What is lower eyelid retraction?
Normally the lower lid rests at or just above the lower edge of the iris. In retraction it sits lower, so a crescent of white shows underneath and the eye can look sad, staring or rounded. In more pronounced cases the lid no longer protects the eye well, causing grittiness, redness or watering.
The commonest cause is previous surgery — usually lower blepharoplasty where too much skin was removed, or lower-lid lowering done for eye widening. Age-related laxity, a prominent eye and a flat cheek also contribute. Lower eyelid retraction surgery restores support from three directions: the outer corner, the middle layer of the lid, and the cheek beneath.
Signs you may need lower lid retraction repair
- White visible between the iris and lower lid when looking straight ahead.
- A rounded or pulled-down outer corner after earlier eyelid surgery.
- Dry, gritty or watering eyes especially in wind or air-conditioning.
- A lid that snaps back slowly when gently pulled down.
- Changes stable for at least 3–6 months after your last operation.
If retraction appeared within the last few weeks after surgery, massage and taping may still help. Revision is usually best delayed until the tissues have softened.
Which repair technique is right for my lid?
| Canthoplasty alone | Canthoplasty + spacer graft | Plus midface support | |
| Suits | Mild retraction, lax lid | Moderate retraction, scarring | Severe, flat cheek |
| What it adds | Tightens outer corner | Lengthens the lid's middle layer | Lifts cheek tissue under the lid |
| Incisions | Outer corner | Corner + inside lid | Corner, inside lid ± mouth |
| Swelling | 2–3 weeks | 3–4 weeks | 4–6 weeks |
| Complexity | Lower | Moderate | Higher |
How is lower eyelid retraction corrected?
Before & after
Before
After
See more eyelid cases in the before & after gallery.
What is recovery like after retraction repair?
| Day 1–5 | Firm swelling and a tight corner; the lid may look over-lifted. Ointment and cold compresses. |
|---|---|
| Day 7 | Stitches removed; protective taping may continue at night. |
| Week 3–6 | Swelling eases and the corner softens; most people are back at work. |
| Month 3–6 | Lid height stabilises; final result assessed. |
“Revision on a lower lid is about support, not tightness. If the foundation is right, the lid stays where it belongs.”
Dr. Lee Yoo-jung · Chief DirectorWhat are the risks of lower lid revision?
This is one of the more demanding eyelid operations, and outcomes are less predictable than in first-time surgery. Risks include partial recurrence, asymmetry, a corner that looks tight or angled, prolonged swelling, graft visibility and temporary dry eye. Some patients need a second, smaller procedure. Dr. Lee will tell you honestly how much improvement is realistic for your lid. For more on correcting earlier eyelid work, see revision blepharoplasty.
Frequently asked questions
How soon after my first surgery can retraction be fixed?
Usually after at least three to six months, once scar tissue has matured and softened.
Can fillers fix lower eyelid retraction?
Fillers can help very mild cases by supporting the lid from below, but established retraction generally needs surgery.
What is a spacer graft?
A thin piece of tissue placed inside the lid to lengthen its middle layer so it can rise without pulling.
Will the white below my iris disappear completely?
Often it is greatly reduced, but complete correction is not always possible, especially after several operations.
Can it be combined with other procedures?
Sometimes, for example with upper-lid surgery, but Dr. Lee usually keeps the focus on stabilising the lower lid first.
How long should I stay in Korea?
We recommend 10–14 days so Dr. Lee can remove stitches and check the lid position.