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.
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.
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.