Why Genetic Lower Eyelid Retraction Repair Needs a Specialized Oculofacial Surgeon

Author: Amiya Prasad, M.D.

Would I Benefit from Upper and Lower Blepharoplasty? Can I Have an Estimate for How Much It Would Cost? I was born with hooded eyes and my lower eyelids. You can see the red part of my eye. Would blepharoplasty correct those issues and what would the estimated cost be? Thank you for your question! You submitted a question with photos where you talked about hooding over your eyes as well as the appearance of your lower eyelids which appears in your left eyelid to show the pink part of your eye.

And you're asking if blepharoplasty would correct this and what the cost would be. Well, you have a unique situation where the anatomy of your eyes, something that you are born with and enhancement has to be done very carefully. And let me explain. When you have the anatomy that you have, it appears that your eyes are very prominent. In some ways, it has some similarities to someone who have thyroid eye disease or grave's disease. Now what that means is that when someone's eyes is very prominent, if you were to actually have a procedure like upper eyelid blepharoplasty where you take a lot of fat and a lot of skin, you can actually make the eyes more prominent or sometimes referred to as a bug-eye look. So you have to be careful when it comes to the upper eyelids. I think the more complex issue has to do with your lower eyes.

Your lower eyelids are retracted. Lower eyelid retraction is basically the appearance of the eyelid would be if you were to look at everyone else where the lower eyelid is at the level of the iris and lower lid retraction means that it's lower than that. Now a lot of people have that as a genetic trait and it's normal and runs in their family. In your situation, it's fairly retracted so the point where you're seeing the pink part of your eye called the conjunctiva. And so, there are different levels of procedure that you can consider in order to get the eyelid to appear the way you want. There can be something as straightforward as lateral canthoplasty or lateral tarsal strip where the eyelid may be reattached at a more internal aspect of your orbital rim or the bone that may get the eyelid to a position that is more symmetric with the other eye.

Or, if you want the eye to be vertically high, then it gets more involved and little procedures where the eyelid maybe pulled slightly typically don't work. Very often, in someone like yourself, we actually have to do some kind of spacer graft which is providing some vertical support of the lower eyelid in order to get that vertical height. So then it gets a little more complex. So without going into all the details of all the possible procedures that you can have , the other aspect of this is the physical examination. So when I examine someone and see how much elasticity they have, it also has an impact on that what kind of recommendation I make on how I can manage the lower eyelids.

Why Genetic Lower Eyelid Retraction Repair Needs a Specialized Oculofacial Surgeon

So at this point, meeting with a qualified and experienced cosmetic surgeon specifically one like an oculofacial plastic surgeon who has a lot of experience with lid retraction is advisable. I think that if you choose to have a routine blepharoplasty performed for your lower eyelids, it is unlikely to deliver the results that ultimately the best results for you. You really need to think through what will make you happy. With that in mind, I wish you the best of luck and thank you for your question!.

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