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Eyelid Retraction & Scarring: Causes and Treatment Methods

December 03, 2020

Eyelid lumps and bumps can either be benign or malignant. They have aesthetic, psychological, and physical consequences and, on occasion, can affect vision or become life-threatening.

Most patients with eyelid lesions also experience general discomfort and facial deformity though mild. Therefore, they look for remedies to repair eyelid issues, either surgical and non-surgical methods. The surgical technique is one of the most effective solutions, but it comes with scarring complications.

This piece will explain eyelid retraction, causes, symptoms, and treatment methods. Also, we will look at how to get rid of eyelid scarring.

Let’s delve in:

What is Eyelid Retraction?

Eyelid retraction means an abnormally low position of the lower eyelids and an unusually high eyelids position. Typically, the eyelids should remain just above or below the iris (this is the colored part of your eye).

Eyelid damage can prevent the eyelids from working correctly, making it fail to protect and lubricate the eyes properly.

What Causes Eyelid Retraction?

Several things can cause eyelid damage. They include:

Cosmetic eyelid facial surgery
non-cosmetic eyelid facial surgery,
skin cancer/ lesions
A traumatic injury such as a car accident, dog bite, or fistfight
Thyroid eye disease (graves disease) mostly causing upper eyelid retraction
Aging
Genetics

Symptoms of Eyelid Retraction

Eyelid retraction causes a wide range of symptoms due to excessive eye exposure. Some of the most common issues that many patients experience due to eye retraction include:

Eye irritation,
Blurry/impaired vision,
Pain or burning sensation
Excessive tearing
Permanent cornea damage
Impaired vision
Exposed sclera below or above the iris
Dry eye syndrome
Redness
Unnaturally round eye appearance

Eyelid Retraction Treatments Methods

Due to the distinctive eyelid anatomy, a repair can be a challenge. However, the injured person needs to receive proper treatment to address both the ocular and cosmetic concerns. Careful examination can determine the exact eye repair procedure that the patient will require.

To treat droopy or sagging eyes, you can either opt for non-surgical or surgical procedures.

Non-Surgical Droopy Eyelids Repair Options

The non-surgical eyelid repair options include the use of botox and fillers.

Botox

This involves using a drug prepared from botulin, and it helps treat specific muscular conditions. Also, it helps remove wrinkles from the face by paralyzing the facial muscles temporarily. It helps create a brow lift by pushing and pulling facial muscles, giving it a more rested appearance.

Fillers

Fillers and facial injections can also help repair the eyelid retraction. This is more effective for the lower eyelid as you can place the fillers in the tear trough to offer extra volume to the under the eye. This also gives the eyes a more rested appearance.

Surgical Procedure for Droopy Eyelids

Surgical Procedures include:

Blepharoplasty - This is a surgery used to repair droopy or sagging eyelids that occur due to excess fat build-up below or above your eyelids. The surgery also helps remove excess skin, fat, and muscles of the eyelids.

The potential risks of blepharoplasty include scarring, dry, irritated eyes, skin discoloration, blurred vision, difficulty closing eyes, anesthesia, and blood clot.

Talk to your doctor about all possible risks before you undergo the procedure. Let the doctor understand your medical history and conditions that you may have, including diabetes, thyroid problems, dry eyes, glaucoma or allergies, etc.

What the Surgical Process Involves

The process involves:

Upper eyelid repair – This involves adjusting the levator eye muscles to lift the upper eyelid. This lets the eyelid close over the ocular surface.
On the other hand, lower eyelid repair surgery depends on the skin condition and the retraction degree. The surgery is restricted to lower lids tightening with canthoplasty and adjusting the tendons that keep the eyelids in its typical position. In some cases, tissue grafting and midface lift are needed to achieve excellent results. The lower eyelid retraction repair can help improve eyes’ appearance by elevating the lower eyelid, improves the eyes’ ability to close, and reduces dryness and associated discomfort. To be an ideal candidate of lower eyelid retraction repair, you need to stop smoking (for smokers) and have no history of significant eye problems or excessive scarring.

If the eyelid retraction is associated with eyeballs bulging, then orbital decompression is the most effective technique. This approach is used before the patient undergoes an eyelid surgery and as a part of the patients’ complete rehabilitation (where applicable). It lets the doctor observe how the eyelids will respond if the protrusion is minimized.

What Causes Eyelid Scarring?

Eyelid scarring occurs from eyelid surgery, facial surgery, or eyelid trauma. Scarring makes it challenging for the patient to close their eyes, and it can result in eye irritation, drying, and infection.

The affected eyelid shows “too much white,” and the eye often alternates between producing excessive tears and remaining functional. An outpatient setting, surgical scar revision, or non-surgical scar removal methods can help restore the eye’s function and appearance.

Treatment Options for Eyelid Scarring

To treat eyelid scarring, the patient may be required to use a non-surgical option to reduce the symptoms. Here are some of the recommended non-surgical options.

1. Non-Surgical Options for Eyelid Scarring

To treat eyelid scarring and retraction, you first need to control the poor ocular coverage symptoms. This includes using conventional methods such as eye ointments, bandages, eye drops, and more.

These methods are only useful in managing and controlling the symptoms. To correct the problem causing the symptoms, surgery is the ultimate solution.

2. Eyelid Scar Revision Surgery

The doctors use specialized eyelid scar revision surgery because the skin surrounding the eyes is susceptible and can quickly get damaged. Therefore, depending on the type of injury that you have and its location, the doctor can recommend the best scar removal procedure.

The different eyelid scar revision procedures include:

Surgical Excision –This technique involves removing eyelid tumours using a scalpel or another sharp cutting instrument. After initial diagnoses, excision of the eyelids lesions is performed. Surgical excision, also called shave excision, is a technique that is used to treat malignant lesions, tumors and moles from your skin.
Flap Surgery – This is a technique that involves moving healthy tissues from one body part to another. Tissues are lifted from a donor site to a recipient site with an intact supply of blood.
Skin Grafts – This technique is similar to flap surgery. However, there is no intact supply of blood in skin graft, and thus, the approach depends on the growth of new blood vessels. This technique is often used to reduce burn scars.

Z-plasty – This is a plastic surgery technique that helps improve the functional and cosmetic appearance of, scars. Functional z-plasty helps lengthen the scar to relax and release linear scars, and cosmetic z-plasty involves regularising the scar to reduce its appearance.

Recovery Process

The type of procedure the doctor uses determines the recovery process. However, since none of these procedures are very invasive, the recovery does not take long.

On average, the patient can expect to wear a bandage for a day or two as it heals. That means a downtime of a day or two, and during this period, you cannot operate heavy machinery or drive. Once the bandage is removed, the patient will need to clean the affected area and apply the doctor’s medication.

The results also depend on the type of procedure and eye scar revision surgery the doctor uses.

Scars require a more extended period to heal, which can be at least from 6 months to a maximum of 2 years. Based on the type of injury that resulted in a scar, the location, and the scar’s size, the surrounding skin will have discoloration that could take longer to heal.

The skin turns pink during the first few months, and in a year, the skin will have fully recovered. After two years, the scar may completely fade.

Post-Operative Follow-up

The doctor can schedule a post-operative follow-up 7 to 10 days after surgery. During this follow-up, stitches are removed. The patient may, at this point, be able to resume wearing contact lenses and makeup. The patient may need a few more after surgery to fully resume strenuous activities like intense aerobics and heavy lifting.

Natural recovery may disappoint some time, which could be due to genetics or if the patient smokes. Thus, it’s essential to use a good scar cream to quicken the recovery process.

Scar Cream for Scarring

Using scar cream after eyelid surgery is vital to reduce scarring. Start using the cream:

Immediately after the operation, if you’re sure about scarring (if your skin easily scars or there is a family history)
a month after surgery, and you don’t notice any significant improvement
You’re uncertain about the formation of scar
If the scar has deformed or thickened

How silicone gel helps scars

Silicone gel increases the stratum corneum hydration, thus facilitating the fibroblast production regulation and collagen production reduction. It makes the scar flatter and softer. Also, it reduces discomfort and itching associated with scars.

According to recent research in the Journal of Drugs & Dermatology, patients who undergo upper eyelid blepharoplasty incisions can benefit from using silicone gel to reduce the appearance of scars.

The Bottom Line

Eyelid retraction can result in eye irritation, pain, excessive tearing, redness, and more. When you have eyelid retraction, you may seek a solution that can either be surgical or non-surgical. The surgical eyelid retraction treatment causes scarring. You can reduce the appearance of eyelid scars using silicone products from AWDMed. You can also use non-surgical options for reducing eyelid scarring symptoms and eyelid scar revision techniques to get rid of the scars.