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Eyelid Surgery (Blepharoplasty)
Common Risks
Serious problems after eyelid surgery are extremely unusual. If they occur, most of these are temporary and can be
resolved with conservative treatment, touch-up surgery or time.
- Bleeding or excessive bruising.— If you avoid aspirin for two weeks before and two weeks after surgery,
and your bleeding is normal, the chances of this are very remote. Sometimes, increased bruising and even
bleeding can occur underneath the eyelids requiring further time to resolve or further operative procedure to release
the collected blood or pressure.
- Infection.— The eyelids and eyes are usually resistant to infection but sometimes due to dry mucous crusts,
deposits around the eyelid area, bacteria can grow and infection can ensue. This is usually treated by irrigation,
antibiotic drops and oral antibiotics.
- Excessive removal of upper and/or lower eyelid skin.— This may result in incomplete closure of the eyelids or
pulling down of the eyelid with a hound dog appearance (ectropion). While swelling is present, some of this may be seen
on a temporary basis. Were these entities to occur, correctional surgery can usually reverse the process. The doctor will
use his best judgment in the amount of skin to be removed; safety and conservativeness often are very important.
- Corneal irritation, ulceration, etc.— If the eyelid is unable to close, or increased dryness is noted after
surgery, corneal irritation or ulceration can occur. We attempt to protect the eyelids and the eyes quite carefully both
during and after the operation. Any corneal exposure, irritation or dryness which shows up as stinging, scratchiness,
feeling something in the eye or inability to open the eye without marked irritation, should be reported immediately to
the doctor. Early treatment is successful.
- Persistent swelling around the eyelids.— The fatty pads of the upper cheek area may not be totally helped by
lower eyelid surgery. People who have a propensity toward facial swelling may have chronic swelling or edema of these areas.
Digital pressure treatments and the avoidance of added salt to the diet may result in some improvement. Frequently the
addition of small cheek implants may help provide improved contour to these areas.
- Asymmetry.— Everyone does not have eyelids that are perfectly equal and, although improvements or attempts at
correction can be made, it is unlikely that complete symmetry results from eyelid surgery. Where significant asymmetry is
noted after surgery, it is recommended that one wait until all swelling resolves (six months to a year) before revision
surgery takes place if at all necessary. Often times the resolution of swelling results in better symmetry.
- Scarring.— The eyelids are very resistant to significant scarring. It is not unusual to have some early thickening
of the scars, particularly on the inside and outside of the upper and lower eyelids. These usually resolve with time.
When they do not, dilute steroid injections or pressure treatment can help resolve these areas.
- Persistent dark pigmentation.— In patients with normal increased pigmentation to the skin, increased bruising
rarely results in prolonged pigmentary changes. Avoidance of sun exposure by using sunglasses and sun blocks, along with
use of special depigmentary topical medications, usually help resolve this.
- Eyelid ptosis (droopy eyelids).— This is very unusual. This may occur temporarily while swelling is in place
because of decrease in eyelid muscle strength. If one were to see an unusual case of ptosis after an operation, this is
usually correctable with revision operation once healing takes place.
- Decreased or increased tearing.— Although usually temporary, there can be some change in the tearing of the eye.
Most frequently, some degree of dryness may be noted requiring the use of eye drops and nighttime protection of the eye.
- Visual deterioration or loss.— This is extremely rare and has not occurred either in our practice or, to my knowledge,
in the city of Tulsa. We may recommend that an eye doctor check your eyes prior to surgery to ascertain if there may be
some abnormalities of the eye during or after an eye operation (extremely rare). These may be impending retinal detachments,
vascular abnormalities, etc.
All in all, this is a very pleasing and satisfying operation for our patients.
A NOTE ON SATISFACTION AND DISSATISFACTION
It is important that you work with the doctor to establish realistic appearance goals. More than seventy items contribute
to a surgical result. With aesthetic surgery, good results are nearly always achieved. When you are willing to reserve final
judgment for a period of six months to a year, our results are usually excellent.
Beautiful paintings and sculptures by world-renowned artists have small imperfections, but these are rarely scrutinized.
Instead, one sees the overall beauty and mastery of the art. In order to remain natural looking, cosmetic surgery will result
in small imperfections when closely scrutinized. To avoid these, the doctor would have to use techniques such as over-correction
and distortion of the features. Instead, we utilize an artistic approach while maintaining your safely. We strive for a
youthful, yet natural look—the mark of an artist.
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Post surgery check list