Lid Retraction Surgery
Lid retraction surgery is used to correct either upper or lower eyelid retraction. Eyelid retraction is where the eyelid is pulled away from the eye, exposing more of the eye than is normal. More of the white part of the eye is seen, which is called “scleral show” and can create a “round eyed” appearance. This exposure of the eye can cause redness, discomfort and tearing. Eyelid retraction can be due to scarring of the eyelid skin or of the inner layer of the eyelid. This can be seen in conditions where the eyelid has sustained inflammation or trauma, too much skin has been removed from a prior surgery, and in thyroid disease that affects the eyelids. Treatment is eyelid retraction surgery to restore the eyelid to an appropriate position. Most often this involves surgery directed at the tissue causing the pulling of the eyelid. This is done by releasing the scarred tissue and repositioning the eyelid but it may require grafts from surrounding areas of the body.
Selecting the right surgeon for lid retraction surgery is critically important. When performing surgery in one of the most delicate areas of your entire body that also has the most intricate anatomy, the pool of surgeons qualified to perform such a procedure shrinks dramatically.
When dealing with any problem near the eye, you need to see a physician trained as an ophthalmologist. Many doctors are not comfortable working in that area because of the specialized anatomy and will refer you to an ophthalmologist anyway. Additionally, because this is an extraocular procedure (outside of the eye) as opposed to an intraocular procedure (inside of the eye), the best choice for lid retraction surgery is an oculoplastic surgeon (also known as an ophthalmic plastic and reconstructive surgeon).
A well trained oculoplastic surgeon can combine his/her knowledge of the eye with the artistic expertise of a plastic surgeon. You need a doctor that can ensure that the procedure is done correctly, but also won’t leave an unsightly scar near your eyes. Dr. Liu is an oculoplastic surgeon, and completed an ASOPRS fellowship, and is therefore one of the most highly qualified oculoplastic surgeons in North America.
Lid retraction surgery can be performed using local anesthesia in Dr. Liu’s procedure room or under IV (intravenous) sedation at an off-site surgery center, but only in very rare cases would general anesthesia be used.
Depending on the cause of the eyelid retraction and the tissues involved, Dr. Liu will select the specific techniques that are suited for your needs. Because Dr. Liu has such specialized training, she has access to a number of techniques that are not utilized by most other doctors, ranging from minimally invasive muscle release to graft harvesting and placement or artificial tissue spacer placement. With certain procedures, no sutures are needed and in other procedures, dissolvable sutures that are finer than a human hair are used.
Lid retraction surgery typically takes about 1-2 hours from start to finish.
Lid retraction surgery may have a scar at the incision site, but it is usually not obvious. Non-specialized surgeons typically have results with more visible scarring.
Lid retraction surgery is generally a very safe procedure. When considering any eyelid surgery, it is important to inform your surgeon of any abnormalities of your eyes, vision, or your general medical health. Dr. Liu requires all eyelid surgery patients to have a full eye exam with dilation completed within the last year before scheduling surgery.
It is important to remember that all surgery carries some risks, even when performed by the most highly trained surgeon and at the best facilities. Below are some of the more common risks associated with eyelid surgery:
The likelihood of serious complications arising from the procedure is typically influenced by both the surgeon’s skill as well as the patient’s individual response to the eyelid surgery. Certain severe risks or complications can be avoided by cooperating fully and completely following your surgeon’s instructions. With patience, a willingness to cooperate, and a qualified surgeon, the complications of eyelid surgery and any associated risks can be dramatically reduced.
Surgery should be scheduled for a time when you can relax for at least 1-2 weeks. The eye being worked on may be patched for a week after surgery. It is important to avoid any strenuous activity, heavy lifting, or bending down for 2 weeks to avoid complications and to promote the best healing. It is also important to avoid taking any blood thinning medications for at least 2 weeks prior to surgery. If you are on a blood thinning medication due to a specific medical condition, you will need to discuss this with Dr. Liu and your primary care physician prior to stopping any medication. Dr. Liu’s staff will review a list of common medications, supplements and vitamins that can cause your blood to be thinner.
Please note that Dr. Liu expects to see patients back in the office a few days after a procedure to ensure that the healing process is going as expected and that you are on track for a good result. Do not plan any travel immediately after your procedure.