Thank you for your question.
You’ve submitted single photo and in the narration of your question you describe a
situation where you underwent upper and lower eyelid surgery in 2014.
You had immediately developed an ectropion or the eyelid turning away from the eye.
And then you underwent two revision surgeries, one by the original surgeon and one by the
surgeon’s partner.
And you remain in a situation where you still have ectropion and you’re asking if this
can be corrected.
Well I can certainly give you a lot of guidance on this question, a little bit of background:
I’m a Board-certified cosmetic surgeon and a Fellowship-trained oculofacial, plastic
and reconstructive surgeon.
I’ve been in practice in Manhattan Long Island for over 20 years and revision eyelid
surgery is one of the major areas of my practice for which people come to me from around the
world.
And one of the most common problems I deal with is a problem exactly like yours.
So I’m going to give you a little bit of a framework as to the basis of why you are
in this situation at this point and what can be done for someone like yourself when I see
people like you in my practice.
So to understand lower eyelid surgery and lower eyelid position.
we always have to go back to some basic anatomical facts and it has to do with the lower eyelid
which it can be deceptively complex.
First of all the lower eyelids in many ways is like a suspension bridge and so there are
critical elements that keep the suspension bridge up.
There’s the tendons that attached to the muscle, there’s the balance of the skin
in the front and the back as well as the tissue, that’s in between the skin and which we
call the conjunctiva, the back of the eyelid that is the part of the support system, and
the support is like pillars.
Very often when lower eyelid blepharoplasty is performed, for example when it’s done
from the outside fat is removed, this system of support is compromised.
In addition when skin is removed in the effort to reduce and improve wrinkles then there
is actually a skin shortage.
So in your situation, without a physical examination I think we can fairly reasonably conclude
that there’s opportunity to restore the anatomy in a way that will restore the position
of the lower eyelid.
It’s critically important that lower eyelid position be restored because it’s not just
about the aesthetics it’s also about the health of the eyes.
Proper eye function requires the continuous lubrication of the surface of the eye with
tears.
When the eyelid is everted away well then that natural distribution of tears is compromised.
So, certainly there are options to help you improve your outcome.
It is still about restoration of anatomy.
So, I think what you need to do, and with due respect to the doctors who were involved
in trying to help you improve your appearance, you may want to consider getting an additional
opinion by a oculofacial plastic surgeon who does a lot of revisional surgery.
You know, many years ago in my practice, this decision to focus on a lot of focused cosmetic
oculofacial and facial aging issues.
It really is almost specialty within oculoplastic surgery from my perspective in the way I work.
We have to address all with not only the medical issue of getting the eyelid in place but also
the cosmetic issue of optimizing a result so they look very good and so there is often
the combination of technologies applied whether lasers, whether platelet rich plasma, whether
it’s regenerative medicine.
So, I think it’s important for you to not only really be comfortable with a doctor who
is going to offer to help you with this procedure who is a revision specialist but understand
that you do have hope that there is something that can be done.
It means, it’s not going be a short journey but it will likely ultimately lead to a better
outcome than what you’ve been dealing with now for a couple of years.
So I hope that was helpful, I wish you the best of luck.
Thank you for question