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Blepharoplasty (Eyelid Surgery) Risks and Complications


                                     blepharoplasty - eyelid surgery risks and complications

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Blepharoplasty is basically a pretty easy surgical procedure to recover from. The eye area heals incredibly fast. Blepharoplasty is a minor aesthetic surgical procedure it rarely or almost never includes systemic risks and complications. Most of the complications can be easily treated with simple treatment or further surgery may be needed.


Symptoms you might have following surgery:

  • Excessive tearing
  • Dry eye
  • Itchy or burning eyes
  • Light sensitivity
  • Blurred or double vision
  • Swelling and bruising




  • Risks or Complications of Blepharoplasty

Complications of Blepharoplasty:



                                                 image of an eye

                                 Copyright 2009 Nucleus Medical Media, Inc - Used with permission


The eyelid may not be able to close properly. Insufficient eyelid closure can sometimes compromise the integrity and health of the eye. While milder cases may respond to massage, advanced cases require the grafting of skin.  




Ptosis may be caused by injury to levator muscle or it tendon. Mild ptosis can resolve itself without any kind of surgical intervention over a period of two to four weeks. If the ptosis is not resolved by that time, then a surgical procedure with an eyelid specialist might be indicated. 




The complication exhibits bleeding that remains within the eyelid area and does not extend deeper into the orbit. This bleeding may form a clot, and although these superficial hematomas are not a threat to the patient's vision, they may impede healing time.

Bleeding with an eyelid lift is usually minimal. Oozing after a blepharoplasty is normally from the small blood vessels leaking - which will in turn result in bruising. 




Although considered uncommon or rare complication after upper or lower blepharoplasty, retrobulbar hemorrhage is serious. This complication can result in a loss of vision due to a build up of blood in the socket behind the eyeball. The vision starts turning grayish and there is some pain associated with this. 




This is a risk with any surgical procedure that is performed.  Blepharoplasty performed under sterile conditions however, rarely result in a serious infection due to the eyelid's good blood circulation. Reported incidence of infections with blepharoplasty is between 0.2 - 0.9%. If there is persistent redness, swelling, and pain 8 - 10 days post operative, then an infection might be present.




Excessive fat removal from the upper eyelid can create a lid crease that appears too high and deep.

Excessive fat removal from the lower eyelid can create a hollowed out appearance.





This complication consists of a pulling down of the lid which exposes the white of the eye. 

Many factors determine the tightness or support of the lower eyelids including the following:

  • Aging

  • Trauma

  • Surgery

  • Genetic Condition




This complication is the pulling away of the lower lid from its normal position on the globe (eyeball).  Ectropion is caused by removal of too much eyelid skin. Sometimes this can be a temporary condition which will improve to normal once the swelling subsides. If this is not the case, then surgical correction is suggested. The surgical procedure to fix ectropion can sometimes be a challenge, and could include grafting of donor skin or reinforcement of the eyelid with a canthoplasty




Entropion is an eyelid that turns inward - and is a problem that typically affects the lower lid. This can be caused from a muscle spasm or scarring from trauma or inflammation from certain diseases that involve the eyelids. When the eyelid turns inward, the lashes rub against the eye, resulting in severe irritation, scratchiness, tearing and redness.




If the main tear producing gland is injured during the blepharoplasty - prolonged swelling in the outer portion of the upper eyelid might be persistent for several weeks. This injury to the drainage canal - called "canalicular laceration" is very rare, however it does require immediate repair by an ophthalmologist.




Little white bumps can develop along the healing incision line. These "whiteheads" are called milia, which are blocked glands. Most of the time, the small milia usually disappear spontaneously or your surgeon may help it along by treating them with a tiny needle.




Normally blepharoplasty will leave a tiny pencil fine scar line which is barely noticeable. Scarring is generally considered "rare" in this procedure, however; sometimes excessive scar tissue can happen. Over active scar production (hypertrophic scarring) can lead to usual appearance of the eyelid including additional folds. If the hypertrophic scarring is severe, a revision procedure might be needed.




Most human faces are not symmetrical, so therefore some minor asymmetries are normal after blepharoplasty. If the asymmetry is severe, it might be contributed from brow droop on one side or it could be that there was too much tissue that was removed from one eyelid.




This is of course, the most devastating complication that can occur with eyelid lifts. The literature puts this risk at 0.04%. These cases are rare - however, if there is a patient who only has vision out of one eye - most surgeons will not do blepharoplasty on these patients.

Vision loss is usually the result of bleeding into the depth of the eye socket, which is not addressed in a timely manner. Most surgeons who are experienced in blepharoplasty will be able to recognize this complication and treat it immediately - which will save the sight in the eye.




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