Eyelid Malposition - Scar Excision and Spacer

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In the presence of significant scarring, a spacer is required to provide vertical height and stiffness to support either the upper or lower eyelid. Scar excision and spacer placement for eyelid malposition is performed when there is shortening of the vertical height, horizontal laxity, or mechanical distortion from cicatricial changes (ie, scarring) of the eyelid. This surgery repairs eyelids that appear pulled back and/or don't fully close over the eye.

Eyelid Malposition - Scar Excision and Spacer Overview - 904

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The Skinny


Average Recovery

5 weeks

Permanence

Permanent

Application

Surgical Procedure

Surgical

Yes

Cost

$2000 - $5000

The Specifics


What is an eyelid malposition - scar excision and spacer procedure?

An eyelid malposition - scar excision and spacer is a reconstructive oculoplastic surgery procedure to correct poor upper eyelid and/or lower eyelid positioning following a previous cosmetic procedure that has lead to lower eyelid malposition possibly from overcorrection.

The Anatomy of the Eye

Eye Anatomy Close-Up Photo

Following a blepharoplasty procedure, some candidates may experience undesirable outcomes leading to excessive scarring and eyelid malposition from cicatricial changes (scarring). Damage to the canthal area or canthal tendon, orbicularis oculi muscle, lamellar structures (anterior lamella or middle lamella), tarsal strip (tarsus), lower eyelid retractors, or other issues with laxity of the lower lid can lead to eyelid malposition or lower eyelid retraction.

A scar excision and spacer procedure removes scar tissue from eyelid skin and places 'spacers' or a spacer graft (usually a full thickness skin graft from the hard palate) to allow for proper lid positioning reducing scleral show and allowing for full eyelid margin closure, and a restored midface aesthetic.

What cosmetic concerns does an eyelid malposition - scar excision and spacer procedure treat?

  1. Sagging & Hooded Eyelids: A scar excision and spacer procedure restores an appropriate eyelid position, and full closure over the eye by releasing eyelid retractors that are scarred and causing lower eyelid retraction, entropion, or eyelid laxity.

Who is the ideal candidate for an eyelid malposition - scar excision and spacer procedure?

A good candidate for a scar excision and spacer procedure has experienced complications from a previous blepharoplasty procedure due to excessive skin resection. A scar excision and spacer procedure is not recommended for individuals prone to scarring, those with certain prior eye/vision surgeries, or some chronic medical conditions (like thyroid eye disease).

What is the average recovery associated with an eyelid malposition - scar excision and spacer procedure?

Most acute symptoms such as bruising, swelling, and tenderness typically resolve within 24 hours. Cold compresses, ophthalmic ointment, and elevating the head can help alleviate symptoms. Patients should refrain from reading or watching television for 24 hours. Sutures will be removed after four days, and exercise may be resumed after 10 days. Sun exposure should be limited for up to six weeks.

What are the potential side effects of an eyelid malposition - scar excision and spacer procedure?

Possible side effects of a scar excision and spacer procedure include corneal abrasions, bleeding, eyelid asymmetry, entropion, scarring, and infection.

What can someone expect from the results of an eyelid malposition - scar excision and spacer procedure?

The results of an eyelid malposition - scar excision and spacer procedure are permanent and immediately noticeable enhancements to the eyelid following the procedure.

What is the average cost of an eyelid malposition - scar excision and spacer procedure?


This plastic surgery procedure can cost anywhere from $2,000 to $5,000. The actual cost of an eyelid malposition - scar excision and spacer procedure is dependent upon location, plastic surgeon, and length and involvement of the plastic surgery.

thumbs-upPros

  • Correct Complications From Previous Surgery
  • Improve Ectropion

thumbs-downCons

  • Asymmetry

Invasiveness Score

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Invasiveness is graded based on factors such as anesthesia practices, incisions, and recovery notes common to this procedure.

The Takeaway


An eyelid malposition - scar excision and spacer procedure is a corrective plastic surgery to repair undesirable aesthetic and functional outcomes from a previous plastic surgery procedure.

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Source List

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AEDIT uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

  1. Dailey RA, Wobig JL. Eyelid Anatomy PubMed; 1982-12-01
  2. Bhupendra C. Patel; Michael J. Lopez; Zachary P. Joos. Anatomy, Head and Neck, Eyelash PubMed.gov; 2020-07-27
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