Is This Lower Lid Retraction After Lower Blepharoplasty?
I'm 30 days post op from an Endoscopic brow lift and lower Blepharoplasty.
My lower lids seem to be drooping down on the outer edges.
My right eye is more prominent than the left.
The doctor has me doing rolling massage three times a day.
I'm devastated by the outcome but I haven't expressed concern about this with my Dr. yet.
I meet him again in two weeks.
What is this and should I call him sooner?
Also, is it normal not to have feeling from the top of my head to my brow?
I'm 50 and a nonsmoker.
Thank you for your question.
You're 30 days after endoscopic brow lifting lower eyelid blepharoplasty and you're asking
about eyelid retraction.
And you've describe one eye being worsen than the other and your doctor has advised you
to massage the lower eyelid and you've also expressed that you are devastated that you
haven't expressed this with your doctor so clearly you're looking for additional opinion
and some guidance.
Well, first of all, being in communication with your doctor so critically important.
Your doctor obviously set out the procedure the best way the doctor knows how and is following
up with you in 2 weeks so you are getting, in my perspective, the appropriate attention
that you will need to deal with the concerns that you have.
The question with numbness after endoscopic brow lift is a reasonable question is not
at all unusual to have numbness so you are clear with that.
There are nerves in the forehead specifically that provide innervations or sensation to
the skin although eyebrow and the scalp and swelling can really have an impact on that.
And so typically, I tell my patients that this is narrowly common endoscopic brow lift
and also face lifting.
In face lifting there is a region of numbness in smaller and smaller as time goes on.
So as far as the lower eyelid retraction is concerned, as a cosmetic ocular facial plastic
surgeon, who specializes in eyelid complications and revision surgery, I have lot of experience
with lid retraction.
When people come to me and as early as someone like you have, I would generally, if there
is no clear indication medically to pursue revisional procedure, then conservative management
is usually the first line of treatment.
The conservative management includes massage.
You see when lower eyelids is performed, sometimes the eyelid can look relatively retracted but
not because of complication or healing complication but rather swelling that causes the muscles
of the lower eyelid called the orbicularis muscle to be having a little bit less tone
so there is a relative sag.
Sometimes I describe the lower eyelid as a hammock and this hammock when its loose can
get sag so if your doctor noticed or physical examination that your lower eyelid is tight
or pulled down, then massage can help that.
Now there are exceptions to this.
We have had many patients who come to us whose eyelids where so pulled down that their eyes
are exposed or the outer core of the eyelid was not connected and they were not only having
overriding of the eyelid where the eyelid was irritating.
The upper eyelid was riding under the lower eyelid and the eyelid was getting irritated
and also the eyelid was also away in the eye that it was causing a lot of ophthalmic issues.
And in any time there is an issue that is potentially vision threatening or ocular health
threatening then we do things more aggressively.
So it seems your doctor is in the right track of management.
Now when things settle, you may feel that your eyelid is retracted more than you want
and then revisional procedure maybe indicated so it is very important that you continue
to communicate with your doctor now, one knows anatomy of your eyelid better than the surgeon
who operated on you assuming that the surgeon also did a proper preoperative assessment.
Understanding that there are definitely times when in the best in hands procedures may need
some kinds of revision procedure that your surgeon will work with you and do whatever
enhancement is necessary if its indicated.
So at this point I would say you best option is to still work with your doctor and see
where the eyelid goes and as your healing process continues.
So I wish you the best of luck, I hope that was helpful and thank you for your question.