Prominent eye might be a family trait or the result of disease, such as hyperthyroidism. But the condition, known as eyelid retraction or post-blepharoplasty eyelid retraction, also can be a complication of blepharoplasty. Surgeons confronted with the unsightly post-surgical complication of patients who develop bug or bulging eyes can correct the condition in a variety of ways, including one that’s relatively new and minimally invasive.
Raymond Douglas, M.D., an oculoplastic and orbit surgeon in Beverly Hills, Calif., and professor of ophthalmology at University of Michigan, Ann Arbor, Mich., presented yesterday on the technique he developed to correct prominent eye that can result from cosmetic eyelid surgery, at the 11th annual Vegas Cosmetic Surgery and Aesthetic Dermatology multispecialty aesthetic symposium in Las Vegas.
“The critical decision point is whether the eyes are relatively prominent compared to the soft tissue and cheek. If so, we can gently allow a better relationship for these structures by removing a small amount of fat and allowing the eyes to settle in better position. This small procedure can dramatically improve eyelid retraction in addition to making other procedures more predictable and successful,” he says.
To make eyes less prominent, Dr. Douglas uses an approach that he says does not typically require external skin incisions.
“We make a little incision inside the eyelid. And very similar to blepharoplasty, we remove some fat, specifically, intra-conal fat, from behind the eye, to let the eye fall back into a normal position,” he explains.
To avoid the complication, he says, surgeons should be very careful in choosing patients with already prominent eyes for cosmetic surgery because they are prone to develop post-blepharoplasty eyelid retraction.
“An option may be to consider a different type of surgery, possibly elevating the mid face or lower eyelid surgery that lifts, rather than removes any fat,” Dr. Douglas says.