Mehryar (Ray) Taban, MD
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Mehryar (Ray) Taban, MD
Oculoplastic surgeon | Views: 53099

Friendname: mytaban
Business Name: TabanMD
Website: www.TabanMD.com
Location: 435 N Roxbury Dr, #104
Beverly Hills, CA 90210
United States
Telephone: 310-278-1839
Languages Spoken: English

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Ask An Expert > Mehryar (Ray) Taban Message Board > Lower Eyelid Retraction
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Lower Eyelid Retraction
I had a lower eyelid reduction some six years ago. After this Ive I noticed one eye formed an obvious flap of skin under it when I smiled but the other didnt. I asked a general plastic surgeon to remove it but he recommended to do both and an upper lid at the same time. I agreed.
I have read the blog here and I know a few weeks is early days and I should adopt the "rolling" massage to assist healing. But Im very worried as to the retraction of the lower eyelid as I didnt get this last time and its quite excessive. Shower, winds, air condition all kills my eyes and now I have drops for them etc. Im also goig blind from a genetic condition and such soreness makes my vision much worse. One eyelid seems to be retracting moreso and moving away from the eye as time goes on rather than toward.
But Im wondering if anyone with expereince has seen this level of retraction and eyelid moving away from the eye a few weeks after surgury, to later find it did return to normal.
My surgeon said it would take another few weeks to heal and to keep massaging. He said he didnt take away much skin on the worse eye(1-2mm) so its possibly just swelling and it will go and the eyelid will return up so the sclera wont show. Im not sure on this surgeon, hes not very comforting, so hence the worry.
Ive read a canthoplasty operation can fix this problem. I press and lift in the eyes outer corners and the lid does lift and looks great, suggesting perhaps theres enough skin, just theres no "form" to the lids, they arent stiff and sag like they no longer have structure.
Also, although it doesnt show in the photo. The incision under the eye seems quite obvious and where the cut ends on the outside of the eye theres very large scar tissue lumps under the skin. Again I didnt get this last time and looks like its been butchered in the wrong light (cant see in pic). How long do non aligned incision lines and scar tissue lumps take to dissapate and is there anything I can do to speed it up. Im supposed to be going back to work in a week and I think Im going to have to quit as I cant go back like this.
Any advice would be greatly appreciated.

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Plastic surgeon
Baltimore, MD
United States
View My Professional Profile
Blepheroplasty  June 20, 2011 12:37 PM

From the pictures posted you have ECTROPION more on the left than the right.
You also have PTOSIS of the right upper lid.
You say "you have genetic disease and going blind"

Plastic surgeon
New York, NY
United States
View My Professional Profile
  June 20, 2011 12:58 PM

What may help is pulling the lower eyelid skin with quite a bit of force over the eye. You may also need cheek support and fat grafting does a beautiful job at that.
Let us know what your doc thinks.
Good luck from NYC

Oculoplastic surgeon
Beverly Hills, CA
United States
View My Professional Profile
Post-blepharoplasty lower eyelid revision  June 20, 2011 2:10 PM

Hi. Your photos show two main problems with the lower eyelids. 1) there skin too tight, pulling the lid down; 2) the eyelid muscle tone is weak. Healing does occur up to 6 months after surgery, so waiting is appropriate. It is important to keep your eyes lubricated in the meantime. If there is not significant improvement by 6 months, you should consult an oculoplastic surgeon for possible revisional lower eyelid surgery (possibly requiring midface lift with graft and canthoplasty). Canthoplasty alone won't fix the problem.

Mehryar Taban, MD

Thank you  June 21, 2011 6:11 AM

Thank you to the three doctors who have answered and to any more who will.
The upper lid on my right is lower after this upper lid operation was done but wasnt before. The surgeon belives it will right itself. It feels tighter like hes cut away more skin on one than the other but Im hoping with massage I may get some relief.
Ive managed to tape up the lower eyelids to an almost normal position, so Im hoping to keep it this way for a few months and pray the muscularture will strenghten and things will get better.
The large balls of protruding scar tissue and obvious cuts under the eye are still a concern, but Ill just keep hoping.
Thanks again for your time.

Plastic surgeon
Miami, FL
United States
View My Professional Profile
  June 22, 2011 3:42 AM

Yes it is very early in your healing and the suggestions from your chosen surgeon and the expert posters are correct. You have a postoperative ectropion (right and left are at differing degrees). Over the next few months as the tissue matures there should be a releasing effect so the sclera does not show as much as now. If after 6 months you are still not satisfied than either or in combination fat transfer with a canthopexy would be my recommendation.



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