Revision Eyelid Surgery
What is Revision Eyelid Surgery?
Revision eyelid surgery usually refers to revision blepharoplasty. This refers to a secondary blepharoplasty procedure done to correct problems from an initial eyelid surgery. Some of the best surgeons in the St. Louis area send such cases to Dr. Holds and his associates at Ophthalmic Plastic and Cosmetic Surgery because of their experience in performing complex eyelid surgeries and revision blepharoplasty.
“How can I thank you enough for all you have done for me? I came to you after another surgeon ruined my eyes and you have devoted many surgeries to correct his major mistake. I am forever grateful to you and your wonderful staff. You are amazing!” – Noreen B.
Who is a candidate for revision blepharoplasty?
The decision to revise eyelid surgery is very personal and important. Undergoing a second procedure requires a precise and thoughtful approach. Therefore, it is necessary to consult with an experienced, board-certified plastic surgeon whose primary focus is the eyes.
Revision blepharoplasty is relatively common and sought by individuals who are unhappy with the initial results achieved with eyelid surgery. Some people seek revision blepharoplasty to resolve concerns related to postoperative scarring or to address the signs of aging that have recurred years after a prior blepharoplasty.
Good general health and habits such as tobacco avoidance are ideal characteristics shared by good surgical candidates. It is also vital that doctor and patient are on the same page before surgery and that realistic expectations of the possible outcome from surgery have been set.
How Long Should I Wait To Have Corrective Blepharoplasty?
Reasons for Corrective Eyelid Surgery
Some people feel that the doctor has not done enough to correct their droopy upper eyelids or undereye bags. In that case, they may wish to have another surgery to reduce the drooping and bags even more.
Obviously, it’s very important to spend time with your doctor before your initial surgery to make sure he or she is aware of the final outcome that you want. This will decrease the possibility of your needing subsequent surgery. Nevertheless, it’s far better to have excess tissue that needs to be removed than to have lost too much tissue in the first surgery.
In other cases, the eyes don’t match well enough after surgery so that another procedure must be performed to improve symmetry. This often has to do with asymmetries that were present before the initial procedure, such as one eyebrow that sits lower than the other, causing one upper eyelid to droop after the first surgery.
In extremely rare cases, a complication may occur after a first blepharoplasty procedure which makes it necessary for revision eyelid surgery to correct the problem. These complications can include a prior excess excision of tissue with hollowing of the eyelids and difficulty with fully closing the eyes, a downwardly pulled lower eyelid due to scarring, or excess tissue excision or uneven eyelids.
What Issues Can Revision Eyelid Surgery Correct?
Revision blepharoplasty is often conducted to correct one of a few problems:
- Under-correction. A second surgery may be sought to further enhance the eyes that were previously under-corrected by removing less tissue than was necessary.
- Over-correction. The eyes can be overdone by removing too much tissue. Over-correction may make it impossible for the eyes to close completely, leading to dry eye. Too much tissue removal also leads to a misshapen appearance.
- Ptosis. Drooping of the upper eyelid may occur due to aging or an anatomical anomaly. Some surgeons perform blepharoplasty to correct ptosis, but the technique needed for this problem is not the same as what is typically involved in cosmetic eyelid rejuvenation. After blepharoplasty, the levator muscle may continue to pull on the upper eyelid, resulting in a droop. In some cases, ptosis is the result of blepharoplasty and accidental disruption to the levator muscle in the upper eyelid.
- Visible scarring may occur when incisions are made too high on the upper eyelid. Usually, incisions are made in the natural crease of the eye, where resulting scars will be well hidden.
- Entropion is an eyelid condition in which the tissue on the eyelid turns inward.
- Ectropion is a condition in which tissue on the eyelid turns outward.
Revision blepharoplasty can improve the appearance of the eyes when one or more of these complications has developed. However, depending on the extent of the problem, 100% correction may not be possible. You can expect your board-certified surgeon to communicate clearly with you regarding the predicted outcome of your procedure.
What to expect during your consultation with Dr. Holds
When you arrive to your consultation, you will need to provide a medical history, as we need to know about major illnesses and problems such as heart disease and hypertension. It’s important that Dr. Holds learn the details of your prior facial surgery. Bringing old photographs from before your first operation can be especially helpful.
Dr. Holds will ask you what aspect of your eyelids and face bother you since your first surgery and will discuss options to correct it. A mutual understanding of the goals, expectations, and outcomes is essential to an optimal result!
During your consultation, an examination is also performed to look at any eye conditions such as dry eye, which could limit or alter the surgical plan or be a concern after your procedure. Depending on the findings of our consultation and analysis, we may recommend a different surgery altogether to achieve the desired outcome. Sometimes, the facial structure and initial results from surgery are best addressed with a procedure such as a brow lift, mid face lift, or fat transfer.
As a board-certified ophthalmologist (eye surgeon), as well as an ophthalmic plastic surgeon, Dr. Holds is attuned to eye diseases and concerns. He is routinely referred patients by some of the best facial and cosmetic surgeons in the area because of this expertise and ability to safely operate on patients at higher risk for complications.
Revision Blepharoplasty Procedure
Every case is different, and it depends upon what has caused the problem and what needs to be corrected. In most cases, you can have the surgery on an outpatient basis, and the recovery is similar to that for your first blepharoplasty. Again, however, this varies from person to person. If your complication is more severe, the surgery will likely be more complex and may require a longer recovery period.
Recovery After Corrective Eyelid Surgery
Recovery processes are very individualized and usually relate to the type of corrective surgery that is performed. For example, the technique involved in revising an overly-corrected eyelid may require more time in the operating room, which translates into a lengthier recovery. Revisional surgery for under-correction, on the other hand, is less complex and usually requires a shorter recovery period than other techniques.
However your eyelids are corrected in your revisional procedure, you can expect some degree of bruising and swelling around your eyes. These side effects gradually decrease over a few weeks For the first few days after surgery, it is common to experience a bit of blurry vision as well as tearing and light sensitivity. Discomfort is typically mild and manageable with over-the-counter pain-relieving medication. If necessary, prescription pain medication can be arranged.