Wrinkles and Excess Skin After Upper and Lower Blepharoplasty? (photo)

Eyelid surgery specifically does not address wrinkles. It addresses excess skin, or in situations such as Asian eyelid surgery it creates a crease or fold in the upper eyelid. If someone has a lot of extra skin, there may be some improvement in the appearance of wrinkles, but often it’s because of the extra skin removed had wrinkles.

With the intention of improving wrinkles in the lower eyelids, a lot of plastic surgeons will remove skin. Unfortunately, after 20 years of experience in oculofacial plastic cosmetic surgery, I can say that is not the best choice. Many surgeons will remove skin which reduces the amount of skin that the lower eyelid requires to function properly. The removal of skin affects the shape and contour of the eyes. Patients are then left with lower eyelids that look like they are pulled down. This condition is called lower eyelid retraction or lateral scleral show.

Lower eyelids need to be in a good position to function properly. Eyelids that are pulled down laterally in the outer corner have a diminished effectiveness in protecting the eye and providing a platform for tear film distribution over the cornea. Patients with this type of condition may have dry eyes and other symptoms. Sometimes I suggest the use of tear drops regularly. I highly recommend that you communicate with your doctor who performed this surgery and see if any corrective procedures are necessary to address your problem.

There are multiple issues that need to be looked at very carefully. That can be done by reviewing the operative note and examination. You have significant scleral show. Some scarring and puffiness in the lower lid. The fine wrinkles do not go away with surgery, they need laser resurfacing. at the same time need correction of lower lid laxity.Redo of any surgery is more difficult than the original surgery.