Q: What are the pros and cons of eyelid retraction repair surgery?

Pros Eyelid retraction repair surgery can give your eyes a more symmetrical appearance. It can improve your ability to close your eyes completely as well as ease dryness, redness, or burning. Most eyelid surgeries take less than an hour. Because the incisions are made inside the lids, there’s typically no visible scarring once healed. If you have impaired vision or medically related eye irritations, the procedure may be covered by health insurance. RealSelf members who rated the procedure “ Worth It ” say they are very satisfied with the results. They also report a noticeable difference in their appearance—specifically, that they look happier and less tired. Cons It may take at least six months for you to fully heal and see the final results. To prevent strains or complications, you’ll need to avoid strenuous activity or lifting weights for about a month after surgery. It’s rare, but doctors on RealSelf report that retraction repair surgery on the lower eyelid could lead to an overcorrection, giving the eyes an even more open look.

Question 1

What is eyelid retraction repair surgery?

Accepted Answer

Eyelid retraction repair is a surgical procedure to correct eyelids that appear pulled back away from the eyeball, contributing to the appearance of bulging eyes and causing exposure problems.

People who are experiencing eyelid retraction typically have one eye that appears more open and unnatural—meaning the white part of the eye (the sclera) is exposed above or below the colored part (the iris). Eyelid retraction can occur either far up on the upper lid and/or far down on the lower lid.

Eyelid retraction typically develops over time, but it can also stem from a congenital condition, trauma, a stroke, or tumors. The most common cause of upper eyelid retraction, however, is thyroid eye disease (also referred to as Graves’ disease or Graves’ ophthalmopathy). Lower eyelid retraction most commonly results from complications after lower eyelid surgery or blepharoplasty.

Most people interested in upper or lower eyelid retraction surgery are experiencing chronic issues that stem from their eyelid not being able to properly close over the eye—including redness, dry eyes, excessive tearing, burning, and impaired vision. Some people may not have any actual discomfort but choose to get the retraction repaired for cosmetic reasons.

Question 2

What are the pros and cons of eyelid retraction repair surgery?

Accepted Answer

Pros

Eyelid retraction repair surgery can give your eyes a more symmetrical appearance.
It can improve your ability to close your eyes completely as well as ease dryness, redness, or burning.
Most eyelid surgeries take less than an hour.
Because the incisions are made inside the lids, there’s typically no visible scarring once healed.
If you have impaired vision or medically related eye irritations, the procedure may be covered by health insurance.
RealSelf members who rated the procedure “Worth It” say they are very satisfied with the results. They also report a noticeable difference in their appearance—specifically, that they look happier and less tired.

Cons

It may take at least six months for you to fully heal and see the final results.
To prevent strains or complications, you’ll need to avoid strenuous activity or lifting weights for about a month after surgery.
It’s rare, but doctors on RealSelf report that retraction repair surgery on the lower eyelid could lead to an overcorrection, giving the eyes an even more open look.

Question 3

How much does eyelid retraction repair cost?

Accepted Answer

Oculoplastic surgeons who specialize in cosmetic and reconstructive eyelid surgery may charge more than general plastic surgeons. Your cost will also depend on the location of the practice, the type of anesthesia used, and whether you’re having surgery on the upper or lower lid. Insurance may apply, if the procedure addresses a medical issue, such as impaired vision or chronic eye infections.

Question 4

Eyelid retraction repair before and after pictures

Accepted Answer

The eyelid retraction repair photos in our gallery have been shared by the provider who performed the procedure, with the patient's consent.

Question 5

What happens during eyelid retraction repair surgery

Accepted Answer

For upper eyelid retraction surgery, the muscle that holds up the lid (called the levator muscle) is usually released to lower the upper eyelid. In extreme cases, skin grafts or spacer grafts may also be used.

Lower eyelid retraction repair surgery can involve a combination of techniques. “Typically, the lower lid retraction is due to a deficiency of skin in the lower lid and would require a skin graft with lower eyelid tightening to adequately correct the problem,” says Sandy, Utah, oculoplastic surgeon Dr. John McCann in a RealSelf Q&A. A 2017 study published in the Korean Journal of Dermatology concluded that milder cases of lower eyelid retraction, however, can usually be corrected without grafts.

Grafts can come from tissue borrowed from your own body (for example, ear cartilage or the oral cavity) or from a material like AlloDerm, which is a tissue derived from donated human skin.

Local sedation can usually be used for upper eyelid repair, but lower eyelid surgery may require deeper anesthesia. Eyelid retraction surgery is done on an outpatient basis and can be completed in as little as one hour.

Question 6

What to expect after eyelid retraction repair surgery

Accepted Answer

Expect swelling and bruising around the eyes to last for around two weeks. You may need to wear an eye patch for a few days following surgery, to ensure the eye remains protected.

Other post-op recommendations by your doctor may include:

Continued application of ice packs, to manage swelling
Limited strenuous activity (including lifting weights or other heavy items) for the first couple of weeks
No contact lenses or eye makeup for at least one week

Depending on the type of surgical technique used, it may take anywhere from 3 to 12 months before you can determine the final results. “Eyelid surgery is a surgery of millimeters,’” says San Diego facial plastic surgeon Dr. Robert Shumway in a RealSelf Q&A. “Therefore, a small amount of residual lid swelling will affect the overall look.”

For those with thyroid eye disease, healing from upper eyelid retraction repair can be an especially “tough deal” because of the possibility of falsely perceived early results, says Beverly Hills, California, oculoplastic surgeon Dr. Kenneth D. Steinsapir in a RealSelf Q&A. “It’s essential to overcorrect the eyelid during surgery, anticipating that with healing there will be contraction of the tissues,” he explains. “Not so occasionally, the surgery can actually bottom out the eyelid, leading to an overcorrection. Generally, overcorrection at [just] three weeks post-op is a good sign. If you were perfect [at three weeks], then by three months you would heal with the eyes too open.”

When the surgery is a success, people, like RealSelf member mcowens1, are very pleased. “What a great decision—my eyes aren’t only beautiful, but I look so much happier since the ‘Basset Hound’ droop is gone. It’s life-changing, in that I feel happier by looking happier.”

Question 7

Nonsurgical alternatives to eyelid retraction repair

Accepted Answer

Before you opt in to eyelid retraction repair surgery, you may want to consider nonsurgical options. But keep in mind, the results with these are temporary.

Injectable fillers, like Restylane or Juvéderm, won’t fix the underlying problem but can add volume to the lid, helping it cover more of the eye, explains Dr. David Gay, an oculoplastic surgeon in Austin, Texas. “The results aren’t as predictable as [those of] surgery but can be worth trying with someone experienced in injecting this area.” Fillers cost $675 on average, and they can last anywhere from 6–18 months, depending on the type used.
Botox is a good option for those who are in the inflammatory stage of thyroid eye disease, according to a study in the journal Ophthalmic Plastic and Reconstructive Surgery. Individual response will vary, but the injectable can be considered a temporary measure until surgery is a viable option.

EYELID RETRACTION REPAIR

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