Eyelid Incomplete Closure After Double Eyelid Surgery

Incomplete eyelid closure

Hello Doctor,
This summer, I underwent double eyelid surgery at a plastic surgery clinic due to ingrown eyelashes (the procedure was done by cutting, and I already had double eyelids).
It has been almost five months since the surgery, but my upper eyelids still appear noticeably thick and swollen, and there is an inability to fully close my eyelids.
This makes me suspect that the surgery may have failed.
However, during my last follow-up appointment, the doctor said that it was just a matter of recovery, and that the swelling would improve over time, which I found concerning since I researched online and found that even if recovery is not complete, there shouldn't be an inability to close the eyelids.

Doctor, do you think this is a failure? Is there a way to recover from this? (I am currently very anxious about how I look when my eyes are closed.) Should I consult the original hospital again or seek a second opinion at another clinic? Additionally, could the inability to close my eyelids lead to any eye problems?
I apologize for the lengthy message, and thank you for your assistance.

QQ, 10~19 year old female. Ask Date: 2016/12/07

Dr. Zhou Hongzhang reply Plastic Surgery

1.
In this situation, it is quite rare to have issues with eyelids that cannot close.

2.
Generally, if after several months (approximately 8-12 months) of swelling subsiding, the eyelids still cannot close, surgery may be necessary.

3.
You can go to a trusted hospital or seek a second opinion.

4.
Prolonged inability to close the eyelids can lead to corneal abrasion and dryness.
It is advisable to apply an eye ointment before bedtime during this period to prevent dryness and potential corneal damage.

Reply Date: 2016/12/07

More Info

After undergoing double eyelid surgery, experiencing incomplete eyelid closure can be concerning and may indicate a few potential issues. It's important to understand that while some swelling and changes in eyelid appearance are common after surgery, persistent problems like difficulty in closing the eyelids may require further evaluation.

Understanding Incomplete Eyelid Closure
1. Post-Surgical Swelling: After any surgical procedure, especially one involving delicate structures like the eyelids, swelling is a normal part of the healing process. However, if the swelling persists for an extended period, it could indicate complications or an atypical healing response.
2. Surgical Technique: The method used during the surgery can influence the outcome. If the technique involved excessive removal of tissue or improper placement of sutures, it might lead to complications like incomplete eyelid closure.
3. Nerve Damage: The eyelids are controlled by muscles and nerves. If the surgery inadvertently affected the nerves responsible for eyelid movement, this could result in difficulty closing the eyelids completely.
4. Scar Tissue Formation: Sometimes, the formation of scar tissue can restrict movement. If the scar tissue is too thick or improperly formed, it may prevent the eyelids from closing fully.

Potential Consequences of Incomplete Eyelid Closure
Incomplete eyelid closure can lead to several issues, including:
- Dry Eyes: The eyelids play a crucial role in protecting the eyes and keeping them moist. If they cannot close completely, it can lead to dryness, irritation, and increased risk of corneal damage.

- Infection Risk: An inability to close the eyelids can expose the eyes to environmental irritants and pathogens, increasing the risk of infections.

- Aesthetic Concerns: As you mentioned, the appearance of your eyelids can be distressing, especially if it affects your confidence in social situations.

Recommendations for Recovery
1. Follow-Up Consultation: It is advisable to return to the original clinic for a follow-up appointment. The surgeon who performed the procedure will have the best understanding of your case and can provide insights into whether your symptoms are within the normal range of recovery or if they indicate a complication.

2. Seek a Second Opinion: If you feel unsatisfied with the response from your original surgeon or if your concerns persist, seeking a second opinion from another qualified ophthalmologist or plastic surgeon specializing in eyelid surgery can provide additional perspectives on your condition.

3. Treatment Options: Depending on the underlying cause of the incomplete closure, treatment options may include:
- Medication: If inflammation is a contributing factor, anti-inflammatory medications may help.

- Physical Therapy: Eye exercises or physical therapy may assist in improving eyelid function.

- Surgical Revision: In some cases, a revision surgery may be necessary to correct the issue.

Conclusion
In summary, while some swelling and changes are expected after double eyelid surgery, persistent incomplete eyelid closure warrants further investigation. It is crucial to communicate your concerns with your healthcare provider, as they can offer tailored advice based on your specific situation. Remember that your eye health is paramount, and addressing these issues promptly can help prevent further complications.

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