What Are the Risks of Blepharoplasty?

Blepharoplasty (Eyelid Surgery)

One of the most carried out cosmetic surgery today is blepharoplasty. Sometimes, it is also performed for medical reasons. If your field of vision is blocked due to a sagging eyelid skin, then you might need an eyelid surgery. The primary goal of the surgery is to ensure rejuvenation as well as functional and cosmetic enhancement of the eye region. The operation is performed on either the upper eyelid, lower eyelid, or both.

Eyelid surgery is typically different for every candidate's needs. Surgery can be done on the upper or lower eyelid region, both eyelids, or in association with other surgical procedures of the nose, eyes, or brown spots on the face. It must be noted that an eyelid surgery will not hinder the aging process, but rather, will make you look younger. However, having a blepharoplasty will remove the excess sagging skin and bags from the eyelid area.

Upper Blepharoplasty or Upper Eyelid Surgery

In this type of eyelid surgery, small cuts are made in the upper region to expose the fat pouches and also the excess skin. The excess skin is then stripped or removed, along with the fat. The incisions made are then closed with stitches.

Lower Blepharoplasty or Lower Eyelid Surgery

A myocutaneous flap is created through a subciliary incision. The excess fat, muscle, and skin are then removed. However, fat can also be added. The incision is then closed with stitches.

In both processes, general anesthesia is administered. Each procedure carried out will take between 30 minutes to one hour to complete. However, if they are to be performed together, the operation might take up to two hours.

Are there any complications or risks associated with blepharoplasty?

Blepharoplasty complications are not common, but when they do occur, they are usually transitional and mild such as chemosis (swollen conjunctiva) and hematomas (collection of blood under the skin). However, sometimes, risks can also be definitive in nature such as blindness, eye ptosis (drooping eyelid), and infections. Such complications cause critical cosmetic and functional damage. Although rare, you should always be prepared for such.

Blepharoplasty Complications

1. Hematomas

A hematoma is a complication that causes amaurosis (partial or total loss of vision) depending on its degree or progression. When there is a hematoma, there is a localized collection of blood outside of the blood vessels. 

2. Chemosis

Chemosis is an accumulated swelling of the eye. Swelling happens when there is a collection of fluids from inflammatory reactions, lymphatic drainage, or minimal eye closure. It is the most common complication after an eyelid surgery, particularly with lower blepharoplasty due to the frequent handling of the conjunctiva.

3. Faulty positioning of the lower eyelid

The proper position of the eyelid is above the lower limbus. A faulty positioning will occur as a result of too much removal of excess skin or the scarring of the orbital septum. Therefore, the doctor should be careful when removing the excess skin. It is the second most common complication associated with blepharoplasty.

4. Bleeding

Bleeding will internally take place under the skin, especially in the surroundings of the eyeball. However, it is uncommon for bleeding to take place after the surgery. When you begin to experience bleeding after the surgery, contact you doctor immediately for further assistance. Avoid anti-inflammatory medications as they contribute to a higher probability risk of bleeding. 

5. Lagophthalmos

Lagophthalmos is an incomplete eyelid closure, which is usually due to the excess removal of tissues of the upper eyelid, lower eyelid retraction, or muscular obstruction due to surgery. It is the most frequent cause of dry eyes after the surgery. It may be treated in some cases through an operation to correct the situation. However, the use of tear drops and eye massage typically resolve the problem.

Unsatisfactory Results

Although most people who undergo surgery expect positive results, sometimes, this might not be the case. There is usually a probability of unsatisfactory results such as visible deformities, loss of sensation, and function loss. If you are not satisfied with the result, you may choose to undergo additional surgery to correct the outcome of the initial surgery. For example, brow lift surgery can be done to correct sagging. 

1. Eyelid ptosis     

When the upper eyelid fails to fall to its normal position, and the elevator muscles cannot raise it, the condition is called eyelid ptosis. It may either be preoperative or postoperative in nature. Preoperative is when you have the condition before surgery. It might be as a result of other conditions, so make sure that you discuss it with your doctor for further assistance. The leading cause of postoperative ptosis is the swelling of the eye. Swelling causes a restriction to the eyelid muscle elevators. Hematomas can also cause muscle lift restrictions.

2. Double vision or diplopia

Double vision occurs when the muscles in charge with eye movement are altered during surgery. It can also occur due to the scars that will be around the eyeball after the surgery. However, the case is very rare. The inferior oblique is usually the commonly affected muscle. Having a double vision will require additional surgery to correct the problem.

3. Allergic reactions

Allergic reactions may occur due to the anesthesia that was administered. The patient can also be allergic to the surgical tools used such as tapes or suture materials. Medications that are administered during the operation, as well as prescription drugs, are also major causes of an allergic reaction. For this reason, it is highly recommended that you inform your doctor about the medications that you may be allergic to before undergoing surgery. Your doctor may suggest for alternative prescriptions or the type anesthesia to be used. However, when allergic reactions do occur, further treatment will be required.

Future Effects

Aside from improving a person's look, blepharoplasty is mostly performed to correct eye deficiencies. However, an eyelid surgery cannot interfere with the aging process. The aging process is naturally independent. Therefore, the eyelids may be subjected to further alteration as you age. Exposure to the sun, weight loss, or weight gain can also cause a change. Therefore, you need to prepare yourself for future surgeries if you want to maintain your appearance.

1. Deeper eye structures may be damaged

Nerves, blood vessels, and muscles of the eye may be damaged during surgery. However, deeper injuries usually depend on the type of blepharoplasty procedure that you went through. The obtained injuries will either be temporary or permanent. Further treatment will be required if deeper injuries are sustained.

2. Scarring

It is expected that after the operation, the surgical wounds will heal without problems. However, abnormal scars may occur in the deeper tissues and on the eyelid, leaving an unattractive appearance. These scars will develop different colors and give a strange appearance to the eyelid. Further treatment will be needed to change the appearance of the scars.

You should stay vigilant and monitor your health. If you notice anything unusual, don't just assume; let your doctor clarify it to you.