Do I need to be worried? (photo)

I had upper & lower lid surgery 17 days ago. My doctor said he had to do considerably more work on my right eye.  The left eye is doing well, but the right eye lid is pulled to the side exposing the inside corner of my eye. The corner and line below my eye are still very hard. My concern was scare tissue but the doctor has told me there is still swelling and he predicts it will correct itself. He is checking me once a week and has prescribed eye drops with steroids.  He's a good doctor and I want to trust him but I'm starting to get concerned.  Still sleeping with my head elevated, using ice and massaging. 

Doctor Answers 7

Post operative ectropion

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 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

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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.

Good Luck

Memphis, TN

Peter A. Aldea, MD
Memphis Plastic Surgeon

Possible canthoplasty sooner than later

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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 

Kamran Khoobehi, MD
New Orleans Plastic Surgeon
4.8 out of 5 stars 154 reviews

R eye concern

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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.

Robert J. Smyth, MD
Cincinnati Facial Plastic Surgeon

Lower Eyelid Ectropion

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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. 

Stephen Prendiville, MD
Fort Myers Facial Plastic Surgeon
4.9 out of 5 stars 104 reviews

Do I need to be worried?

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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

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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.

Robert Brueck, MD
Fort Myers Plastic Surgeon
4.9 out of 5 stars 70 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.