Post operative ectropion
Thank you for sharing your question. It appears that you have ectropion of the right lower eyelid following lower blepharoplasty. This is not an unusual complication and may improve if you massage the eyelid and tape it upwards. If this does not correct the issue, then make an appointment with an oculoplastic surgeon for comprehensive evaluation and guidance. Good luck.
Pulling and "WHITE SHOW" of the lower lid after Eye Lid Surgery
It is impossible to advise you based on this one photograph but I can make some suggestions.
IF the photograph was taken perfectly perpendicular to your eyes (not high, lower or to a side) then it appears you have at least SCLERAL (or White) show and may even have Ectropion. When the lower lid is lax BEFORE surgery, any inflammation or pulling (such as taking too much skin, OR the skin pulling on the lashes) will result in exposure of the lower white of the eye. In the corners, it causes a rounding of the angles and as it moves to the center it may pull the lower lid away from contacting the globe leaving a visible tough between the lid and the eye which results in eye dryness, redness and irritation.
This CAN be prevented by tightening the eyelid corner during surgery (Canthopexy or Canthoplasty) OR by putting in a TEMPORARY stitch which holds the corner of the lower lid to its upper lid. This prevents dryness and shortening of the lower lid which will lead to needing another operation. Such a tarsorraphy stitch can be put now and upward massages may be initiated IN ADDITION to the eye drops and steroids.
Have a discussion with your surgeon as only he knows how serious the situation is and see what he says.
Peter ALDEA MD
Possible canthoplasty sooner than later
Your picture shows ectropion and this can happen after lower lid in patients with lax lower lid. Canthoplasty can be done to support the lower lid. Sooner better
R eye concern
You are doing exactly what you should be doing--keeping in close contact with your surgeon. Unless it bothers you, I would suggest switching over to warm compresses at this time. Ice applications are usually beneficial only for the first 48 hrs after surgery. You may also want to see whether your surgeon tthinks taping the outside aspect of the lower eyelid up and out would be indicated.
Lower Eyelid Ectropion
You certainly need to stay in close contact with your Surgeon. The photos show left lower eyelid ectropion which may or may not resolve with time. Ocular lubrication measures are paramount, but a second procedure (tarsal strip) may be required.
Do I need to be worried?
Sorry for the postoperative complication of an ectropion. But your surgeon sounds like he is treating this correctly. But if after 3 to 6 months still with this issue you must consider revision cantopexy operation if not sooner.
Pulling down of lower lid
This can happen after a lower lid bleph and allowing the swelling and hardness to go down is good.It may require a second operation.You may need to patch your eye at night if you can not close it completely.