Lateral
Medial canthal webbing occurs when incisions are carried too medially as seen in Figure 9. The skin then bridges the superomedial hollow of the upper lid in a straight line. Early recognition and aggressive massage will eliminate the majority of cases. Persistent cases are treated by a V- to-Y plasty procedure.
Chemosis occurs as a result of conjunctival response to a variety of inflammatory conditions of the eye or eyelid, including allergy, infection, and trauma (surgical or otherwise).
Complications in blepharoplasty are uncommon and, when they occur, they are usually mild and transient, such as hematomas and chemosis. However, sometimes they can be severe, such as blindness, or they might require surgical correction, such as ectropion.
The eyes appear asymmetrical
Having mismatched or asymmetrical eyelids after blepharoplasty is a common mistake that can occur with Eye Lid surgery. It can occur due to the tissues having been over-excited – or simply due to natural changes in the way each eye responded to surgery or to healing processes.
However, it involves removing the fat pads below the eyes and often a hollow, sunken look can occur if too much fat is removed. Over time, the cheek fat pad descends lower in the face and this adds to a hollow, sunken appearance.
After blepharoplasty surgery, the eyelids will be bruised and swollen for one to three weeks. However, most patients say their eyes look normal and better than before after one to three months.
Conclusion. Post-upper blepharoplasty syndrome is characterized by upper eyelid ptosis, lash ptosis, high or indistinct upper eyelid crease, hollow upper eyelid sulcus (absent upper eyelid fold), and a compensatory eyebrow elevation. We call this configuration a “synform” upper eyelid fold.
Occasionally, stitches closing the surgical incision come apart before the skin edges are healed together. This is called a wound dehiscence. This most commonly occurs in the upper eyelid where an incision is made to remove excess skin. The raw edges of skin separate and the wound gapes open.
The approach to correcting botched eyelid surgery will depend on the specific issue. In some cases, the surgeon may need to perform revision surgery to correct the issue fully. In other instances, non-surgical treatments such as dermal fillers or Botox injections may be used to address the problem.
Chemosis is a sign of eye irritation. The outer surface of the eye (conjunctiva) may look like a big blister. It can also look like it has fluid in it. When severe, the tissue swells so much that you can't close your eyes properly.
If insufficient fat was removed, usually from the outer part of the lower lid, that can be fixed with a revisional procedure. -Deep indentation at the lid cheek junction. Some people have a deep indentation where the lid meets the cheek.
If further eyelid procedures have been performed such as canthopexy, canthoplasty or facelifts, chemosis may be more common. In general, chemosis after blepharoplasty is very rare. In the less than a handfull of patients we have encountered chemosis, it resolved after 4 to 6 weeks spontaneously.
Lateral canthal webbing is a known complication of blepharoplasty, which occurs when the lateral aspect of the upper blepharoplasty incision is taken below the equator of the lateral canthus. Removing excessive eyelid skin laterally can also result in a lateral canthal web.
Lower eyelid retraction is a devastating complication of bad blepharoplasty results in which the lower eyelid is pulled down. Lower lid retraction has primarily been reported in patients who underwent a transcutaneous approach to lower eyelid surgery – when the surgery is done through lower lid skin.
Asymmetry, The Eyes Look Different, Or Heal Differently.
The eyes may look or feel quite different from one another in the days following surgery. This is normal; no two eyes in nature or following surgery are perfectly symmetrical.
Canthal webs occur because there is a relative deficiency of skin in the vertical as compared to the horizontal plane. They are surgically corrected by a variety of micro-skin flaps. Most plastic surgeons avoid addressing canthal webs as they are difficult to correct and can lead to significant scaring.
Chemosis can last anywhere from a few days to weeks or months. In rare cases, chemosis may last for a year or longer. The length of time chemosis lasts depends on the cause and severity of the chemosis. Mild chemosis caused by minor eye irritation can go away quickly.
Treatment of lagophthalmos with skin grafts
Since the reason the patient cannot close the eyes is a lack of sufficient skin on the upper eyelids, the only effective way to treat this complication is to add skin.
Short-term changes in the shape of the eye can occur. The position of the eyelid can temporarily change due to the bruising and swelling associated with eyelid surgery. For the majority of patients, this issue usually resolves itself within approximately 6 weeks.
Full blepharoplasty recovery time typically takes about 3 months but you can expect to get back to your normal routine after 2-3 weeks of healing.
An ectropion (out-turning lid) can occur after blepharoplasty. This can lead to an impairment in appearance and vision. In addition, ocular pain and irritation and tearing can occur. When an ectropion occurs after blepharoplasty surgery an expert in revision eyelid surgery is needed to correct the problem.
This may feel strange or even frightening at first, but rest assured that this is a normal postoperative effect that should subside with time. The majority of patients report tightness after eyelid surgery to last for about two weeks, though numbness or a change in eyelid sensation may last longer.
According to this, the overall incidence of visual loss following blepharoplasty was calculated at 0.0052% (five of 100,000 cases, or one in 20,000). Permanent visual loss was calculated at 0.0033% (three in 100,000, or one in 30,000) and temporary visual loss at 0.0019% (two in 100,000, or one in 50,000).
It takes a full 12 months for scars to fully mature, flatten and soften. The following videos are techniques Dr. Kolstad recommends for his patients during the recovery period. He typically recommends massaging the incisions 10-14 days after surgery and continuing them until the scars have softened.