Does A Midface Lift Risk Lower Eyelid Retraction?
Q: Dr. Eppley, I am a 32 year old female who underwent several facial procedures last year. I had a vertical chin shortening and a midface lift. I know feel that my chin is too short for my face. Also the midface lift has caused my eyes to look worse than before with too much scleral show. What can be done for these problems now? Wouldn’t you agree that I really do not look better than before?
A: Whether an aesthetic operation produces a pleasing outcome is for the patient to judge not me. What I can say is that you obviously have concerns/questions about the chin and eye areas so I will make some comments about them. If you just showed me the after result of your chin, I would not say it is too short. But given where you started I could understand why you may feel that it is. The good news is that chin lengthening is more reliable than chin shortening whether it be done by an opening bony genioplasty or a vertical lengthening chin implant.
Your eyes clearly have lower lid retraction, a sequelae of the midface lift, which is unclear to me why that was ever done. Given how your eyes looked and your young age, undergoing a midface lift runs a very high risk of lid retraction because you have no extra skin. Such lower lid retraction most likely will require posterior lamellar reconstruction with palatal grafts to get the lid margins up a few millimeters. Lower lid retraction is a far more challenging problem than vertical chin lengthening.
Dr. Barry Eppley