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.
- Droopy Eyelids
- Unsatisfactory Shape or Contour from Previous Surgery
- You Can’t (Fully) Blink or Shut Your Eyes
- A Hollow Look Under Your Eyes
- 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.
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.
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.
Read Dr. Taban’s manuscript about Lower Eyelid Retraction Surgery with Alloderm vs. Hard Palate.
Read Dr. Taban’s Englove Approach for Eyelid Retraction Surgery.
Read an Article by Beverly Hills Dr. Taban about his Postoperative Wound Modulation techniques.
Revisional Eyelid Surgery Results
Before & After Photos
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.
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.
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
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.
Before & After Photos
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
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
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.