How Skin Grafts are Avoided or Minimized in Eyelid Retraction Repair Surgery

More on revision eyelid surgery: eyelifts.com/eye-lift-revisio...
For more about Dr. Prasad's training and background, please go to: eyelifts.com/about-dr-prasad-...
A man underwent a lower blepharoplasty two years ago, which resulted in lower eyelid retraction. One of the surgeons he visited recommended the use of skin grafts to fix this. He wants to know if skin grafts would be an effective solution; if skin grafts have a tendency to scar; what the possible complications are after skin graft placement, and if the addition of skin grafts will weigh the lower eyelids down even further.
New York oculoplastic and reconstructive surgeon Amiya Prasad, M.D. reviews his concerns in this video, and explains how the common transcutaneous blepharoplasty technique can damage certain structures of the eyelid, which likely lead to his issue; and how he avoids or minimizes skin grafts in the eyelids:
1:28 - Dr. Prasad details his background training in cosmetic oculofacial plastic and reconstructive surgery, as well as his experience as a specialist in eyelid surgery and revision eyelid surgery
2:31 - Why lower eyelid surgery is a deceptively complex procedure; and how a transcutaneous lower eyelid blepharoplasty is performed
3:13 - How the transcutaneous approach to lower eyelid blepharoplasty affects specific structures of the lower eyelid, and the undesirable results that it could give rise to
4:15 - Why Dr. Prasad chooses to avoid using skin grafts in younger individuals with eye retraction
4:41 - How Dr. Prasad assesses a patient and determines if it’s possible to avoid using skin grafts for their case; and an alternative solution to fix eyelid retraction
5:46 - What Dr. Prasad does when a skin graft is necessary
6:04 - How the physical weight of a skin graft is not an issue, but the appearance of it is
6:38 - The role of platelet-rich plasma and extracellular matrix in facilitating speedy healing of the skin grafts; as well as other modalities that help with healing
7:28 - The challenge of achieving the ideal eyelid height with the help of skin grafts
8:16 - Dr. Prasad’s recommendation
8:39 - Why it is critically important to minimize the number of surgeries as much as possible; and how multiple skin grafts only address the front part of the eyelid and not the back part
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[@salemalk8474]

Im binge watching your videos, its so interesting to listen to as a kinesiology major! (+who knows, perhaps Ill get my "little problems" fixed whenever corona is gone haha!) Dr, whats your take on Alloderm grafts for lower eyelid retraction? :)

[@AmiyaPrasadMD]

Hi Salemalk, I have used Alloderm in the past, but I have gotten better results with newer graft materials, so I'm currently not using Alloderm in my practice. I hope this helps you.

[@ArchiesBhanushali]

DOCTOR please make video on sebopsorisis. I have on my head scalp and eyebrows, behind the ear. Tell any treatment

[@AmiyaPrasadMD]

Hi Tiger Shroff, Sorry to hear about your problem, but that's not an area I treat regularly. I suggest you see a dermatologist about your problem.

[@shraddha5963]

U r amazing sir...i never found anyone like you in india..who genuinely care so much about their patients I wish u were in india Need someone like u..who can fix my botched up surgery

[@AmiyaPrasadMD]

Thank you, @shraddha5963. I did send you videos in your other comment, but these videos explain why lower eyelid retraction is so common, yet so avoidable: kzbin.info/www/bejne/j4W3k2avmdZoa5I kzbin.info/www/bejne/bZaTXpuworOUoNE

[@Dandelion_flight]

Even those cases with skin graft look so good. You are really amazing doctor. Wish every eye surgeon is as excellent as you are. So many doctors do botched jobs and you had to help these cases. It must be such a challenge.

[@AmiyaPrasadMD]

Thank you for the compliment!

[@christines3005]

hi doc after watching this and reading the other comments, i too had too much of everything removed and my eyes are very flat. this video looks like you built up the "columns" under eye that the margin looks fuller ?? did you place a internal and posterior graft to plump the margin ? or was that grafted skin? thank you so much for an answer and for your wealth of info

[@AmiyaPrasadMD]

Hi christine s, You have done well with researching how lower eyelid restoration is done. There are many options oculoplastic/oculofacial surgeons have to restore the lower eyelid, including the ones you mentioned. It is also possible to use other graft materials like Enduragen. It is best to have your eyelids physically examined by an eyelid specialist to determine what procedures will best restore your lower eyelids. I hope this clarifies things for you.

[@christines3005]

thank you and God bless and thanks for the quick reply !!! :0)

[@AmiyaPrasadMD]

You're welcome christine s!

[@PSalas94]

Dr I have rare congenital Euryblepharon eyelid anomaly characterized by the bilateral horizontal enlargement of the palpebral fissure with vertically shortened eyelids, lateral canthus malpositioning and lateral ectropion. It effects both of my lower eye lids. I have been consulted to have corrective surgery reformation of the lateral canthal angle, removing of excess horizontal eyelid tissue, and replacing the deficient eyelid skin with either skin grafts or flaps. Have you ever treated this condition and do you agree with this?

[@AmiyaPrasadMD]

Hi Apaullos, Since your surgeon has physically examined your condition, and I have not, it's not place to contradict their diagnosis, so I defer to their judgment. I hope this helps you.

[@daisyfish7202]

What would you say is the success rate of a revision blestroplasy in good surgical hands.

[@AmiyaPrasadMD]

Hi Daisy Fish, I would say chances of success are highest with an oculoplastic/oculofacial surgeon who specializes in cosmetic eyelid surgery, but only if revision is out of the skill set of the original surgeon. There is an advantage of the original surgeon performing revision since they know the details of the original surgery, but if procedures like skin grafting and canthopexy are needed, and out of their skill set, then an eyelid specialist is needed. I hope this clarifies things for you.

[@kristinahill2641]

You are incredible!!!!!

[@AmiyaPrasadMD]

Thank you for your kind words, Kristina Hill

[@The_Zuko]

I had chronic insomnia for last 5 years and my lower eye lid (muscle) did get looser and more saggy, i am 25 years old. Is it a good idea to do a lower eyelid surgery? If u have weak under eye lid muscled cauze of insomnia?

[@AmiyaPrasadMD]

Hi Zuko, Sorry to hear about your problem. While it's not confirmed that your eyelid issue is caused by insomnia, a physical evaluation of your muscle tone, and other lower eyelid support structures are needed before I can recommend surgery for you. I hope this helps you.

[@cakepudding3220]

Dr I need advice.. 2 weeks ago I had Right eye lower eyelid elevation by retractor recession with lateral hornlysis local anastestic sedation. However my lower lid looks still retracted with white on show. Other than slight post surgery bruising it looks like it didn't work.. Is this swelling or did the surgery fail?

[@AmiyaPrasadMD]

Hi Nik Pudding, I would need to see your eyes, as well as your medical records regarding both your surgeries to give you an answer. It's hard to say with your brief description only. I hope this helps you.

[@mahmoodmarfani1175]

Dr. Prada’s, I’m 69 male having Catract and Gulucoma surgeries now having dry eyes and my lower eye lashes going inside my eyes and damaging my eyes. He said I have To go for Entropion surgeries of both my eyes My Opthamologist recommend me to

[@mahmoodmarfani1175]

Board Certified Opthamologist Surgen, who is expert in this kind of surgery, according to himself and planning Entropion surgery soon. I’m already and extrem anxiety and depression patient going through lots of Panic attacks, stress etc. I’m very much worried and feared about this kind of surgery by an Opthamologist Surgen. What in your opinion I should do? Should I need plastic Surgen like you for this kind of surgery. Can I send you both eyes photos from different angle. Kindly respond ASAP

[@AmiyaPrasadMD]

Hi MAHMOOD MARFANI, It's important to meet with your surgeon and get to know them and their experience to ease your concerns. I'm not just a plastic surgeon, I'm an oculoplastic/ oculofacial surgeon, meaning I'm trained as an ophthalmologist, as well as specialty cosmetic procedures of the eyelids. General plastic surgeons do not perform specialty eyelid surgeries such as lower eyelid retraction restoration, or revision surgeries for ectropion or entropion. I hope this clarifies things for you.

[@mollyherzfeld4556]

I had a transconjuct lower bleph that caused my right medial tendon to be stretched - now my right eye lid (tarsus) sits lower from the inner corner causing 2 different shaped eyes. Is there a way to tighten the medial canthus?

[@AmiyaPrasadMD]

Hi Molly Herzfeld, Sorry to hear about your problem. It is possible to correct, but I would have to examine your eyelids to determine the best approach for you. I hope this helps you.

[@Shaleahselena]

I had upper/lower eyelid surgery and I’m botched! I’m depressed everyday!!!! I have terrible scaring and most importantly I have ectropion now please help 😭😭😭😭

[@AmiyaPrasadMD]

Hi shaleah donato, Sorry to hear about your problem. You can contact our offices for an appointment for consultation. Our offices are located in Manhattan, New York City which you can call at [phone]; Garden City, Long Island at [phone]; or Vienna, Virginia at [phone]. You can also reach us through www.prasadcosmeticsurgery.com, www.eyelifts.com, or www.puffyeyes.com by filling out a contact form, and we will get back to you. I hope to hear from you soon.

[@sangeetaarora1812]

Do you visit to India.. Or could you please suggest me any specific Dr in India for this surgery? Regards

[@AmiyaPrasadMD]

Hi sangeeta arora, I suggest you seek an oculoplastic/oculofacial surgeon in India. I only practice medicine in the US, and I'm not familiar with eyelid specialists in India. I hope this helps you.

[@maliah8158]

Hi doctor, I was born with minor golden haar syndrome, and it is most prevalent in one of my eyes. Would this eye retraction surgery help my under eye if I never had eyelid surgery? Edit: I believe I would need a skin graft, as my under eyelid is tight and there seems to not be enough skin there

[@AmiyaPrasadMD]

Hi Malia H, Sorry to hear about your problem. I would have to examine your eye area to determine what is best for you. Generally, skin grafting is avoided unless there are no safer and more predictable options available. I hope this helps you.

[@Dandelion_flight]

I am very intrigued as you have said in a few videos that skin grafting in younger patients is of a challenge to you. Why is it so Dr Prasad? Is it because younger patients have less loose/excess skin to use? I thought younger patients would heal much better than older ones? And what is the meaning of younger? Less than how old would that be roughly? Thanks.

[@AmiyaPrasadMD]

Hi, Skin grafts are used as a last resort at any age because grafted skin can look more conspicuous, and can be a visible sign that surgery was done. I hope this clarifies things for you.

[@Dandelion_flight]

@@AmiyaPrasadMD ahhhh totally makes sense now. Thank you so much for clarifying this for me 😀

[@AmiyaPrasadMD]

You're welcome!

[@countrygirl8424]

dr Prasad i had my orbicularis oculi and the little "puff fat" removed from my lower lids, my eyes are flat, can you place graft of some type to make my lower lids look fuller and to get the "roll" back ? i had 4 lower lid surgeries please help !!! i need to get them natural looking

[@AmiyaPrasadMD]

Hi countrygirl, Sorry to hear about your problem. Fat grafting is not recommended under the eyes because the thin skin of the lower eyelids can show irregularities of fat, it's an unpredictable procedure, and removing the fat is a complex and expensive procedure. You can consider filler under the eyes, but I will need to perform a physical exam to see your best course of treatment. I often leave a little fat when doing lower eyelid surgery to preserve the natural contour of the lower eyes, which is why under eye surgery is an art. I hope this clarifies things for you.

[@countrygirl8424]

hey dr Pras, on this video, you show a person who looks like their lower lids are more fuller w volume, did you put an interior lamella graft w skin graft ? i showed ur pic to an eye dr and that what he thought you did ??? if so wouldnt that give me more volume and make my eyes look less flat ?

[@nessa5753]

How can I contact you so you can give me tips on massaging the eyelid

[@AmiyaPrasadMD]

Hi Charming Nessie, Before I recommend that you massage your eyelids, I would have to examine your eyelids. If there is a problem with your eyelid because of previous surgery, you should consult your surgeon first as they know the details of your surgery, as well as your skin condition. I hope this helps you.

[@dillon.phelps3]

Hi Doctor Prasad can my minor lower eyelid retraction be temporarily lifted with Hyaluronic acid gel treatment? Thanks

[@AmiyaPrasadMD]

Hi Joe Flacco is Elite, but now he's hurt, I have read about this being done, but I don't find it particularly beneficial. Lower eyelid retraction is due to a tissue shortage, not a lack of volume, so it's not the ideal approach. I hope this clarifies things for you.

[@dillon.phelps3]

@@AmiyaPrasadMD thanks so much

[@AmiyaPrasadMD]

You're welcome, @@dillon.phelps3!

[@carlitacabrera5845]

Doc Does transfer of fat between the lower eyed lid and the cheek work well as elevator of the area and as a consequence support provider? ( I think that the support was given by the bags which had been removed ) thank you doc.

[@AmiyaPrasadMD]

Hi Carlita Cabrera, If volume or a "shelf" is needed at the eyelid-cheek junction for support, I use a hyaluronic acid filler. Fat grafting is less predictable as 30-70% of grafted fat is absorbed soon after surgery, and not advisable under thin eyelid skin where it is prone to complications. You can refer to this video where I perform lower eyelid surgery, as well as upper cheek volume enhancement - kzbin.info/www/bejne/ameuoWmXrsussMk

[@carlitacabrera5845]

@@AmiyaPrasadMD hola Doc. Thank you! I havent had mental peace since my blefaroplasty and i am lookkng for the best advice. I will check your video now and thank you for your help. I wish i lived in usa to be able to ask you in person. Gracias!

[@AmiyaPrasadMD]

You're welcome,@@carlitacabrera5845

[@bartomiejjarosz5392]

Hi doctor. Can it be done under local anesthesia?

[@AmiyaPrasadMD]

Hi Bartłomiej Jarosz, Yes, I perform eyelid surgery, both primary and revision, with local anesthesia. You can refer to this video about it - kzbin.info/www/bejne/mHK4mXqInt-fmZI

[@Deniz-dx7yh]

hello doctor is a lower eyelid retraction surgery with spacer transplant and canthoplasty,( for someone with negative orbital vector) to treat scleral show successful or does the negative vector have to be treated as well to fix the scleral show and the canthal tilt?

[@AmiyaPrasadMD]

Hi Deniz 1905, Your anatomy does need to be examined before I can recommend the best approach for your case.

[@Deniz-dx7yh]

@@AmiyaPrasadMD how can i have contact with you? I live in Europe.

[@AmiyaPrasadMD]

Hi@@Deniz-dx7yh, You can contact our offices to arrange for a formal consultation, which can be done initially online through Skype or FaceTime. Consultations do require a consultation fee, but the fee can be applied to the cost of treatment. Our offices are located in Manhattan, New York City which you can call at [phone]; Garden City, Long Island at [phone]; or Vienna, Virginia at [phone]. You can also reach us through www.prasadcosmeticsurgery.com, www.puffyeyes.com, or www.eyelifts.com by filling out a contact form, and we will get back to you. I hope to hear from you soon.

[@hebaabdulrazik2157]

can lower eyelid retraction occur with transconjunctival blephroplasty ?

[@AmiyaPrasadMD]

Hi Heba Abdulrazik, As long as lower eyelid support structures are preserved, such as the muscle, tendon, ligaments, and skin, it should not cause lower eyelid retraction. I hope this clarifies things for you.

[@melindachisholm6418]

Hi I did have a lower retraction repair with one eye being webbed at the lateral canthal and the other was blunted at the lateral canthal. I had hard pallet graft and a very thin orbital rim placed only for the fixation for the SOOF. Looked great while I was still swollen. The very round webbed eye looks good enough. The blunted eye has rounded again but maybe worse. Also in the lateral canthal area on that side is thick and looks like a masquito bite. I also see thickness of the graft under that eye but only in certain lights. That does not bother me so much. What does bother me is the whelp looking bump in the lateral canthal area. As I push that bump in … the corner fixes itself. It appears to anyway. I did bring this to my surgeons attention …. However he wants almost as much money to fix this one eye. I am flabbergasted and sick. I feel betrayed . I do not expect a revision to be perfect but the unreasonable price and just to say sorry , we have to cover our cost and the surgery room cost as well blows my mind. I think it could be tweaked easily. He seems to think the canthoplasty failed in that eye but not sure he can actually see the thick bump in the corner in the photos I sent. If it’s just a canthoplasty that can fix this … I can have this done in my area…. But I don’t know if the pallet graft in the lateral corner is causing this issue…. And I don’t want someone wrecking the foundation that has been placed there … even though it’s not perfect.

[@AmiyaPrasadMD]

Sorry to hear about your problem, Melinda Chisholm. A proper second opinion does require a physical examination, as well as reviewing your medical records of your previous eyelid procedures. I hope this helps you.

[@melindachisholm6418]

@@AmiyaPrasadMD Thank you, I agree it needs to be seen in person. From the front view it looks good and I have no doubt no one notices. The SOOF itself looks great. I don't regret it.... I just wish he was reasonable about taking care of it at a fair fee.

[@AmiyaPrasadMD]

You're welcome,@@melindachisholm6418

[@angryjoblesswomen693]

Doctor i have one quetion that temporal lift can lift your eyes dropiness or not

[@AmiyaPrasadMD]

Hi, A brow lift is only for when droopiness is caused by the brow descending. Droopy eyelids are caused by the muscle that lifts the eyelid, while hooded eyelids are caused by stretched or redundant eyelid skin. You can refer to this video about these two conditions, and how they are treated - kzbin.info/www/bejne/qZiUg56Dj5qcjK8

[@heenadesai9812]

Doctor I have done skin pinch blephro plasty in that doctor remove morning skin while take mid levels juction ...later I went ocloplasty surgeon he did hylronic acid filler to support my left eye. But now it's getting dissolve so again retraction is visible when I look down so oculoplasty surgeon next step is skin grafting.can you advice me what should I do instead of skin graft? What are the option.if I wanted to avoid skin graft..cantho plexy, or tarshal strip. Because I heard skin graft looks weird in the begining..

[@AmiyaPrasadMD]

Hi @heenadesai9812, Sorry to hear about your problem. While I do revise surgeries performed by other doctors, I hope you understand that I would have to physically examine your eyelids before I can make specific treatment recommendations for your case.

[@heenadesai9812]

@@AmiyaPrasadMD doctor plz guide me should I go for skin graft or without graft with the help of canthoplexy retraction can be reversed? Or any other way .plz I request you

[@AmiyaPrasadMD]

Hi@@heenadesai9812, Please understand that I have not seen your eyelids, or diagnosed your problem, so I can't tell you which procedure you should have without knowing these details. As the video states, skin grafts are only done when there are no other options. I hope you understand.

[@heenadesai9812]

@@AmiyaPrasadMD ok

[@ibexautogroup2097]

I underwent a lower blepharoplasty 10 years ago, which resulted in lower eyelid I got a line on top my check and my under eye look loos and bad the doctor redo it with no charge it didn't help so I went during 8 years to money doctors they asked me what this is we don't know and we don't if we can help or fixe i did some lease co2 tighten skim in 2018 I did for 3rd time surgery in Virginia with a oculoplastic doctor who first not recommend surgery then she did some leaser then after no result she did after 2 years surgery I was not happy end up lower eyelid little bit droopy and lower skin to me to loos and fine line around eye and check line was worst in 2 years waiting then I sow a doctor in turkey for something else and I ask him what he think about my eyes but he said I'm not professional on eyes I do lower and upper eyelids surgery but I can tell you what this is and who you can go this looks like festoon after surgery mescals not put right way and get loos he give me name in USA doctor massry and 2 professor in Italy who can fixe this with much cheaper price witch in USA asked me over 10k and i did $3500 I went to Italy 6 weeks ago and her daughter did operation since his appointment was booked over a year and she did grad job and fixe the problem but I have a lower eyelid retraction witch she tole I may get it she did best since I was not living there now you can imagine what I went throw all this years I know is long story but maybe wort to know some people go throw this i need your help to fix this I know your great on your work thanks

[@AmiyaPrasadMD]

Hi ibex autogroup, Sorry to hear about your problems. You can make an appointment for a physical evaluation so I can determine a strategy that would help your case. Our offices are located in Manhattan, New York City which you can call at [phone]; Garden City, Long Island at [phone]; or Vienna, Virginia at [phone]. You can also reach us through www.prasadcosmeticsurgery.com, www.puffyeyes.com, or www.eyelifts.com by filling out a contact form, and we will get back to you. I hope to hear from you soon.

[@somamondal3529]

My baby's age 3 month..from birth her left upper eyelid line has down from other eye's upper eyelid line of the another eye..so she can't open her left eye fully ..she can only open her right eye fully but she can't open other eye fully ..so,her left eye looked small than right eye .so pls sir help me that is this have a treatment??

[@AmiyaPrasadMD]

Hi Soma Mondal, Sorry to hear about your daughter. I suggest you seek a pediatric ophthalmologist in your area to properly diagnose this, and give you options for treatment. If you're not sure where to find a pediatric ophthalmologist, you can ask your pediatrician for a referral. I hope this helps you.

[@dawatsamlhoe309]

Dr due to burn I have do lower eyelid surgery, so I am really 10000 times scared.plez if u give me some advice it would very grateful. Thank you

[@AmiyaPrasadMD]

Hi Dawa Tsamlhoe, Sorry to hear about that. I understand you went through something traumatic, but I do need to perform a physical exam to assess your situation before giving any advice or recommendations. I can tell you it's best to see an oculofacial plastic and reconstructive surgeon like myself who specializes in eyelid surgery and restoration. I hope this helps you.

[@dawatsamlhoe309]

Amiya Prasad, M.D. sir actually I have shown to plastic surgeon , I am from india , I wish I am at new York,

[@AmiyaPrasadMD]

Hi Dawa, It is important you see an eyelid specialist as general plastic surgeons may only have basic training in eyelid surgery, and your problem sounds like one for a specialist. I hope this helps you.

[@tashilhamu4084]

Amiya Prasad, M.D. sir I did etropion lower eyelids two weeks before .now it is looking so scary. Can u plz help me by giving some advice.i am dawa tsamcho. Thank you

[@AmiyaPrasadMD]

Hi dawa tsamcho, It is unclear from your description if you have entropion or ectropion after lower eyelid surgery. I really would have to physically examine you before giving specific recommendations, but I suggest you find an eyelid specialist like an oculoplastic/oculofacial surgeon in your area for help with this. I hope this helps you.

[@Bts_V_tamil]

Sir how much for this surgery in India..doing this surgery is permanent? Im 18 years old can i do this surgery?

[@AmiyaPrasadMD]

Hi @Shveyy-Glow, I generally don't recommend eyelid surgery until the face stops growing and maturing in the early 20s. It's important to remember that almost any medical cosmetic treatment does not stop the effects of aging, or prevent the effects of excessive sun exposure, diet, stress, pollution, etc, so expecting permanent results is unrealistic as the body itself is not permanent and subject to changes. I hope this clarifies things for you.

[@shashanktiwari6837]

Dr are result of lower eyelid retraction surgeries are permanent and if not how long may result last

[@AmiyaPrasadMD]

Hi Shashank Tiwari, It depends on the cause of the eyelid retraction, and how surgery was performed. It's also important to remember that surgeries don't stop aging, or prevent effects of environmental exposure, or lifestyle choices that can affect the lower eyelids. I hope this clarifies things for you.

[@shashanktiwari6837]

For how much time (generally)results last

[@shashanktiwari6837]

Like for 2 to 3 years or more than that

[@AmiyaPrasadMD]

Hi@@shashanktiwari6837, Same as the previous answer. The way the doctor performs the surgery, and patient behavior affect longevity. There is no way to predict these for all cases and variables. I hope this clarifies things for you.

[@renukagowde5915]

How to contact you sir

[@AmiyaPrasadMD]

Hi Renuka gowde, Consultations are by appointment only, and can be arranged by our offices to be done remotely on a one-on-one video call on Skype or FaceTime. Consultations do require a consultation fee, but the fee can be applied to the cost of treatment. You can contact our offices or websites to arrange an appointment. Our offices are located in Manhattan, New York City which you can call at [phone]; Garden City, Long Island at [phone]; or Vienna, Virginia at [phone]. You can also reach us through www.prasadcosmeticsurgery.com, www.puffyeyes.com, or www.eyelifts.com by filling out a contact form, and we will get back to you. I hope to hear from you soon.

[@Iam-me]

With face,better find best surgeon, its no joke…

[@AmiyaPrasadMD]

You're absolutely right, Its Me. Getting complications from cheap surgery often results in requiring more expensive revision surgery by a specialist. It costs less in the long run to get it right the first time.

[@wat3915]

Hi doctor, if i have a lot of white part which i think is called the sclera that is showing under my eyeball, i want the white part to disappear naturally so that i get a for attentive and hunter look, is it possible without surgery? Will trying to keep my eyes like that consciously all the time eventually hide it?

[@AmiyaPrasadMD]

Hi @wat3915, Excessive scleral show will likely need surgery, as there is no safe or predictable way to raise the lower eyelid non-surgically. A physical examination is needed to determine the best approach for your situation. I hope this clarifies things for you.