Ectropion Surgery in London
Rolling out eyelids
Ectropion is a condition in which the lower eyelid turns outward and droops away from the eye, causing it to roll outwards and the eyelid margin to be visible. This can be uncomfortable and can affect a person’s self-image and confidence. Artificial tears can help to reduce the symptoms such as foreign body sensation and mucous discharge. It is usually not serious, but if the condition persists, surgery may be necessary to reposition the eyelid.
Symptoms of ectropion include the following:
Ectropion and rolling out of the eyelids is caused by:
Involuntary ectropion develops with age as the muscles and tendons of the eyelid become weaker and relax over time.
Eyelid lump or cyst-an eyelid lump or cyst where the extra weight pulls the eyelid away from the eye causing mechanical ectropion.
Nerve paralysis : Facial nerve palsy is a condition in which the nerves that supply the eyelid muscles become paralyzed, resulting in weakness of the eyelid muscles and a condition known as paralytic ectropion. Symptoms of this condition include the lower eyelid turning outward and drooping away from the eyes.
Skin shortening – damage to the eyelid skin in burn injuries, long-term sun damage, eyelid surgery, and contact dermatitis can also lead to ectropion due to skin shortening which is also known as Scar ectropion.
Congenital – Less common cases present at birth are known as congenital ectropion.
Why is ectropion surgery done
Surgery for ectropion is done to restore the normal position of the eyelid, allowing it to turn inward and restoring a natural look. If left untreated, ectropion can lead to corneal exposure, which can in turn result in corneal ulceration and infection, as well as potentially causing scar tissue and damage to the cornea, leading to a decrease in vision. Surgery is typically recommended to avoid the potential complications of ectropion. See Before and after cases.
What are the risks?
Possible risks of ectropion surgery include:
Surgery carries general risks such as anaesthetic reactions and blood clots. To understand more about the risks associated with ectropion surgery, as well as the potential benefits, it is important to speak to your doctor. Depending on the severity of the ectropion, different surgical techniques may be used. For mild cases, the most common procedure is a lateral canthotomy and lateral tarsal strip procedure, with possible tightening of the orbicularis muscle. Severe cases may require skin grafting. Ultimately, the surgical technique chosen will depend on the underlying cause of the ectropion, and the goal is to address any issues with both the anterior and posterior lamella portions of the eyelid.
Non surgical treatments for ectropion are often to provide temporary relief and include:
Using artificial eye tears to relieve discomfort
Inject filler to the eyelid to push the eyelid back into position
How you prepare
Before having ectropion surgery, you will meet with an oculoplastic surgeon who specializes in ectropion surgery to discuss your medical history, expectations, and any potential risks associated with the procedure. Your doctor will perform a vision examination to check the eyes prior to surgery, as well as a physical examination of the eyelids to ensure that this is the correct procedure. Additionally, your doctor may take photographs of your eyelids to help with surgical planning and any insurance claims.
It is important to stop taking any blood thinning medications such as aspirin, ibuprofen, warfarin, apixaban, and any other medication that can cause increased bleeding during ectropion surgery. Your doctor will discuss these medications with you to ensure that it is safe for you to do so prior to your ectropion surgery, and will tell you how long before the operation you should stop taking them. Additionally, stopping smoking several weeks before surgery can help improve the healing process.
Finally, it is important to arrange for someone to take you home after the procedure and stay with you for the first night following the operation. Surgery is usually done in Central London.
What you can expect before the procedure
Ectropion surgery is usually performed as a daily case as you can go home the same day. The surgeon will inject an anesthetic into your eyelids to numb the area and you can also take medicine through a drip to help you relax.
What you can expect during the procedure
For age-related ectropion, your oculoplastic surgeon will remove a small section of the eyelid to make it tighter. For more significant cases of ectropion, an incision will be made on the inner surface of the eyelid to access the eyelid muscles, which will then be tightened to provide better turning in of the eyelid. The incision will be closed with stitches. In cases of ectropion caused by scarring, injury, or previous surgery, a skin graft or flap may be placed on the outer surface of the eyelid to help the eyelid turn inwards. This procedure is typically done under general anesthesia, with the patient asleep.
What you can expect after the procedure
After surgery you are monitored for complications. You are able to leave later that day to recuperate and begin the healing at home.
After surgery you may temporarily experience:
Your doctor will likely suggest you take the following steps after surgery:
Seek medical attention immediately if you experience any of the following:
What are the results of surgery?
Many patients are pleased with the results of ectropion surgery, which corrects the rolling outward of the eyelids and restores a more natural appearance, as well as improving vision if it was affected. The effects of the surgery can last a lifetime, but for some people, ectropion may recur over time. Bruising and swelling typically settle within two weeks, giving patients a more natural look and the confidence to go out in public. Most cases of subtle swelling should resolve over a period of two months. The scars from the surgery can take months to fade, but should be hidden within the skin crease or under the eyelashes. To protect your eyelids from the sun, you should take the same precautions you take to protect the rest of your skin.