Can a mid-face lift correct ectropion caused by too much skin removal during an upper and lower eyelid surgery?

Question

I once had a facelift and eyelid surgery that left me with ectropion. I’ve had multiple surgeries to correct my ectropion without success. My eyelids do not close completely when I blink. This has caused severe dry eye. An oculoplastic surgeon suggested the possibility of a mid-face lift to correct my problem. Has anyone had a mid-face lift for this reason? How successful was the outcome? Who in the Washington DC area specializes in this type of surgery to correct dry eye?

Zoran Potparic, MD · Answer

Yes and no. Depending of how mid-face lift is performed it can help to mobilize and lift skin from the cheek and possibly correct ectropion. However, additional surgeries like skin graft/flap and lateral canthopexy may be needed.There are different types of mid-face lift and different ways of fixation around orbit to maintain lifted tissues in their new position. This is a very complex surgery and you should look for a board certified plastic surgeon with significant experience with this type of reconstruction. Good luck.

Franklin D. Richards, MD · Answer

It really depends on the
severity of your ectropion.Most
ectropion can be corrected without doing a mid-facelift procedure, but if it is
severe lifting the face and cheek area can help to raise the lower eyelid to a
normal position.

Arthur Dean Jabs, MD, PhD, FACS · Answer

I am not familiar with using a mid-facelift to correct lower eyelid ectropian caused by a previous blepharoplasty. Ectropian after blepharoplasty is usually caused by a retraction of the scar tissue, but can also be due to an issue with deeper underlying structures. Sometimes a “spacer” needs to be placed to correct the issue.

Earl Stephenson, Jr., MD, DDS, MBA · Answer

In my opinion mid face lifts are not the solution to ectropion.   Typically, ectropion requires lower lid tightening.  I would advise you to seek more opinions through consultation.

Luis A. Mejia, MD · Answer

Hi... thank you for the question and sorry for this condition... Mid-face face lift do not correct ectropion, there are several techniques to correct this... repost this question with some photos.. so i could orient you better.

John J. Martin, Jr., MD · Answer

A midface lift might help you.  It will depend on the amount of scarring you have and what surgeries you have had previously to the lower lid.  A midface lift helps to elevate the cheek so that there is less pull inferiorly on the lower lid.  See an oculoplastic surgeon who can help assess if it will work in your case.

Vincent N. Zubowicz, MD · Answer

Midface facelifts are notorious for creating ectropion. Using the approach to generate the redundancy to correct ectropion should be done by someone who has a large amount of experience with the technique.

William Marshall Guy, MD · Answer

Hello 301Linda,Sorry to hear about your eye issues.  When you develop ectropion there are several treatment options.  The goals of each are to bring the eyelid back into a normal position.  This may be something as simple as releasing the original scar that caused the eye to pull down, making a larger incision and pulling the eyelid up and to the side (canthoplasty/canthopexy), releasing the scar and taking a skin graft to push up the eyelid, or bringing up the entire area below the eye as in a mid face lift.  As far as frank ectropion where the eyelid is pulling away from a scar I would recommend the canthopexy or canthoplasty and possibly using a skin graft to push everything up depending on the severity of the ectropion.  To answer your question about the mid face lift helping, it is useful for an eyelid positioning issue.  What I mean by that is sometimes after surgery patients will get a swooped look of the outside part of the eyelid.  There is not a frank ectropion but the eye does not look how it should.  In this situation depending on how much of a lift you can get, the mid face lift or cheek lift can help to bring up the tissue which pushes the eyelid into a better position.  Make sure in the meantime that you are using lubricating drops or ointments to protect your eye during the day and at night based on the recommendations of your surgeon.  I hope this helps and good luck.

Ravi Dahiya, MD · Answer

Linda:Thank you for your question. I have performed thousands of lower face and neck lifts as well as blepharoplasty procedures. Some of that work has included corrective work from previous blepharoplasty. It would be difficult to tell you without seeing either pictures or better yet you in person to determine which correction would be best for you. Certainly, a mid face lift can be used to some degree to help with ectropion but rarely is that the sole solution. I am located in Rockville Maryland, so please feel free to call the office if you would like to come in for a consultation. Best of luck

Brooke R. Seckel, MD, FACS (retired) · Answer

Generally speaking eyelid reconstruction with release of scarring and canthoplasty is the first step in extropion repair. A mid face lift alone is unlikley to correct this problem and i would seek a second opinion from an occuloplastic surgeon

Can a mid-face lift correct ectropion caused by too much skin removal during an upper and lower eyelid surgery?

Answers (11)

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