What you Need to Know about Revisional Eyelid Surgery

Revisional surgery is surgical correction of previous poorly performed surgery. Some of the most dreaded complications of facial plastic surgery are those associated with the eyelids. This usually happens when the surgeon is not experienced or familiar with the delicate anatomy around the eyelids. The field of oculoplastic surgery focuses on cosmetic, reconstructive,and revisional surgery around the eyes. It is important to consider this when referring a patient for cosmetic surgery. Depending on the specific problem, the necessary correction may involve a simple procedure or a complex eyelid reconstruction. The goal of revisional surgery is to regain normal function while maintaining aesthetic outcome.

The most common complaint that is referred for revisional surgery is the inability to close the eyes completely after previous cosmetic surgery. This problem usually happens when excess tissue and skin were removed during the previous surgery. Depending on the severity of the case, there are several procedures which can be done or combined to achieve the desired functional and cosmetic outcome. For example, skin from behind the ear, which very closely matches the texture of eyelid skin can be harvested and used to raise the eyelid. The mid-face can also be elevated by suspension sutures to raise the lower eyelid. The conjunctiva can be elevated by borrowing mucosal tissue from the mouth.

Although subtle, the natural youthful eyelid is V-shaped at the corners. The rounded corners of the eyelids after some cosmetic eyelid surgery is an artificial “operated appearance.” The rounded corners are not only a cosmetic problem for the patient, but they also can interfere with normal blink dynamics. The patient usually complains of tearing or dry eyes. This problem can be reversed by a special surgical technique on an outpatient basis. Postoperative hollowness can be revised by placement or injection of fat into the eyelid or orbit.