Blepharoplasty safety – risks and contraindications

Is blepharoplasty safe?

Eyelid surgery is one of the most common operations around the eyes. With proper qualification and an experienced surgeon, serious complications are rare. No operation is completely risk-free, though – which is why the pre-operative examination, careful planning and following aftercare instructions matter so much.

Common, temporary effects

After surgery most patients have:

• swelling and bruising of the lids, sometimes the cheeks,
• tightness, mild pain or discomfort,
• watering or, conversely, dry eyes,
• light sensitivity, temporarily blurred vision (partly from ointment),
• slight unevenness and firmness of the scar in the first weeks.

These usually settle on their own within days or weeks. See recovery after blepharoplasty.

Possible complications

• haematoma under the lid skin; rarely needs draining,
• wound infection – rare thanks to the rich blood supply of the lids,
• asymmetry – eyelids are never perfectly symmetrical, but a clear difference may need correction,
• poor scar healing – thickening, redness, rarely a hypertrophic scar,
• incomplete eyelid closure – usually temporary; the eye needs lubrication,
• worsening of dry eye,
• change in lower-lid position (lowering, turning out) – mainly a risk of lower-lid surgery,
• under- or over-correction – e.g. remaining excess skin, or a lid set too high or low in ptosis surgery,
• double vision – very rare, usually temporary,
• bleeding behind the eye – very rare but serious; it can threaten sight and needs immediate treatment.

Contraindications

Surgery is postponed or not performed, among others, in case of:

• an active infection, conjunctivitis or eyelid margin inflammation,
• poorly controlled high blood pressure or diabetes,
• bleeding disorders,
• active thyroid eye disease,
• severe dry eye,
• pregnancy and breastfeeding,
• recent eye surgery or laser vision correction – the required interval is set by the doctor,
• unrealistic expectations of the result.

Taking blood thinners does not always rule out surgery, but it must be planned with your prescribing doctor. Never stop these medicines on your own.

How to reduce the risk

• tell the doctor about all your conditions, medication and supplements (including e.g. ginkgo or fish oil),
• stop or reduce smoking for several weeks before and after surgery,
• avoid alcohol for a few days before and after the operation,
• follow the instructions and attend follow-up visits,
• report worrying symptoms straight away rather than waiting for your next visit.

Qualification is the basis of safety

Many complications stem from the wrong procedure – e.g. removing skin in someone with ptosis, or over-aggressive correction in someone with dry eye. That is why every operation at Oculy is preceded by a consultation and examination, and the doctor may advise against surgery if the risks outweigh the benefits.