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Common Eyelid Malposition After Blepharoplasty

Common Eyelid Malposition After Blepharoplasty

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Droopy eyelids can become a continuous source of eye-related problems. If you have such eyelids, then you must be suffering continuously from eye infections. Blepharoplasty is the only way to redress the problem. It is a surgical process where the ophthalmologist will remove the excess skin, fat, and muscles. Accumulation of excess fat above and below the eyelids happens with age as the eyelids stretch and the supporting muscles began to grow weak. This results in droopy upper lids or sagging eyebrows.
If you have such eyelids, you will look much older than your actual age. You will also face problems in vision as the sagging skin can reduce the side vision significantly. To eliminate the vision problems, you need to undergo blepharoplasty. Unfortunately, eyelid malposition are the common impact of the surgery. You need to know about the problems in detail before making the final decision.

Lower eyelid position

To achieve a successful blepharoplasty, you need to consult a facial plastic surgeon who knows about the importance of maintaining your lower eyelid position. Defective positioning of the lower eyelids include lateral canthal rounding, frank ectropion, and scleral show. You can undergo either of the two types of surgical approaches for aesthetic rejuvenation of your lower eyelids- transconjunctival and transcutaneous.

Lateral canthal dysfunction

After blepharoplasty, many patients suffer from the problem of inadequate closure of the eyelids. The problem arises from tissue tethering that happens due to skin deficiency or the stiffness of the intrinsic eyelid. The lesser support from lower lateral canthal attachments can be the chief reason for poor eyelid closure.
It is difficult to detect the condition from static photographs of the patient. Instead, you have to undergo a dynamic diagnostic evaluation process where the doctor will analyze the systematic eyelid blinking to detect the issue. In the language of a doctor, it is more popular as Fish-mouthing Syndrome.


An inaccurate or over-aggressive execution of the incision during blepharoplasty may result in ptosis. It is a condition of upper eyelid drooping, which in this case, happens due to the wrong methodology of treatment. On covering the pupil, you can suffer from limited vision or even complete blockage of normal vision. Mishandling of the elevator muscles during the treatment is the cause of the glitch.
The condition demands another surgery, which is an outpatient procedure. So you can go home right on the day you undergo surgery. However, as you have already undergone the blepharoplasty, it becomes very complex for the surgeon to plan or perform the surgery.

Dryness of eyes

Often, the malposition of the eyelids after the surgery leads to dry eyes. The tear glands fail to produce the necessary moisture. If your eyes turn dry at a young age, you will have to suffer from various eye related problems. Due to the lack of lubrication, you will feel extreme pain and discomfort while moving your eyeball.
The problem arises, especially after blepharoplasty, when you are unable to close the eyelids completely. The gap affects the production of moisture from the tear glands. The condition can be chronic or temporary. Your symptoms might get better with some medication, but the problem does not usually have a permanent solution.

Eyelid retraction

This is again a common after-effect of the blepharoplasty procedure. When your eyes are in primary position, if your sclera is visible above the superior corneal limbus, you are suffering from eyelid contraction. It happens if the removal of skin is more than the required volume. It will affect the vertical eye movement mostly.

Identification of defects

Your surgeon should look for pre-existing laxity of lower eyelids, which is not unusual in patients with droopy eyelids. If you undergo the procedure without the detection of the condition, then there will be a high chance of post-operative ectropion, dehiscence, or retraction of the lateral canthal tendon.
During blepharoplasty, it is simple to expose the lateral canthal tendon with plication to the periosteum that lies over the Whitnall’s Tubercle. The part lies inside the lateral orbital rim. It supports your lower eyelid and will prevent the malposition of the eyelids during the procedure.

Preparing for blepharoplasty

If you want to avoid the common negative impacts of the procedure, ensure that you follow these points, sincerely before the surgery.

1. Find the right doctor:
It is the matter of your eyes, which is the most precious asset of the human body. Why undergo the surgery under some amateur when you can easily consult an experienced ophthalmologist for the purpose? Always check the expertise and experience of the surgeon before proceeding with the treatment.

2. Provide medical history:
It is essential for the doctor to know your past and current health conditions. Did you have any surgeries ever? Do you have glaucoma or any other eye problem? Are you allergic to any drug? These and many other questions are important, and you need to discuss carefully about these points.

3. Thorough physical examination:
Often, an individual may have some health conditions that the person is not aware of due to a lack of symptoms. But before undergoing blepharoplasty, it is essential to know about the complete health status. The neurological examination is especially very important in the revelation of any neural weakness, and you cannot undergo surgery. Eyelid issues or muscle problems will definitely arise as a result of neural weakness.

4. Quit smoking:
Now, this is something that your doctor can’t help medically. You have to control your smoking habit as it has an adverse effect on your healing process. If the healing is not proper, you will start suffering from various eye problems instead of the one for which you consulted the doctor.

5. Vision examination:
A thorough examination of your peripheral vision and normal vision is vital. After blepharoplasty, a little displacement of the eyelid may lead to a serious vision problem, especially for the peripheral vision. Also, it will help you to claim for insurance if there is any obstacle in your peripheral vision. Only after the examination can the surgeon determine whether the surgery is possible, and you can also decide whether to undergo the risk.