Eyelid Mucosal Exposure, Eyelash Eversion, and Upper Eyelid Ectropion After Double Eyelid Surgery

Today’s post covers the following topics:

Mucosal exposure after double eyelid surgery, eyelash eversion, and upper eyelid ectropion.

When a double eyelid surgery does not yield the desired result, the mucosal lining of the eyelid may appear exposed or lifted.

Of course, this can occur immediately after surgery due to swelling, which typically improves over time and resolves within about six months.

However, if the mucosa and eyelashes still appear upturned after six months, a corrective procedure is necessary.

As shown, there are cases where the mucosa is exposed and the eyelashes are pointing toward the sky after surgery.

You may have heard that for those born with entropion (inward-turning eyelashes) that irritate the eye, double eyelid surgery can improve the condition.

Let’s first examine the causes of eyelash eversion (upturned lashes).

When a double eyelid is fixed normally, the original fixation point A should be secured at A’.

However, if there is insufficient skin, point A is pulled upward and fixed at point B.

As a result, the eyelashes below are pulled up along with it.

To correct this:

Dissection must be performed along the light blue arrows, separating the orbicularis oculi muscle from the tarsal plate.

In this process, the orbicularis oculi muscle can be damaged, which increases the risk of lagophthalmos.

Lagophthalmos refers to a condition where the eye cannot close completely.

The orbicularis oculi is the muscle responsible for closing the eye.

Therefore, rather than aggressively correcting mucosal exposure, I recommend correcting it only to the extent that no functional side effects occur.

Even with this approach, the mucosal exposure can be significantly improved.

If you desire a more definitive correction despite the risk of functional side effects, please clearly state your preference during the consultation.

Case 1

Case 2

Case 3