Repairing the lower lids after failed cosmetic eyelid lift

A significant portion of my practice is devoted to repairing the “multi-operated” patient, in which cosmetic eyelid surgery has led to problems in appearance or problems with the health of the surface of the eye. An example of the subtle reconstructive cases that I have worked on recently is described below.

My cosmetic reconstructive patient had prior lower lid surgery with fat injections. That surgery left her with both lids too low.  The outer corners of the lids tended to droop as well, leading to a “sad” apperance.  There is additional bulk in the right lower lid due to fat injection.

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She underwent release of scarring in both lower lids, placement of lower lid implants, removal of some injected fat on the right, and reanchoring.  Her one month postoperative photo can be see below. Notice that there is much less “white” of the eye visible.  There is no white visible beneath the colored iris.  The outer corners do not droop down.

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Direct preoperative and postoperative comparisons for each side are seen below:

Right lower eyelid: pre / post
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