Eyelid Repair & Restoration (Lower Eyelid Retraction)
There are a variety of causes for lower eyelid retraction including trauma, eyelid tumors and the commonest internal scarring after a lower eyelid blepharoplasty. Lower eyelid retraction is often the result of a combination of factors including too much removal of skin tissue in lower blepharoplasty and damaged to the lower eyelid resulting in scarring and lower lid traction. The lower eyelid has a complex anatomy with three independent anatomical planes, damage to any of these structures may lead to scarring and lower lid retraction. The results can be devastating to the patient as scarring changes the shape of the eye resulting in compromised cosmetic result, tearing and discomfort.
The treatment of lower eyelid retraction is challenging and dependent on careful evaluation and identification of the cause. The techniques involve:
- Skin grafting for shortening of the lower eyelid skin
- Use of fillers to prevent recurrent scarring
- Elevation of the mid-face
- Tightening of the lower eyelid to the boney rim with canthoplasty
- Use of material (termed spacers) to elevate the lower eyelid
- Use of graft (hard palate from roof of mouth) to elevate the lower eyelid
- Post-surgical use of lower lid elevation
- Post-surgical use of anti-inflammatory agents
Depending on the cause of the lower eyelid retraction, severity and previous surgery, Dr. De Silva utilizes a combination of different approaches to elevate the lower eyelid and prevent recurrence. Lower eyelid retraction is a challenging eyelid condition to treat, although the eyelid position can be improved, Dr. De Silva discusses with each patient what are realistic expectations that can be achieved through surgery.