Revision eyelid surgery – doing it again
Cosmetic eyelid surgery is not a pure science, and no surgeon is infallible. When done by an expert who is trained in oculoplastic surgery the need for a revision is very low. In my practice in NY the revision rate is less than 5%, and these tend to be minor revisions.
There is some unpredictability in post-surgical healing and the body’s response to surgery, but fortunately many issues can be corrected with a secondary procedure.
Why revision eyelid surgery is done
There are a few reasons someone might need a secondary procedure after cosmetic eyelid surgery. Here are some of the more common reasons:
- noticeable scars that require scar revision
- left-over fat pouches
- incomplete correction of initial concern
- suture cysts (bumps along the incision line)
- eyelid retraction (pulling down of lower lid)
- Rounding of the outer corners of the eyelids
Secondary droopy eyelid surgery
Surgery to correct a droopy eyelid (ptosis surgery) is done for both cosmetic and functional reasons. This surgery usually involves tightening the eyelid muscle as I describe in this post. It is known to have a higher rate of revision because the brain has control over the balance of height between the two eyelids and the height is not under control of the muscle alone. It’s been reported by eyelid surgeons that the redo rate can be up to 10% to 12%.
This patient of mine was a young woman who was bothered by her droopy eyelid. Her first surgery was an improvement but it wasn’t good enough in my opinion and in hers:
A few months later we decided to revise the original surgery to give her more lift of the left upper eyelid. I did so by further tightening the eyelid muscle tendon (levator muscle aponeurosis). Here is the result:
She and I were both pleased with the revision results and she wanted me to share the photos so that others in the same situation can see that secondary surgery can be worthwhile and rewarding.
Brett Kotlus, M.D.