Revisional eyelid surgery
This patient had undergone previous eyelid surgery years prior and was left with retraction in her lower eyelids, right more so than left. She was unable to properly close her lids and was left with tearing and dry eyes. A revisional/reconstructive eyelid surgery with volume augmentation fat grafting was performed to help improve the function and appearance of her eyelids. A canthoplasty (lid suspension), retraction repair using hard palate grafts, and fat grafting to the midface/cheek area was performed. Notice the improvement, the patient’s symptoms and eyelid function dramatically improved.
Preoperative Diagnosis: Retraction in lower eyelids, rounding of lower eyelids from previous surgery
Procedure performed: Reconstructive lower eyelid surgery, canthoplasty, hard palate grafts for retraction repair, and peri-orbital fat grafting.
Surgeon: Christopher Zoumalan, MD. Oculoplastic Surgeon
Location: Beverly Hills, California
This patient had an overcorrected left upper eyelid position from prior surgery and underwent a left upper eyelid retraction repair. The left eyelid position was brought down through an eyelid surgery. Notice the symmetric results post repair.
Preoperative Diagnosis: Left upper eyelid retraction
Procedure performed: Left upper eyelid retraction repair
Surgeon: Christopher Zoumalan, MD. Oculoplastic Surgeon.
Location: Beverly Hills, California
This patient underwent Asian eyelid surgery (double lid surgery) in the past and now has residual ptosis, left worse than right. She also has an epicanthal web in her left upper lid which requires scar revision as well. A minimally invasive ptosis repair was performed to lift her lids with no open incision (posterior incisions). Epicanthal scar was also revised in the left upper lid.
Preoperative Diagnosis: Ptosis, bilateral. Epicanthal web, left upper lid
Procedure performed: Revisional ptosis repair, bilateral with epicanthal web revision.
This patient had prior lid surgery to repair her facial trauma but still had lower lid retraction where the lid is positioned lower than it should normally. She also had an ectropion in her left lower lid (the lid was turned outward). These were resulting in significant discomfort, ocular irritation, and a cosmetic deformity. She underwent revisional eyelid surgery to help repair the lid to a more appropriate position. An ectropion repair and retraction repair using an alloderm spacer graft was performed. A midface lift was also performed at the same time to keep the eyelid in better position as the patient continued to heal.
Preoperative Diagnosis: Left lower lid ectropion and retraction
Procedure performed: Left lower lid ectropion repair and retraction repair using an alloderm spacer graft, midface lift.
This patient has moderate right lower lid retraction in addition to mild upper lid ptosis. She is unhappy with the asymmetric appearance to her lids and wished to have them corrected. She also complained of a persistent ocular irritation to the right eye which was due to the lower lid retraction she had and subsequent dry eyes.
She underwent a mild upper lid ptosis repair and a right lower lid retraction repair using a lid resuspension technique (canthoplasty) and a posterior spacer tissue graft. We were able to improve the symmetry in her lids and also alleviate her ocular symptoms and dry eye syndrome.
Preoperative Diagnosis: Bilateral upper lid ptosis and right lower lid retraction
Procedure performed: Bilateral upper lid ptosis surgery and right lower lid retraction repair through a canthoplasty lid resuspension technique and posterior spacer tissue graft.
Preoperative Diagnosis: Right lower lid retraction from prior trauma
Procedure performed: Right lower lid retraction repair using an Alloderm spacer graft with a canthopexy.
Preoperative Diagnosis: Bilateral lower lid retractions and ectropions (outward everted lids) from prior surgery and chronic sun damage.
Procedure performed: Bilateral lower lid retraction repair using an Alloderm spacer graft with a canthoplasty (lid resuspension and tightening).
This patient had trauma to the right lower lid and it was unsuccessfully repaired in the past. She underwent eyelid reconstructive surgery in order to free up and excise the scar tissue and to repair the lower lid position by using a tissue graft along with lid resuspension.
Preoperative Diagnosis: Right lower lid retraction
Procedure performed: Right lower lid retraction using a tissue graft and canthoplasty
This patient had prior surgery to both lowerlids which as resulted in lower lid retraction and difficulty closing her lids. She underwent eyelid reconstructive surgery in order elevate her lower lids to a more anatomically normal position. A canthoplasty (lid resuspension) with a hard palate graft (taken from the roof her mouth) was used to help keep the lower lid in a new position. A midface lift was also performed to elevate her midface and to allower her lower lids to be resuspended and supported at a more anatomically appropriate position.
Preoperative Diagnosis: Lower lid retraction
Procedure performed: Lower lid retraction using a hard palate graft, canthoplasty, and midface lift
She had undergone a prior blepharoplasty in the past and now had some retraction of her lower lids. Note the rounding of the corner of her left lid and the “whites” of the eyes that are showing above her lower lid. She complains of chronic dry eyes and irritation to both eyes. The lower lids where resuspended and a palate graft (tissue from the roof her mouth) was used to resupport the lower lids.
Preoperative Diagnosis: Bilateral lower lid retraction
Procedure performed: Bilateral lower lid retraction repair using a hard palate graft and canthoplasty.
This patient had undergone prior upper and lower blepharoplasty in the past. He complained of a droopy appearance to his upper lids and irritation in both eyes due to the retraction in his lower lids. Retraction of the lower lids is a result of a downward displacement of the lower lids either from prior surgery (cosmetic or trauma), thyroid related problem, or just as a result of aging changes. He had ptosis in his upper lids which may have worsened with time. He wished to have his eyelids appear more natural appearing, see better, and improve his irritation.
The goal of my surgery was to help him see better by lifting his eyelids and also to correct the laxity and retraction he had in his lower lids. The retraction in his lower lids prevents him from closing his eyes at well so he has problems with excessive exposure to the eyes. This results in his irritation and redness to the eyes. As a result, he underwent bilateral upper lid ptosis surgery with no additional removal of eyelid skin though. He also underwent retraction repair to help lift up his lower lids to a more normal position by a canthoplasty. A canthoplasty is a type of a lower lid resuspension technique.
Preoperative Diagnosis: Bilateral upper lid ptosis and lower lid retraction
Procedure performed: Bilateral upper lid ptosis surgery and lower lid retraction repair through a canthoplasty lid resuspension technique.
This 65 year-old female had undergone prior upper and lower lid blepharoplasty years prior and has been unhappy about her droopy upper and lower lids. She has upper lid ptosis and lower lid retraction where the lower lids rest lower than they should. She has difficulty closing her eyes and complains of ocular discomfort and red eyes. She also has bags under lower lids and wishes to have them removed as well. She underwent upper lid ptosis surgery, revisional lower lid surgery, and lower lid blepharoplasty. This photograph is six months after her surgery and she has healed well with no evidence of her incisions and now looks more awake, refreshed, while having a natural looking result. Most of her ocular symptoms have also improved and she is able to close her eyes better.
Preoperative diagnosis: Bilateral upper lid ptosis, lower lid retraction, lower lid excess fat pockets.
Procedure performed: Bilateral upper lid ptosis repair,revisional lower lid retraction repair using Alloderm graft and canthoplasty, and lower lid blepharoplasty.
This 29 year old female had thyroid eye disease and underwent prior eyelid surgery to improve her eyelid positions since they were affected from thyroid disease. She still had lower lid retraction where the whites of her eyes were showing near her lower lid. This was still resulting in difficulty closing her lids and ocular irritation. Dr. Zoumalan performed a revisional lower lid repair to help lift her lower lids to a more natural position. Alloderm graft was used as a spacer graft to help lift her lids. This graft was placed on the back surface of her eyelids using minimally invasive techniques so that the scars were not visible. She healed well and was able to close her eyes fully.
Preoperative diagnosis: Bilateral lower lid retraction.
Procedure performed: Bilateral revisional lower lid retraction repair using allodermposterior spacer graft.