Upper Eyelid Surgery (Blepharoplasty) Risks
You will have a general anaesthetic
The administration of general anaesthetic agents by, or under the direction and supervision of the surgeon(s) and the accompanying qualified anaesthetist.
Blepharoplasty involve certain risks and possibilities of complications
The procedure will result in scar formation, as with all surgery. With upper eyelid surgery the scar is positioned within the eyelid crease (extending laterally) and is generally well hidden. Scarring is generally pink, but fades to become white, soft and supple in the weeks or months after the operation. Most patients find that the wound heals quickly and that the appearance is ultimately acceptable to them. However, abnormal scarring occasionally occurs within the skin and deeper tissues and these may be unattractive and of different colour to the surrounding skin. Scars may also exhibit contour variations and “bunching” due to excess skin, or may be asymmetrical (with a different appearance between the right and left side of the body). In some cases scars may require surgical revision or treatment. In rare cases keloid scars form, which are thickened by an inflammatory process in the scar tissue. This occurs due to an irregularity of the patient’s healing process.
Antibiotics are administered during the operation and, if required, you will be prescribed oral antibiotics to take afterwards. This minimises the risk of infection. Nevertheless infections can occur and, should this be the case, they are treated either by oral antibiotics or, in severe cases, by admission to hospital for intravenous antibiotics and further drainage procedures.
General complications applicable to all types of operations include, but are not limited to:
- Heart problems (although very uncommon with modern anaesthetic techniques).
- Lung problems; small areas of the lungs may collapse, increasing the risk of chest infection. Such problems may require antibiotics and physiotherapy to correct. Other potential lung complications are quite rare.
- Clots in the legs with pain and swelling. Rarely, part of such a clot may break off and travel to the lungs, causing fatal complications.
- Allergic reactions to medications.
- Potential for injury to deeper structures including nerves, blood vessels, and muscles.
- Itching, tenderness, or exaggerated responses to hot or cold temperatures. Usually this resolves during healing but, in rare cases, may be chronic.
- Deep sutures may spontaneously poke through the skin, become visible or produce irritation that require removal.
- Wound disruption or delayed wound healing – especially in patients who do not stop smoking before their operation. Necrosis (skin death) can also occur.
Postoperative pain will occur in varying degrees, from quite severe to moderate to mild on the first day. It gradually improves over the next few days and is assisted by using the prescribed pain medication. Increasing, unresponsive pain should be brought to the attention of the surgeon as this may be an indication that complications are developing.
Intermittent mild discomfort or intermittent sharp pains after the first few weeks may also be evident as swelling resolves and nerves recover.
Chronic pain, ranging from mild to sharp nerve pain can persist for more than a year.
Bruising and swelling is normal after this operation,and varies with each patient.
To reduce risks the patient should stop treatment with such drugs as Aspirin, anti-inflammatory drugs or other blood-thinning agents, including high dose vitamin E tablets or capsules, 10-14 days prior to surgery. We will provide you with a comprehensive list of substances to avoid in your pre-operative instruction sheet. However if you are taking any medications and you are unsure if they affect bleeding, please ask us at least two weeks before your operation.
Specific complications relating to upper blepharoplasty surgery may include:
- In rare cases bleeding may occur under the skin or internally around the eyeball. This may require admission to hospital to identify the bleeding vessel.
- Blindness is extremely rare but can be caused by internal bleeding around the eye during or after surgery. This occurrence is not predictable.
- Accumulations of blood under the eyelids may delay healing and cause scarring. Hematomas can occur.
- Infections – either superficial or deep.
- Permanent dry eye problems due to decreased tear production can occur.Individuals who normally have dry eyes may be advised to use special caution in considering this type of surgery.
- Some patients experience difficulties closing their eyelids after surgery and problems may occur in the cornea due to dryness. Should this rare complication occur, additional treatments and/or surgery may be necessary.
- Eyelash hair loss may occur where the skin was elevated during surgery. This is not predictable and it may be temporary or permanent.
- Changes in skin sensation are possible. While these usually resolve quickly they may become more permanent.
- Skin contour irregularities and depressions may also occur, with visible wrinkling of the skin. Residual skin irregularities at the ends of the incisions or “dog ears”may require additional surgery.
- Skin discoloration and swelling around the eyes, which in rare circumstances may persist for long periods or become permanent.