11/08/2025
This 45 year-old had lower eyelid surgery in the UK approximately 5 years ago. Unfortunately, surgery pulled his lower eyelids down. He had revisional surgery about 1 years later and was persuaded to have work on the upper and lower eyelids. Not only were the lower eyelids unimproved, but now he also felt the upper eyelids were heavy and skeletonized. He came to have an initial consultation with me about 1 year after the second surgery. Both the upper and lower eyelids were compromised but the upper eyelid findings were consistent with very aggressive surgery leaving limited resources for reconstruction. The first set of surgeries were directed at reconstructing the lower eyelids with a midface lift, a custom hand carved orbital rim implant, and a hard palate graft sewn into the back side of the eyelids. He is three years out from this work. The uppers were addressed subsequently. He has had reconstructive crease lowering surgery with anterior levator resection
surgery. Due to his prior aggressive upper eyelid surgery, his right upper eyelid benefited from the internal placement of an amniotic membrane graft.