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

Frequently Asked Questions

My mucous membrane appears lifted after double eyelid surgery. How long should I wait?

It is generally recommended to wait up to about 6 months. Immediately after surgery, the mucous membrane may appear lifted due to swelling, which naturally improves over time. However, if the symptoms persist after 6 months, re-correction should be considered.

What causes the eyelashes to remain lifted even after 6 months?

This is because there is insufficient eyelid skin, and the double eyelid fixation point has been pulled upwards from its original position. As the skin is pulled upwards, the underlying eyelashes and mucous membrane also rise, pointing towards the sky.

What is the surgical method to correct a lifted mucous membrane?

It is corrected by precisely dissecting between the orbicularis oculi muscle and the tarsal plate. This method involves releasing the raised fixation point to lower the lifted mucous membrane and eyelashes back to their original position. However, care must be taken not to damage the muscle during this process.

Are there any side effects that can occur during re-correction surgery for a lifted mucous membrane?

Yes, lagophthalmos, a condition where the eye does not close completely, can occur. This is because there is a risk of damaging the orbicularis oculi muscle, which is responsible for closing the eye, during the dissection process for correction. Therefore, it is best to avoid excessive correction.

How can I safely treat a lifted mucous membrane without side effects?

It is recommended to correct only within a safe range where functional side effects do not occur. Aggressively trying to achieve perfect correction can lead to lagophthalmos, so even if the surgery is performed only to the extent that the eye closes well, the lifted mucous membrane can be sufficiently improved.