What is lower eyelid tightening?
Lower eyelid tightening an operation to help protect the eye and limit the amount of tearing that can take place with facial paralysis. The facial (or 7th cranial) nerve is responsible for closing both the upper and lower eyelids. While the upper lid is responsible for about 85% of eye closure, the lower lid provides the rest. The lower eyelid muscles are also responsible for keeping the punctum (a small hole through which tears drain from the eye to the nose) close to the eyeball. When the lower lid is week, the eyeball is more exposed, and tears simply spill out onto the cheek. The lower lid will also often have a droopy, reddened appearance.

Who is a good candidate for surgery?
If your doctor feels that the facial nerve will not be functioning for several months, you may be a good candidate for lower eyelid tightening. Young people with good resiliency in the lower lid usually do not need the procedure.

How is a lower eyelid tightening performed?
The surgeon will make a small incision at the outside corner of the eye where the upper and lower lids meet. If there is an excess of lower lid tissue, part of this will be trimmed. The lid is then secured to the underlying bone. The incision is closed with dissolving sutures. Eyelid tightening can be performed under general or local anesthesia. Either way, it is typically a day surgery procedure. The operation lasts for less than an hour.

What is the recovery from surgery like?
Recovery from lower eyelid tightening involves several phases. If general anesthesia is used, you may experience some nausea for the first 24 hours, and you should avoid eating substantial amounts of food. Slight oozing may occur around the incision. Most people get some bruising and swelling around the eye, which tends to reach a maximum about 48 hours after surgery. Limiting strenuous activity and keeping the head elevated will cut down on much of the swelling. The bruising resolves in about 7-9 days. Placing a cool pad over the eye for the first 48 hours will help with the bruising. Most of the swelling is gone by two weeks.

When should I come back to the doctor?
Since the sutures dissolve by themselves, there is some leeway about when you may come back to the doctor for a check up.

When can I go back to work?
Workers that perform heavy tasks should avoid work for a week or so. After about a week, patients may resume their normal exercise routines. Some office-type workers are able to return to work after 4-5 days to read mail, make phone calls and do some work with the computer.

Will my insurance pay for this?
Most insurance companies consider lower eyelid tightening a functional procedure and do provide coverage.