Blepharoplasty is one of the most popular facial procedures for improving the appearance of the upper or lower eyelids. While the surgery is safe in skilled hands, some patients may experience a temporary issue called lagophthalmos. This condition can be unsettling, especially during sleep, but it is usually manageable and can be treated effectively with proper care. Understanding why it happens and what treatment options are available can help patients feel more supported throughout the healing process.
What Is Lagophthalmos?
Lagophthalmos refers to the inability to close the eyelids completely. After blepharoplasty, it often appears as a small gap between the upper and lower eyelids when the eyes are gently closed. Some patients notice it only during sleep, while others see it in a mirror when attempting full closure.
Symptoms may include:
- Dry or irritated eyes
- A gritty or burning sensation
- Difficulty sleeping due to incomplete closure
- Light sensitivity
- Tearing or blurred vision
While the condition can be concerning, it is often temporary and related to early postoperative changes.
Why Does Lagophthalmos Happen After Blepharoplasty?
Lagophthalmos after blepharoplasty is usually temporary and related to normal healing rather than permanent structural problems. The most common causes include postoperative swelling, which limits smooth eyelid movement, and early skin tightness that improves as the tissues soften. In rare cases, excess skin removal can create tension that affects closure, and the eyelid-closing muscle may be temporarily weakened during surgery. Less commonly, internal scarring can restrict movement.
Identifying the cause is important because treatment is tailored to what’s affecting eyelid function.
Is Lagophthalmos Permanent?
In most cases, lagophthalmos after blepharoplasty is temporary and resolves over several weeks to months as swelling subsides and tissues soften. The eyelids are extremely delicate, and even mild inflammation can affect closure. With proper care, patients often regain full eyelid function without long-term complications. More persistent cases may require additional nonsurgical interventions or, rarely, revision surgery.
Treatment Options for Lagophthalmos
Managing lagophthalmos after blepharoplasty typically begins with conservative, nonsurgical approaches. Most patients improve as swelling decreases and tissues relax, but treatment is tailored to the severity of symptoms and the underlying cause.
Protecting the Eyes
- Lubricating eye drops: Provide daytime moisture and reduce irritation.
- Nighttime ointments: Thicker formulas keep the eyes protected while sleeping.
- Moisture goggles or shields: Create a humid environment around the eyes to prevent dryness.
Reducing Swelling and Tightness
- Cold compresses (first 72 hours): Help minimize swelling that interferes with closure.
- Warm compresses (after initial swelling improves): Encourage tissue relaxation and soften firmness.
- Surgeon-approved eyelid massage: May help release mild tightness or adhesions.
Supporting Eyelid Closure
- Nighttime eyelid taping: Gently keeps the eyelids fully closed to protect the eye surface.
- Temporary neuromodulator (Botox) treatment: In select cases, relaxing the forehead or brow can relieve upward tension and improve upper eyelid closure.
Medical Management
- Prescription drops or medications: Reduce inflammation, dryness, or irritation that worsens symptoms.
Corrective Options for Persistent Cases
- Hyaluronic acid fillers: Used selectively to improve eyelid support or reduce tightness if volume loss contributes to lagophthalmos.
- Revision surgery (rare): Addresses issues such as excess skin removal or significant scarring when nonsurgical treatments are not sufficient.
Most patients never require revision; however, when needed, it can be highly effective in the hands of a skilled facial surgeon.
Preventing Lagophthalmos in Eyelid Surgery
While mild lagophthalmos can occur temporarily during recovery, proper surgical planning and postoperative care can help reduce the risk. Preventive measures includes:
- Choosing an experienced eyelid surgeon to avoid overly aggressive skin removal.
- Using precise skin measurements to ensure safe, balanced tissue removal.
- Removing tissue conservatively to prevent postoperative tightness.
- Protecting the orbicularis muscle to maintain natural eyelid closure.
- Managing swelling early with cold compresses and proper head elevation.
- Approaching revision surgery cautiously to avoid creating new tension.
- Attending routine follow-ups to address tightness or early symptoms promptly.
- Keeping the eyes lubricated with drops and ointments during recovery.
With professional surgical technique and attentive aftercare, long-term lagophthalmos is uncommon. At Sarasota Surgical Arts, Dr. Sessa emphasizes careful planning and close follow-up to help ensure comfortable eyelid closure and smooth recovery.
Concerned About Your Eyelid Healing?
If you’re experiencing lagophthalmos after blepharoplasty or have concerns about your eyelid healing, call us at 941-923-1736 for an evaluation. Dr. Alberico Sessa provides detailed assessments, individualized treatment plans, and the advanced surgical skill needed to restore comfortable eyelid closure. Whether you’re managing early postoperative symptoms or exploring options for correction, you’ll receive attentive, comprehensive care designed to support your recovery.
Read more:
How Many Years Does A Blepharoplasty Take Off?
How To Massage Lower Eyelid After Blepharoplasty
