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Eyelid Revision Surgery

What is Revisional Eyelid Surgery?

Revisional eyelid surgery addresses cosmetic or functional concerns of patients who have had unsatisfactory or problematic results from previous eyelid and facial surgery, including blepharoplasty, canthoplasty, brow lift, ptosis surgery, etc. It is important for revisional surgery to be performed by surgeons with training and experience with original, facial and eyelid revision surgery. A major component of Dr. Taban’s practice in Santa Barbara is performing cosmetic, reconstructive, and revisional eyelid surgery as he has had extensive training (three years of fellowship) in the field of oculofacial plastic surgery, which deals with structures around the eyes and face. He is member of the American Board of Cosmetic Surgery, the American Society of Ophthalmic Plastic Reconstructive Surgery, and the American Board of Ophthalmology.

Restoration for Various Post-Surgical Eyelid Problems

Lower Eyelid Retraction Surgery after Previous Lower Blepharoplasty (Post-Blepharoplasty Lower Eyelid Retraction Repair)

One of most common issues for Dr. Taban’s patients in Beverly Hills is lower eyelid retraction and rounding of the eye with sclera show, related to previous bad lower blepharoplasty and/or Canthoplasty procedures. The formation of scar tissue in different layers of the lower eyelid can cause tethering or contraction of the lower eyelid, developing retraction (pulling down) of the lower eyelid. There might have been too much skin removed from the lower eyelid or damage to the eye closure muscle (orbicularis oculi) or others.

5 Signs You Need the Revisional Blepharoplasty

Not all cosmetic eyelid surgeons have such skill, training, and results. Blepharoplasty is a delicate procedure that doesn’t forgive mistakes very easily. If a first procedure done incorrectly, hastily or carelessly begs for corrections, yet a revision eyelid surgery is no less forgiving.

That’s why talking to a specialist of Dr. Taban’s caliber is so crucial to getting the results you want. He specializes in revisional procedures to correct what has unsatisfactorily happened before.

If you’re not sure whether or not revisional blepharoplasty is for you, here are five common signs that could indicate your viability.

  1. Droopy Eyelids
  2. Unsatisfactory Shape or Contour from Previous Surgery
  3. You Can’t (Fully) Blink or Shut Your Eyes
  4. A Hollow Look Under Your Eyes
  5. Your Eyes Are Now Noticeably Asymmetrical

A eyelid revision surgery realigns everything so that the previous symmetry you had is restored. Although in reality, most people’s set of eyes is completely symmetrical, it’s usually close enough that it looks perfect. This corrective surgery will modify the eyelids so that they are at matching heights and, thus, look symmetrical.

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In this video, view a patient testimonial from Dr. Taban on her revision lower eyelid retraction surgery (after previous transcutaneous lower blepharoplasty).

Young woman, with severe eye/facial trauma due to motor vehicle accident, underwent initial left orbital fracture repair with orbital implant and then underwent bilateral lower eyelid retraction surgery plus left infraorbital rim silicone implant.

In addition to rounding and surgical appearance of the eye, it can cause significant ocular/visual discomfort with tearing, redness, dry eyes, and blurry vision secondary to lagophthalmos (eyes not closing or blinking normally). In these cases, the lower eyelid needs to be raised and the canthus surgically repaired. This is usually done through hidden incisions the lower eyelids (conjunctiva) with lifting of the lower eyelids (+/- midface lift and internal eyelid space graft, such as Alloderm or hard palate graft) and canthoplasty.

60+ year old woman underwent lower eyelid ectropion/retraction repair with skin graft after botched aggressive lower blepharoplasty.
60+ year old woman underwent lower eyelid ectropion/retraction repair with skin graft after botched aggressive lower blepharoplasty.

At times, skin grafts are used to replace missing lower eyelid skin, which tends to heal very fast with effective results. It is important to realize that Canthoplasty (tightening the outer corner of eye) alone is rarely sufficient to address these issues due to significant scarring of the lower eyelids. To restore the natural almond shape of the eye, Dr. Taban performs a technique called the Madame Butterfly Procedure. Through a hidden incision inside, the scar tissue is released, the midface is lifted (which provides support for the lower eyelid and recruits necessary skin), and the lateral canthus is revised. Dr. Taban, a cosmetic eyelid surgeon, has penned several articles on eyelid restoration surgery, including lower eyelid reconstruction and the use of fat grafts in reconstructive surgeries. Dr. Taban performs revision Canthoplasty in Beverly Hills using minimal invasive approach.

Read Dr. Taban’s manuscript about Lower Eyelid Retraction Surgery without Internal Spacer to learn more.

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Read Dr. Taban’s manuscript about Lower Eyelid Retraction Surgery with Alloderm vs. Hard Palate.

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Read Dr. Taban’s Englove Approach for Eyelid Retraction Surgery.

Read an Article by Beverly Hills Dr. Taban about his Postoperative Wound Modulation techniques.

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Revisional Eyelid Surgery Results

Before & After Photos

*See disclaimer below
Lower eyelid retraction repair in a man who suffered from lower eyelid retraction after botched lower blepharoplasty. Note improvement in eye shape, going from rounded eyes to more almond shaped eyes.
Lower eyelid retraction repair in a man who suffered from lower eyelid retraction after botched lower blepharoplasty. Note improvement in eye shape, going from rounded eyes to more almond shaped eyes.
Before (left) Middle age woman with right lower eyelid retraction after previous lower blepharoplasty, now needing revision cosmetic surgery. After (right) 4 months after right lower eyelid retraction surgery with internal Alloderm graft, midface lift, canthoplasty, giving more natural almond shape eye appearance. (later she would also benefit from ptosis surgery and brow lift).
Before (left) Middle age woman with multiple prior eyelid surgeries and blepharoplasty, resulting in right lateral canthal angle distortion and lowering, unnatural right lower eyelid contour, and droopy upper eyelid. After (right) 2 months after revisional eyelid surgery, right canthoplasty, right lower eyelid retraction surgery (internal, with midface lift, without graft) and lower eyelid contour surgery. Fat injection in upper eyelids.

Before (left) and after (right) 44-year-old female, with post-blepharoplasty lower eyelid retraction with sclera show and loss of natural eye shape, underwent corrective revision lower eyelid surgery, namely lower eyelid retraction repair, using internal eyelid approach with soof lift and alloderm spacer graft and canthoplasty.

47-year-old Russian female, with post-blepharoplasty lower eyelid retraction and sclera show and rounded eyes, underwent revision eyelid surgery with lower eyelid retraction surgery (internal eyelid lift, alloderm spacer graft, canthoplasty) to restore almond eye shape. Before and 3 months after lower eyelid retraction repair photos are shown.
46 year old Asian female, with lower eyelid retraction after previous transcutaneous lower blepharoplasty, underwent revision eyelid surgery to raise the lower eyelids (lower eyelid retraction surgery) using internal eyelid approach with soof lift and internal alloderm graft and canthoplasty. Before and 5 months after oculoplastic surgery photos are shown.

38 year old male, with lower eyelid retraction due to previous lower blepharoplasty (by another surgeon), underwent lower eyelid retraction surgery (with alloderm spacer graft), Canthoplasty, and tear trough (orbital rim) implant placement. Before and 6 months after surgery results are shown. You can see his written testimonial on realself.

49 year old male, with history of multiple prior lower eyelid operations with resultant right lower eyelid retraction, underwent revision lower eyelid retraction surgery (internal approach, soof lift, alloderm spacer graft, canthoplasty). Before and 3 months after revisional eyelid surgery photos are shown.
70+ year old female, with botched lower blepharoplasty (by another surgeon) causing lower eyelid ectropion and retraction, underwent lower eyelid ectropion repair with skin graft.

Revisional Eyelid Surgery – Upper Eyelid Skin Graft

Another potential complication is when too much skin is removed from the upper eyelids during upper blepharoplasty. These patients cannot close their eyes (lagophthalmos) with dry eyes and blurred vision. Dr. Taban in Los Angeles replaces the necessary skin by using skin grafts, with effective results.

Before & After Photos

*See disclaimer below
Before (left) and 2 months after (right) revisional eyelid surgery. The patient was unable to close eyes due to too much skin being removed from prior surgery.
Middle age woman with multiple botched upper and lower blepharoplasty where too much skin was removed with inability to close her eyes. She underwent reconstructive upper and lower eyelid skin graft placement with significant improvement of eye closure and comfort. Before and 2 months after eyelid surgery photos are shown.

Revisional Eyelid Surgery – Eyelid Scar Revision

Eyelid scar revision is another procedure that Dr. Taban performs in Beverly Hills. Common areas for scarring are the medial canthus and lateral canthus. These often cause the patient significant emotional pain as they do not look like themselves. Dr. Taban, a cosmetic eyelid surgeon in Santa Barbara uses various minimally invasive techniques, such as a z-plasty, to revise and hide the scars better. Epicanthoplasty with z-plasty is one such procedure.

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Before & After Photos

*See disclaimer below
Before (left) and after (right) Revisional Eyelid Surgery. Note the severe hollow upper eyelids with deep scars (creases) from prior surgery.
Before (left) 29-year-old female with left medial canthal web or scar. After (right) 3 months after left medial canthal web-scar surgery, epicanthoplasty.
This patient suffered from severe eyelid scarring in the medial canthus from previous blepharoplasty with canthal web. She underwent revision eyelid scar surgery with epicanthoplasty. Preoperative and 3 months postoperative photos are shown.
Before (left) and after (right) 86-year-old female, with significant eye irritation from previous canthoplasty, underwent revision right canthoplasty.

Revision Droopy Eyelid (Ptosis) Surgery

Revision droopy eyelid surgery (eyelid ptosis surgery) is another common procedure performed by Dr. Taban in Beverly Hills. Traditionally, ptosis correction is done by tightening the levator muscle responsible for lifting the upper eyelid, thereby raising the upper eyelid. However, previous surgeries cause significant scarring, which makes repeat surgery very difficult and unpredictable. Dr. Taban in Los Angeles uses a special technique that uses the existing scar to effectively raise the upper eyelid.

Before & After Photos

*See disclaimer below

Before (left) and 3 months after (right photo) of revisional left upper eyelid ptosis surgery (after two previous failed operations).

Before (left) 21 year old female, with history of 2 previous failed right upper eyelid ptosis operations. After (right) 3 months after revisional right upper eyelid ptosis surgery (using full-thickness method).

Before (left) Middle age woman with multiple prior eyelid surgeries and blepharoplasty, resulting in right lateral canthal angle distortion and lowering, unnatural right lower eyelid contour, and droopy upper eyelid. After (right) 2 months after revisional eyelid surgery, right canthoplasty, right lower eyelid retraction surgery (internal, with midface lift, without graft) and lower eyelid contour surgery. Fat injection in upper eyelids.
Before (left) 87 year old female, with persistent left upper eyelid ptosis after previous droopy eyelid surgery. After (right) 3 months after revision left upper eyelid ptosis surgery.

Revision Lower Blepharoplasty

Revision lower blepharoplasty is yet another corrective cosmetic procedure that Dr. Taban performs. These patients could have a myriad of different problems, such as bumps and lumps, too much or too little fat (bags), wrinkled or missing skin, scarring, prolonged chemosis, among others. These eyelids are especially delicate to work with and care must be taken to avoid further worsening of the eyelids. Dr. Taban uses minimally invasive techniques to help restore the eyelids and eye shape.

Before & After Photos

*See disclaimer below
49-year-old female, who had a history of 3 previous cycles of under eye hyaluronic acid gel (Juvederm and Restylane) injections to fill “hollow” under eye area (tear trough), followed by hyaluronidase injection to get rid of “excess filler”, resulting in puffy, unnatural under eyes area. After examination, it was determined she had more under eye fat prolapse with some residual filler. She underwent transconjunctival lower blepharoplasty (scar-less, stitch-less incision inside the lower eyelid) with fat repositioning. This revision cosmetic procedure was done under local anesthesia in our Beverly Hills office. Note the improved, smoother under eye (lower eyelid) appearance after surgery. Preop and 3 months postoperative photographs are shown.
Before (left) Middle age female, with under area eye contour irregularities after previous lower blepharoplasty and multiple filler injections. After (right) 2 months after revisional lower blepharoplasty with fat repositioning (and dissolving of fillers).

Fat Transfer to Correct Hollow Eyes after Blepharoplasty

Another important cosmetic complication that needs attention is when too much fat is removed from either upper or lower eyelid during upper or lower blepharoplasty, respectively. These patients are left with hollow, sunken, older appearing eyes. Dr. Taban in Los Angeles injects either fat or filler around the eyes, deep to the eyelids, to give more fullness and bring back a youthFUL eye appearance.

Eyelid fat transfer is accomplished by harvesting fat (with stem cells) from the belly or thighs and injecting the fat in the hollow area around the eyes and brows. Fat is great since it is natural, has stem cells and the results are long term. However, they are not as predictable as synthetic fillers. Hyaluronic acid gel filler is excellent alternative option to fill the hollow sunken area.

Eyelid Filler Injection to Correct Hollow Eyes after Blepharoplasty

Filler is injected in hollow under eyes or upper eyelids with immediate results, which typically last around 2 years. It is important to know the anatomy of normal eyelids and anatomy of previous surgical eyelids to achieve the best natural results.

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Young woman underwent upper eyelid filler injection to correct hollowness caused by previous aggressive upper blepharoplasty (by another surgeon). She returns over one year after filler injection and still happy.

Read Dr. Taban’s abstract about Lower Blepharoplasty with Previous HA Fillers.

Before & After Photos

*See disclaimer below

Before, prior aggressive upper blepharoplasty resulting in hollow upper eyelids, and 2 months after filler injection in upper eyelid-brow area.

Before and immediately after FILLER (Belotero) injection in both upper eyelids to correct significant upper eyelid hollowness after prior upper blepharoplasty in a 59-year-old female.

Before, prior aggressive upper blepharoplasty resulting in hollow upper eyelids, and 2 months after filler injection in upper eyelid-brow area.

Before and immediately after FILLER (Belotero) injection in both upper eyelids to correct significant upper eyelid hollowness after prior upper blepharoplasty in a 59-year-old female.

Removal of Fat Lumps from Prior Eyelid Fat Injection

Before & After Photos

*See disclaimer below
Young mother and model, underwent upper eyelid fat lumps granulomas removal (plus upper blepharoplasty) that had resulted from prior fat injection (fat transfer) by another surgeon. Before and 6 weeks after revision eyelid plastic surgery photos are shown.
62 year old female, with history of prior under eye fat transfer (eyelid fat injection) resulting in fat lumps underwent revision lower blepharoplasty with removal of fat granuloma lumps. Before and 2 months after revision cosmetic eyelid surgery photos are shown.
47 year old female, with history of fat injection under eyes creating lumps, underwent revision lower blepharoplasty with removal of injected fat lumps and granulomas. Before and 2 months after surgery photos are shown.
Middle age African American female, with history of eyelid fat injection (by another surgeon) causing significant lumps, underwent scarless technique (from inside the lower eyelid) to remove fat lumps or granulomas. Before and 1 month after revision eyelid surgery photos are shown.
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Eyelid Fat Lumps Granuloma removal from prior Fat Injection

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Young mother and model, underwent upper eyelid fat lumps removal (plus upper blepharoplasty) that had resulted from prior fat injection (fat transfer) by another surgeon.
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47 year old female, undergoes revision lower eyelid surgery by Dr Taban using scarless technique to remove under eye fat lumps or fat granulomas from prior under eye fat injection (by another surgeon) which was initially done to correct dark circles under eyes due to hollowness.
Next, read about Revisional Droopy Eyelid Ptosis.
*Disclaimer: Results vary from patient to patient. Results are not guaranteed.