Cicatrix Optima of Windsor ON | Blepharoplasty Complications

Cosmetic Surgery>>Face >> Blepharoplasty (Eyelid Surgery)

CICATRIX * OPTIMA 1720 HOWARD AVE, SUITE 364 WINDSOR, ON N8X 5A6 TEL/FAX: 519.971 0971

Possible Complications

Haematoma (blood collection under the eyelid tissue): You should expect a small amount of bleeding from your incision line during the first 24 to 36 hours after your surgery.

Any type of surgery may result in excessive bleeding in the operated area. This may be due to a temporary increase in blood pressure, for example due to coughing. It can also occur from the effects of medication like aspirin or anti-inflammatory drugs. Bleeding is usually manifested by acute swelling of the area, discolouration of the skin, pain and a feeling of tension. External compression of the wound usually stops it. In rare cases, if it continues, we may have to stop it after reopening the incision. Massive bleeding may require hospitalization and transfusion.

If the accumulation of blood is small, it may be allowed to absorb by itself or aspiration may be indicated as with a seroma. However, if it is large, formal drainage in an operating room may be necessary.

Post operative swelling: Some swelling after your operation is normal. Time and elevation of the head are the two most important factors in reducing swelling. It is not unusual to have asymmetric postoperative swelling. It is important to understand that perfect symmetry following a plastic surgical procedure on the eyelids is not possible.

Prolonged discolouration: If you bruise easily, discolouration may remain for several weeks after surgery. You should advise us of any past history of bleeding disorder. In rare cases, discolouration may be permanent. This condition is probably caused by extensive bruising with subsequent deposition of blood pigments into the skin itself.

Dry eye syndrome: Patients with pre operative dry eye syndrome may still have a blepharoplasty, but it must be a more conservative procedure and should be performed only after the endorsement of the patient’s ophthalmologist. If this occurs the surface of the eye must be kept well lubricated. If this condition persists for more than a few weeks, consultation with an ophthalmologist may be indicated. In rare cases, this can lead to corneal ulcers and blindness.

Unsightly Scarring - Prominent, unsightly scars (thick, red, ropy, itchy, and painful): The normal healing of wounds is a physiological process which continues to take place in the depths of the tissues for many months before final resolution. At first, the surgical scar is almost invisible. Then it becomes red and somewhat elevated for about 3 months. It then becomes paler, softer and flatter and reaches its resolved state in 6 to 12 months. Aesthetic surgery has its limitations. Any time the skin is opened a scar of some kind results. This may be a good scar (fine white line) or a conspicuous one, but there is always a scar of some sort.

Each individual’s healing is different. Some form fine white lines while others will form heavier ones. The surgeon has no influence on the actual formation of a scar. Factors that can influence the quality of healing include smoking, obesity, infection and nutrition. The complete mechanisms of wound healing are not yet fully understood. Thus, the factors that may lead to formation of a conspicuous scar are not yet known.

Very heavy (hypertrophic) scars or keloids (scars which escape the confines of the original wound) are uncommon. They are found most frequently on the front of the chest, abdomen, and shoulder area. Dark skinned peoples (particularly those of African, Asian or Mediterranean descent) are more susceptible to the development of hypertrophic scars.

Sun exposure of a new scar should be avoided for the first year following your operation. An immature scar exposed to sun may become more visible and pigmented.

Despite meticulous technique and attentive post operative management, a small percentage of patients will develop some unsightly scarring. The scars may widen over a period of several weeks or months or possibly exhibit a true hypertrophy (red, raised, itchy, and painful). These scars can be treated by a variety of methods including local pressure, massage, cortisone injections, topical creams, and surgical revision. Rarely, hypertrophic scars are permanent and will not respond to treatment.

Damage to eye muscles: This is extremely rare. Persistent double vision is the presenting symptom. Consultation to an ophthalmologist is indicated.

Blepharitis: This is inflammation of the eyelid margins and is a rare complication. It is caused by irritation of the hair follicles at the eyelid margin.

Contour irregularities: Slight bulges and irregularities especially at the outer edge of the incision may occur. These tend to improve markedly in the first 6-8 weeks. Scar revisions are rarely necessary.

Infection: Infection following blepharoplasty is rare. The incidence is less than 1% and severe infections are extremely uncommon. However, any surgical wound can become infected. An infection usually will become apparent a few days after the surgery. The signs are: pain, redness, heat and swelling. Antibiotics and dressing changes will often control it. On rare occasions, hospitalization and formal drainage in the operating room may be needed to control more significant infections.

You will be given a prophylactic antibiotic when undergoing your blepharoplasty. In addition you will be sent home with a prescription for antibiotics for 4-5 days.

Inability to close the eyes: It may be difficult for you to completely close your eyes during the early post operative period, especially while the swelling persists. Drying of the corneal surface can be prevented by using ointments and lubricating drops. If you are sensitive to light, you should wear dark glasses. Rarely: if there is a skin shortage on the eyelids, a skin graft may be necessary.

Ectropion/Entropion: Scleral show (exposure of the white of the eye) or its extreme variant, ectropion (pulling down of the lower eyelid) can occur when too much skin is removed or even when the procedure has gone as planned.

Ectropion can occur if you have lax lids prior to your surgery. You may need a tightening procedure of the lower eyelids with your blepharoplasty. If Ectropion occurs immediately after your operation, it is treated with tape support and gentle massage.

Entropion is a rolling in of the eyelid. This can result in corneal irritation from the eyelashes. If it does not respond to medical therapy, it may require operative correction.

Excessive tearing: A small percentage of patients experience excessive tearing during the immediate postoperative phase because of mechanical alteration in the tear collecting mechanism or obstruction in the ductal system. This condition usually subsides in a matter of days. If this persists consultation with an ophthalmologist may be indicated.

Blindness: This is extremely rare. It can be caused by bleeding within the eye socket. This is accompanied by a swollen eye and pain with concomitant loss of vision. If you experience sudden pain or changes in your vision, call us immediately.

Drooping of the upper eyelid (ptosis): This may due to damage to the elevating mechanism of the eye. If this persists, consultation with an ophthalmologist may be indicated.

Persistent small wrinkles: The lines at the outer aspects of the eyes also known as “crow’s feet” will not be affected by a blepharoplasty. These lines are best treated with a topical chemical peel or laser.