Cosmetic surgery on the eyelids is usually gratifying for the patient and the surgeon, especially on the upper eyelids. Like any procedure, there are times when blepharoplasty does not go as planned or does not yield the desired satisfaction for the patient. A botched eyelid surgery, where the surgeon has actually done something wrong, is rare but would also be an indication for revision blepharoplasty.
Revision blepharoplasty is an additional surgery performed to correct unsatisfactory blepharoplasty results.
Blepharoplasty is one of the most common cosmetic surgery procedures. When done correctly and on the right patient, it rejuvenates and refreshes facial appearance. However, complications, especially in lower eyelid surgery, can be devastating and difficult to correct. Even when the procedure is not associated with a complication, it may subtly change the shape of the eyelids and outer corner of the eye in a way that make the patient look “surgical” or operated on.
Revision blepharoplasty is usually straight forward in the upper lid but is more complex in the lower eyelid.
Revisional eyelid surgery is often performed to correct one of the following issues:
If residual skin is left after the original procedure then it is easy to take a little more. Commonly, however, the excess skin is due to sagging of the brow and there comes a point where removing more skin will not treat the problem. These patients benefit from a lateral brow lift.
Sometimes the margin of the upper lid, where the lashes are, is too low and blocks the vision. If this is apparent after surgery it is usually because it was missed preoperatively. Ptosis or drooping of the upper eyelid may be due to previous surgery but is more commonly an anatomical anomaly or an aging change. Correcting ptosis in most people involves shortening the muscle that opens the upper lid called the Levator muscle.
One of the complaints of aging is excess lower lid skin. The problem is that the lid is not very strong and removal of too much skin often results in pull down of the lower eyelid or so-called lid retraction. Other related problems are entropion, or inward rotation of the eyelid so the eyelashes irritate the eye, or ectropion, or outward rotation of the lid, where the eye is irritated and can’t lubricate itself properly. These problems are usually treatable but require expertise and experience.
Lower eyelid blepharoplasty is good at removing bags but is not so good for removing wrinkled skin for the reasons mentioned above. A croton oil peel may help remove some of the persistent wrinkles in the lower eyelid after surgery has done all it can do.
Sometimes the sharp angle of the corner of the eye is rounded after surgery because of excess skin excision or because of attempted manipulation of the lateral canthus (outer corner). Revision surgery to sharpen the angle to a more normal appearance is often possible.
Dr. Charles Thorne has more than 30 years of experience in the field of cosmetic plastic surgery. He is a top facelift surgeon in NYC and is an expert in highly specialized areas of reconstructive plastic surgery.
If you have problems with your previous eye lift, you may be a good candidate for revision eyelid surgery. To see if revision blepharoplasty is for you, schedule a Virtual Consultation today.
Dr. Thorne is the Editor-in-Chief and the author of several chapters in Grabb and Smith's PLASTIC SURGERY, 7th Edition.