Revisional Cosmetic Eyelid Surgeries

Cosmetic eyelid surgery, also known as blepharoplasty, ranks among the most frequently performed procedures in facial rejuvenation surgeries. Since eyelids play a crucial role in facial expression, an unfavorable surgical outcome can alter a person's appearance. Proper evaluation of patients during the preoperative stage is crucial to minimize the risk of needing revision surgery later on. It is imperative that patients undergo a detailed ocular and periocular examination by an oculoplastic surgery specialist, including assessment of existing refractive errors, evaluation of the functions of the eye and eyelid muscles, visual field examinations when necessary, and assessment of accompanying additional pathologies. Understanding the patient's expectations and explaining how this surgery will meet those expectations, as well as providing information on the necessity of combined surgeries are essential. Based on all these evaluations, the correct technique must be chosen for the appropriate patient.

Revision surgeries are always more complicated compared to primary surgeries because the surgeon must work in a more adherent and fibrotic area due to the previous surgery. In primary surgery, excessive or insufficient corrections, asymmetries, and evolving anatomical and functional disorders may necessitate revision surgery.

Most common situations requiring revision surgery:

• Inability to close eyelids due to excess skin removal, leading to dryness of the eye surface and corneal problems
• Asymmetries of eyelid folds
• Insufficient corrections due to improper technique and resulting shape deformities
•  Retraction or ectropion due to excessive skin removal from the lower lid
• Shape deformities in the outer parts of the eyelids
• Significant scars
• Cases where accompanying problems such as ptosis (eyelid drooping), brow ptosis, scleral show (excessive white of the eye visible), and negative canthal tilt (excessive downward angulation of the outer corners of the eyes) were not corrected adequately in primary surgery, necessitating additional corrective procedures.