Dear Dr. Seckel, I believe a prior blepharoplasty has left me with “weakened” lower lids. Now my eyes have kind of a “floating” look to them. Is there anything that can be done to “tighten” up my lower eyelids? I have had a laser resurfacing done and it didn’t pull up my lower eyelids at all. Also. What can be done about a “hollowed” look under my eyes Thank you, Donna, Pekin, IL
Dear Donna,
Unfortunately a weakened lower eyelid is a common problem after a traditional “cold scalpel” lower blepharoplasty in which a scalpel is used to make an incision on the lower eyelid to remove loose skin and fat as part of the blepharoplasty procedure. The weakened lower eyelid, called an ectropion, gives a sad eyed look also called hound dog eyes, and is more common when laser resurfacing is done on an already lax lower eyelid.
To avoid this I do a transconjunctival laser lower blepharoplasty through a tiny laser incision on the inside of the lower eyelid, through the pink conjunctiva, to remove puffy eyes and eye bags and correct dark circles under the eyes. This procedure rejuvenates the eyelid without weakening the lower eyelid.
Since you do have a weakened eyelid following blepharoplasty the only way to correct the weakness and tighten the eyelid and give it a nice natural shape is to do a procedure called a canthoplasty. This procedure is relatively minor and tightens the canthal ligament which supports the eyelid. It does require a plastic surgeon who is very experienced in oculoplastic or eyelid surgery-many plastic surgeons are unfamiliar with the operation so you need to ask the right questions and be certain your doctor knows how to do it.
The hollowed look you describe is also common after a blepharoplasty when too much fat is taken out during the blepharoplasty. This can be corrected by transplanting or replacing the fat into the eye socket and also by a procedure called an arcus marginalis release which helps remove the dark circles under the eyes, which also make the eye look hollow.
These procedures are advanced procedures which require the expertise of a plastic surgeon who is very experienced in eyelid surgery. Be sure to ask questions and find a good doctor. Chapter 10 of my book “Save Your Face” entitled “Don’t Let Just Anyone Touch Your Face” gives good advice on how to find the right doctor.
For more information on dark circles under the eyes, hollow eyes, blepharoplasty and plastic surgery read Save Your Face or contact me.
Thank You,
Boston, Massachusetts