Dear Dr. Seckel, I had a lower blepharoplasty (not transconjunctival) and a rhinoplasty (tip area only) performed about a month ago. Since the surgery the outer corners of my eye have turned down (as if I was intentionally pulling them downward (the Sad Eye/Hound Dog Look you mentioned). The inner lid also is turned slightly out in the corners making me look like a different person. I have voice my concerns with my plastic surgeon and he says I look refreshed while others who know me say differently. I’m concerned that I may need corrective surgery however other specialists do not want to see me until six months or so. If the muscle is damage, does it ever correct itself and how long do most patients have to wait until there eye integrity is back again? Lee, Port Jefferson, NY
Dear Lee,
The sad eyed look, also called an ectropion or hound dog eyes, following the eyelid rejuvenation procedure called a blepharoplasty is common after traditional scalpel blepharoplasty an eyelid surgery during which an external incision is made on the outside skin of the eyelid. The turned down lower eyelid not only looks bad but can cause serious damage to the eye if not corrected.
This look can improve with time, but I am concerned that your plastic surgeon did not notice it or address the issue with you.
For the time being I urge you to be proactive and massage the lower eyelids 3 times a day for 5 minutes. Place a moisturizer or eye cream on the lower lid and with your finger start at the inside corner of the eyelid near the nose and sweep the finger to the outside pulling the lower eyelid up to stretch it out and push the lid against the eyeball.
Massage will help and time will tell.
I usually wait at least three months to correct the sad eyed look or ectropion by doing a corrective secondary blepharoplasty or eyelid surgery usually a canthoplasty or canthopexy. This cantholasty or canthopexy procedure tightens the eyelid and brings the lower eyelid up against the eyeball correcting the sad eyed look or ectropion.
Sometimes if the ectropion is very noticeable and causing discomfort I do a temporary one stitch tightening procedure on the outer corner of the eyelid right away to help pull the lid up called a temporary tarsorraphy but I don’t think you need this.
Please send me a photo of a close up of both eyelids front view and I can give you a better opinion.
For more information on blepharoplasty and eyelid rejuvenation read Save Your Face or contact me.
Boston, Massachusetts