Abstract ID: 26-589
Severe Cicatricial Eyelid Retraction After Blepharoplasty: A Layered Reconstructive Strategy
Author: Altug Cetinkaya Base Hospital / Institution: Yüksek İhtisas Üniversitesi & Private Clinic, Ankara, Türkiye
Presentation Type: Rapid Fire Presentation Session: Eyelid Surgery & TumorsDate: 12th SeptemberTime: 08.12
Purpose
Severe lower eyelid retraction after aesthetic periocular surgery remains a major reconstructive challenge because of cicatricial shortening, middle lamellar scarring, lid laxity, and structural support loss. This study evaluated reconstructive strategies in patients undergoing revision surgery for severe post-blepharoplasty eyelid retraction.
Methods
A retrospective review was performed of patients presenting with eyelid retraction after aesthetic periocular surgery between 2021–2026. Eighteen patients (32 eyelids) undergoing reconstructive revision surgery by one surgeon (AÇ) were included.
Preoperative eyelid findings, graft usage, adjunctive procedures, and reconstructive techniques were analyzed. Procedures included scar release, lamellar reconstruction, spacer grafting, tarsal support procedures, and regenerative adjunctive treatments.
Results
Mean age was 56.9±12.8 years, and 77.8% were female. Bilateral involvement was present in 77.8% of patients. Lower eyelid retraction was the predominant deformity (78.1%). Most patients had undergone previous four-lid blepharoplasty (77.8%), most commonly performed by plastic surgeons (72.2%).
Mean preoperative lagophthalmos was 0.97±1.84 mm and inferior scleral show was 2.44±1.82 mm. Lower eyelid laxity was present in 60% of patients. Scar release and cicatricial revision were performed in all eyelids. Spacer or reconstructive grafts were required in 71.9% of eyelids (mostly hard palate grafts (34.4%)). Tarsal support procedures were required in 62.5% of eyelids. Adjunctive treatments including 5-FU, PRP, filler, nanofat, mesotherapy, and energy-based treatments were used in selected cases.
Conclusion
Severe lower eyelid retraction after blepharoplasty represents a complex cicatricial disorder rather than an isolated eyelid malposition. Successful management frequently requires layered reconstruction combining scar release, lamellar lengthening, graft-based structural support, and adjunctive periocular rehabilitation.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Demet | Yabanoğlu | Hacettepe Üniversitesi Tıp Fakültesi Ankara, Türkiye |