Blepharoplasty (eye surgery) Questions and Answers

Q. What are some of the risks associated with a sugeon removing muscle in an upper blepharoplasty as oppossed to just removing the skin? Are there less risks with just skin removal in an upper Blepharoplasty?

A. In an upper Blepharoplasty (Eyelid Surgery) excess fat, skin and a strip of the eyelid muscle can be removed depending on the goals of the Blepharoplasty. The skin can be removed and openings subsequently created in the muscle created for fat removal. These small openings in the muscle can be closed thus avoiding the need to remove muscle. The deeper the layers, of upper eyelid tissue removed during the Eyelid Surgery, the greater the risk of post-op bleeding which would be considered the main complicatiion.

Other considerations for not removing muscle (which I rarely do or have done for the past 15 years) is the possibility of creating a hollow appearance to the upper eyelids that is perceived as feminine. For men this should be avoided. Removal of the muscle strip is generally indicated for women who have shallow upper eyelids and as such could benefit from an increased, open upper eyelid. Dry eye is a contarindication to excessive skin or muscle removal as these may increase exposure to the eye.

Q. How long will I experience dry eyes after bleph and can I prevent it?

A. I have performed Blepharoplasty (Eyelid Surgery) for over 25 years and IMHO, the surgery rarely causes dry eye but if it already exists, the procedure can make the dry eye worse. Lubricating eye drops and/or ointment is frequently used for the first week. Following that moisturizing eye drops may be required especially if you’re working on the computer which does increase eye strain.

If you already have dry eye symptoms then this should be discussed during your consultation as to how severe the symptoms currently are and then weigh the possibility of these becoming worse against the aesthetic goals. A compromise, let’s say of removing less upper eyelid skin, may have to be made to avoid further dry eye.

Q.I had an upper Bleph done approximately 10 years ago. One eyelid is significantly “drooping”, is there usually any leniency if this surgery has been done before?

A. If you had an Upper Eyelid Surgery (Blepharoplasty) done 10 years ago, this should not need to be repeated. The upper eyelid droop is more likely due to true upper eyelid ptosis or because the eyebrows have dropped in position. Either, of these scenarios, would require something other than another upper Blepharoplasty. You should have a few consultations with experienced Plastic and Cosmetic Surgeons to make the correct diagnosis and recommendations.