Blepharoplasty complications: Part I

Before entering the surgery room

As with any surgical process, cosmetic blepharoplasty may cause postoperative complications. Surgery indications, as well as possible complications must be carefully discussed with the patients before practicing the intervention, as for establishing a relationship with the patient, as for diminishing any possible postoperative complaints that might result of unreal expectations.

The surgeon must encourage the patient to speak openly during the preoperative instruction about her esthetic wishes; moreover, it’s convenient to offer the patient a mirror to point out the ocular areas she is worried about. Doing this, the surgeon minimizes the risk of misunderstanding the patient’s wishes. The plastic surgeon must keep an eye on the patient who believes complication is unacceptable at any circumstance, due to the fact that this type of patient won’t be fine for an eyelid surgery. Finally, before photos are worthy as an objective record for the patient to who subsequently has any doubt of the surgical results.

Upper eyelid surgery complications

Blepharoplasty complications in the upper lid are relatively harmless and easily to treat, from a milia (small whitish lump on the skin) to the most devastating as blindness.

Dry eyes

Besides giving mechanic protection to the eyeballs, eyelids help lubricate cornea, extending the lachrymal film. Tissue excision or shortening of the upper lid during blepharoplasty tends to alter the position of the eyelid over the globe dynamic.

The result may be a dry keratoconjunctivitis (ocular infection) or a lagophtalmos (the eye con not close completely) that ends up in a cheratopathy for exposure. As with many other upper lid blepharoplasty complications, preoperative evaluation is a crucial step to avoid this result.

Every patient should undergo routinely exams to cast out if there is a dry eye in the preoperative, as well for determining the presence of an intact Bell phenomenon (upward outwars turning of the eyeball). Detecting on time these deficiencies, the surgeon can modify the operation in a suitable way and avoid mistakes during the procedure.

Frequently in the postoperative, dry eyes and sclera (membrane that forms with cornea the outer covering of the eyeball) exposure symptoms are of transitory nature. A low level of lagophtalmos disappears in a few days or weeks. A new variety of eye-lotion and creams can be used in the meantime to ease the patient’s discomfort.

Occasionally, secondary eye irritation symptoms to the postoperative retraction or a persistent lagophtalmos need a deeper intervention.