About the Procedure
Lower eyelid retraction surgery corrects a lower eyelid that rests too low, exposing white below the colored part of the eye and sometimes pulling away from the eyeball. Retraction can follow facial paralysis, previous eyelid or cosmetic surgery, thyroid eye disease, trauma, or scarring, and it can leave the eye dry, irritated, watery, and poorly protected.
The goal of surgery is to restore the lower eyelid to a normal height and position so the eye closes and is protected. Depending on the cause, this may involve tightening lax eyelid tissues, releasing scar tissue, and adding a graft or spacer to provide vertical support.
At Norelle Health, lower eyelid retraction is evaluated alongside overall eye protection and facial function, particularly in patients with facial paralysis, so that treatment addresses both the eyelid position and the underlying cause.
Who may be a candidate
Candidates typically have a lower eyelid that is too low or pulled away from the eye, with symptoms such as dryness, irritation, tearing, or poor eye closure that persist despite lubrication.
Common causes include facial paralysis, previous lower eyelid or cosmetic surgery, thyroid eye disease, trauma, and scarring. An examination identifies the cause and the structures that need to be corrected.
Considering lower eyelid retraction surgery? The next step is a quiet, unhurried conversation.
How it is performed
The specific repair depends on the cause. It may include tightening lax eyelid tendons at the outer corner, releasing scar tissue that pulls the lid down, and placing a graft or spacer—such as cartilage or other supportive tissue—to give the eyelid vertical height and support.
The procedure is often done under local anesthesia with sedation, and incisions are placed to be as inconspicuous as possible.
Recovery and aftercare
Swelling and bruising are common for one to two weeks, and the eyelid may feel tight or look slightly raised at first. Lubricating drops or ointment are often used while the eye surface recovers.
Most patients return to routine activity within a couple of weeks, avoiding strenuous activity and rubbing the eye early on. The final eyelid position settles over the following weeks to months.
Risks and alternatives
Possible risks include undercorrection or overcorrection, asymmetry, swelling, infection, bleeding, and the possible need for revision. When a graft is used, there may be mild changes at the donor site.
Alternatives and supportive measures include lubricating drops and ointments, taping or supportive devices, and treatment of the underlying cause; in facial paralysis, eyelid procedures are often combined with other measures to protect the eye.
Results and follow-up
Successful surgery raises the eyelid to a more normal position, improves eye closure and comfort, and reduces dryness and exposure. Some asymmetry can remain, and results settle over time.
Follow-up monitors eyelid position and the health of the eye surface, and coordinates any additional treatment for the underlying condition.
Medical review
This page is a patient-education resource reviewed by the responsible Norelle Health clinician before publication. It does not replace an in-person evaluation. If symptoms are severe or rapidly worsening, seek immediate medical care.
Specialists who perform lower eyelid retraction surgery
Dr. Moustafa Mourad
MD, FACS
Double Board-Certified Head & Neck and Facial Plastic & Reconstructive Surgeon
Dr. Moustafa Mourad is a double board-certified head and neck and facial plastic and reconstructive surgeon who cares for the full range of cosmetic and complex conditions affecting the face, head, and neck.
- Facial plastic and reconstructive surgery
- Head and neck cancer surgery
- Microvascular free-flap reconstruction
- Facial trauma and reconstruction
Also caring for this area
Not sure who to see? Our patient coordination team can help match you with the right specialist.
(212) 444-8006Frequently Asked Questions
It is a lower eyelid that rests too low or pulls away from the eye, exposing white below the iris and sometimes leaving the eye incompletely closed, which can cause dryness and irritation.
Common causes include facial paralysis, previous lower eyelid or cosmetic surgery, thyroid eye disease, trauma, and scarring that pulls the eyelid downward.
Depending on the cause, surgery may tighten lax eyelid tissues, release scar tissue, and add a graft or spacer to support the eyelid and raise it to a normal height.
No. Its main purpose is functional—restoring eye closure and protecting the eye surface—although it also improves the symmetry and appearance of the lower eyelid.
Swelling and bruising are common for one to two weeks, and lubricating drops or ointment are often used. Most people return to routine activity within a couple of weeks, with the final position settling over months.
Some repairs use a graft or spacer—such as cartilage—to give the eyelid vertical support, especially when the lid lacks height. Whether one is needed depends on the cause and severity.
Yes. In facial paralysis, it is often combined with measures to protect the eye, and it may be coordinated with upper eyelid procedures when both lids are involved.
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