Eyelid Retraction CENTER FOR FACIAL PLASTIC SURGERY AT ENT SPECIALISTS
Eyelid Retraction
Eyelid retraction is a condition characterized by the abnormal elevation or retraction of
one or both upper or lower eyelids, leading to a widened appearance of the eyes. This
condition can affect the aesthetic appearance of the eyes and, in some cases, may lead
to functional issues such as exposure keratopathy (corneal drying) due to the inability of
the eyelids to fully cover the eyes.
Causes:
1. Thyroid Eye Disease (Graves' Disease): One of the most common causes of eyelid
retraction is thyroid eye disease, often associated with Graves' disease. In this
condition, the immune system mistakenly attacks the tissues around the eyes,
leading to inflammation and retraction of the eyelids.
2. Trauma: Eyelid retraction can occur as a result of trauma to the eye or
surrounding structures, such as fractures involving the orbital bones.
3. Scarring: Scarring of the eyelids or surrounding tissues, possibly due to previous
surgeries or injuries, can cause retraction.
4. Prior blepharoplasty surgery: excessive removal of skin and muscle at the time of
blepharoplasty surgery can lead to eyelid retraction.
5. Congenital Factors: Some individuals may have a congenital predisposition to
eyelid retraction, meaning they are born with this condition.
Treatment:
The treatment of eyelid retraction depends on the underlying cause and the severity
of the condition. Here are common strategies for managing eyelid retraction:
1. Addressing the Underlying Cause:
If eyelid retraction is associated with thyroid eye disease, managing the
thyroid condition is a primary focus. This may involve medications,
radioiodine therapy, or surgery to address hyperthyroidism and reduce the
inflammation affecting the eye tissues.
2. Artificial Tears and Lubrication:
Lubricating eye drops or artificial tears can help manage symptoms of dry
eyes, which often accompany eyelid retraction. Keeping the eyes moist can
reduce irritation and discomfort.
3. Eyelid Massage and Stretching Exercises:
In some cases, eyelid retraction may be managed with gentle eyelid massage
and stretching exercises.
4. Botulinum Toxin (Botox) and Filler (Hyaluronic Acid) Injections:
Botulinum toxin injections can be used to temporarily relax the muscles that
are causing eyelid retraction. This can be particularly useful in cases where
the retraction is due to muscle dysfunction.
Hyaluronic Acid can also be injected in the upper eyelid where it works like a
weight than brings the eyelid down or into the lower eyelid where it works
by propping the eyelid up. It can also be used in the lower eyelid as a tissue
expander that stretches the retracted tissue.
5. Surgery:
Surgical correction may be considered for cases of eyelid retraction that do
not respond to other treatments or when the condition is severe. Surgical
procedures may involve adjustments to the eyelid length, repositioning of
tissues, or other techniques to normalize eyelid position.
BEFORE THE SURGERY
From the time of your first consultation (whether on-line or in person) till the day of surgery you will have the opportunity to discuss with Dr Georgescu and his staff all your questions and concerns related to the surgical procedure, the preparation and the recovery. Make sure you fulfill all your financial obligations at least 2 weeks prior to surgery. Stop all anticoagulants (Eliquis, Pradaxa, Xarelto, Plavix, Coumadin, Warfarin), anti-inflammatory medication (Aspirin, Ibuprofen, Naproxen, Diclofenac, Indomethacin) and all vitamins and supplements (except for Calcium and Vit. D) two weeks prior to surgery, but only with the approval of your primary care doctor or cardiologist. Make sure you fill your prescriptions before surgery. You need to make arrangements for someone to bring you to the surgery center and take you back home, as you will not be able to drive the day of surgery. You also need someone to stay with you for at least the first night after surgery.
THE DAY OF SURGERY
If your surgery is scheduled in the office, you can have a light meal before coming in.
Take your regular medication as usual. Avoid drinking coffee or alcohol on the day of
surgery.
If the surgery is scheduled in the ambulatory surgery center, do not eat or drink anything
past 10:00 PM the night before! If you need to take your blood pressure or anxiety
medication, do so with a sip of water when you wake up. Make sure you arrive at the
office or the surgery center at the time indicated (our staff will call you the day prior
with the exact time you need to be there). Our surgery center staff will greet you and
make sure all the consent forms have been signed. Your companion can either wait in
our comfortable waiting area, where there is coffee, water and snacks, or can return
back home and we will call as soon as the surgery is over. You will be then taken to your
room where our nurses will place an IV and EKG electrodes. A urine pregnancy test is
performed on all pre-menopausal women. Then, you will meet in person our
anesthesiologist who will explain the anesthesia procedure. Most surgeries are done
under sedation. Dr Georgescu will come and read to you the consent form and answer
any last-minute questions you may have. He will then do the skin markings and may take
some additional photographs. The bed will then be wheeled into the operating room
where the time out will be performed before you go to sleep. The anesthesiologist will
then give you IV medication that will allow you to fall asleep. At the end of surgery, you
will be taken to the recovery room where you will wake up with no pain. We typically
use ice-packs in recovery for 20 minutes to decrease swelling. You and your companion
will be shown in detail how to apply the ointments and ice. After approximately 30
minutes you will be discharged to go home with your companion. We will bring you to
the car in a wheelchair. You will be given Dr Georgescu’s personal cell number to call at
any time if you have any questions or concerns.
RECOVERY & RESULTS
Most patients take between 7 and 10 days off after Eyelid retraction surgery. Stitches
dissolve or are removed at 10 days. Bruising and swelling typically go away in about 2-3
weeks. Antibiotic and pain medication may be prescribed for a few days. You will need
to apply ice packs 20 min / hour while awake for 2 days. Starting on the 3 rd day you
switch to warm compresses twice a day 10 min each till the bruising is completely gone.
You will need to apply antibiotic ophthalmic ointment on the incisions and inside the
eyes 4 times a day for 3 weeks. You will also apply Refresh Relieva PF artificial tears
every hour for 2 weeks followed by every 2 hours for 2 weeks and 6 times a day for 2
more weeks.
Strenuous activity, such as golfing, swimming, tennis and weightlifting should be avoided
for 3 weeks. Walking is allowed the day after surgery. Light running and biking can be
resumed after 1 week. The hair can be dyed after one month. Makeup can be applied as
early as 2 weeks after surgery.
You will need to come back to the office the following day to ensure that your eyes are
not dry and that you are healing well. You will also be seen on days 7 and 14 followed
by 1 month, 3 months and 6 months. However, Dr Georgescu is available to see you at
any time if you have questions or concerns.
Although most patients look really good at 6 weeks, they are only 25% healed at this
time and may still experience dry eyes, tearing and blurry vision, especially when
working on the computer or phone extended periods of time. Full healing normally takes
6 months, at which time the numbness around the incisions is typically resolved.
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2122 NW 62nd ST, Ste 229 Fort Lauderdale, FL 33309
