Is there anything that can be done for lower eyelid drooping post lower blepharoplasty? (Photo)

Question

Hello, I had a lower internal blepharoplasty 5 years ago. Immediately after surgery my right eye appeared sunken in, drooping, and my bottom eyelid was turned inward to the point my eyelashes were touching my eye. Although it has improved a lot, I still feel and notice the asymmetry of my eyes. Is there anything that can be done for this?

Zoran Potparic, MD · Answer

It is possible to further tighten both lower eyelids and slightly lift lateral canhus (corner) by means of lateral canthopexy. This is very meticulous procedure and you should seek an expert plastic or oculoplastic  surgeon for a consultation. Good luck.

Kenneth D. Steinsapir, MD · Answer

Although transconjunctival lower eyelid surgery is less likely to cause post blepharoplasty lower eyelid retraction, it can still an issue like you are experiencing. Before I launch into a description of what you might need, let me advise you that there is no substitute for a detailed, in person assessment. These are generally a soft tissue and bone support issue. One cannot simply pull really hard on the eyelid corner and fix this. Do not accept a skin graft for this. They are disfiguring. Generally it is necessary to recruit more skin and soft tissue from the cheek into the eyelid. This is done by vertically lifting the cheek. To hold this material, felting material is needed to hold this lifted tissue. This is accomplished with a rim implant. To shape the lower eyelid an additional graft is needed behind the eyelid using a small strip of tissue borrowed from the room of the mouth. Your eyelids can be your best feature.

Basil Pakeman, MD · Answer

The first photo showed that there is a mild symmetry between the right and left lower eyelids. There is rounding of the right lateral, lower eyelid. The sloping of the left left lower eyelid is much more crisper. This may be an indication that there is some laxity in the lateral canthal tendon. This can be corrected by tightening the lateral canthal tendon. This can be accomplish with a canrhopexy or a canthoplasty. It may also help to decrease some of the hollowness in the lower right eyelid.

Mats Hagstrom, MD (license on probation) · Answer

It may be possible to improve your lower eyelids with a canthoplasty or canthopexy.
Any attempt at revision surgery also has the risk of making things worse.
How much does your condition really bother you and what are you hoping to achieve?
I suggest having a few in person consultations with oculoplastic surgeons or plastic surgeons who have a lot of eyelid surgery experience in your area.
I do not recommend relying on virtual consultations.
 For a second opinion consultation come prepared to bring with you a complete set of proper before and after pictures and a copy of your previous operative report.
These should still be available from your previous provider if you request them.
To make a quality assessment, we need quality information and that generally means having a really good understanding of what you look like before your procedure, what you look like immediately after and exactly what was done during surgery.
Gather those documents, then schedule a few in person consultations.
I don’t see a really strong indication for doing surgery.
There appears to be mild ectropions. We really need to see before and after pictures to make a good assessment.
Unless surgery has a fairly good chance of making improvements The default should be to not have surgery.
This is especially true when the situation is complex, and the chance of high-quality outcomes is uncertain.This is usually always the case when it comes to revision procedures.
Revision surgery is almost always more difficult than primary procedures. In other words, if you feel like you ended up with problems from your first procedure, then you should anticipate that a second procedure could do the same.
This is not to say surgery may not be beneficial.
I would just be cautious and focus your efforts and finding the most talented experience providers in your community.
Provider selection is the most important variable.
For that reason, I usually recommend patients have three or four consultations before selecting a provider for complex situations.
During each consultation, ask each provider to open up their portfolio and show you as many before and after pictures of the previous patients who had a similar situation or facial appearance.
Most plastic surgeons do far more primary procedures than they do revision surgery.
Still, a highly experienced oculoplastic surgeon would most likely have taken care of of previous patients with very similar conditions and should be able to show you documentation with pictures ofResults.Best,
Mats Hagstrom MD

Is there anything that can be done for lower eyelid drooping post lower blepharoplasty? (Photo)

Answers (4)

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