank you for your question and answer, recommaned for you to do follow up with your surgeon and get more information about after care and recovery process.
At 4 weeks, it is too early to be able to determine whether you will require additional surgery. As mentioned by others, massage of the eyelid might be helpful. Your surgeon may also recommend steroid or 5 FU injection in hopes of modulating the scar further.
I would recommend at least 6 months before considering further surgery. Early surgery may be less effective, or sometimes unnecessary.
You may want to get a second opinion from an Oculoplastic surgeon in a few months.
Mild ectropions can resolve
with time and massage and exercises your surgeon should be instructing you about to help yourself as you heal.
Can ectropion recover itself
From your picture it seems that the edge of the eyelid is slightly rotated outwards which indicates an early ectropion. Regardless of the terminology used your lower lid is not in a good position and is retracted. This is typically the worst time in terms of healing and scarring after surgery and you should wait until the scar tissue softens up. I think that it is possible for you to see improvement with time. Things that you can do to minimize your symptoms in the meantime is using adhesive tape (steristrips) to elevate the eyelid an support its position. It is however tricky to apply and keep in place. Massage is controversial but I think it helps, You want to put your finger on the lid and push up against the eyeball and do that several times a day. Keep your eye lubricated with artificial tears every few hours. If you have signs of eye irritation and your eye doesn't close fully at night you may want to consider putting eye ointment at bedtime and taping the eye. In 2 months you should be evaluated if there is no improvement in lid position. Surgical correction may be indicated and it can be fixed.
Eyelid ectropion after lower blepharoplasty
The best answer to your question at this early point in recovery is "time will tell". You should give it at least 3 months for the eyelid to heal before considering revisional surgery which would possibly be ectropion surgery with skin graft. In the meantime, do eye squinting exercises and lubricate the eye.
Post blepharoplasty ectropion often does get better without surgery.
Sometimes surgery is necessary before the eyelid resolves on its own because people can not be patient while the eyelid heals on its own.
However, this is not ectropion. Ectropion specifically refers to a situation where the lid margin does not sit against the eye but is pulled off the eye surface. Here the eyelid does sit against the eye surface. However, the eyelid rides low on the eye surface. It is often called an ectropion by surgeons who are not primarily trained in oculoplastic surgery. This is horizontal and vertical inadequacy of the lower eyelid due to scar and motor nerve injury. This is often called an ectropion but it does not respond to the surgical repairs normally performed for ectropion. My best advice is to follow your surgeon's directions. They may have you massage the eyelid, they may inject the eyelid with steroids or 5FU. These often improve the eyelid enough for many patients to be satisfied with the results. Please consider posting your progress here.
In the picture where you are looking up the lid looks low. In the other one, it looks like it is almost even with the other one. So the ectropion is not bad. I would recommend warm compresses, and massage the lid up. YOur surgeon can also inject some kenalog with 5-FU to soften any scar bands which may be pulling the lid down. You should do fine. The incision is usually done in the crease directly below the lashes so it is hidden post-op
Healing after blepharoplasty: #ectropion
healing after blepharoplasty: #ectropion
complete healing of the lower eyelids can take
six weeks if the muscle and fat are treated. Ectropion can be improved with massage. taping , stretching and the use of 5fu injections to soften the tissue.