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The Ocho. Revision series, part 8 AND the eyes have it, part 8: Eyelid malposition after prior blepharoplasties. Start here with taking a panned-out, scanning view of the overall changes. This spunky, lovely woman was left with eyelids out of position after very recent prior blepharoplasty, which you can see as a drooping left upper eyelid and scleral show on the left lower eyelid. The colored portion of our eyes should sit right on or right below our lower eyelash line, there should be no white visible between the colored portion and the eyelashes; when it is visible is called scleral show and is a sign of weak, dysfunctional, aging or unnatural lower eyelids. Unfortunately, this is far too common after old-school lower blepharoplasty techniques, and correcting this issue is very difficult. In her case, the malposition of the eyelids left her eyes looking grossly asymmetric. You can see the results after surgically correcting the droop, or ptosis, in the upper eyelid to make the lids function and match each other properly and supporting the lower eyelid to elevate and eliminate her scleral show by putting her eyelash margin in a more appropriate position covering the brown portion of her eye. The individual results are meant to be subtle, but the overall improvement in looks and symmetry is striking.

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