Complications following blepharoplasty

Abstract

Blepharoplasty is one of the most common surgical procedures performed in the USA for both functional improvements in the aging patient as well as aesthetic rejuvenation of the periocular region and midface. A thorough understanding of periocular anatomy, as well as a detailed pre-operative ophthalmic examination is important for a good outcome. While severe complications are rare, the surgeon performing a blepharoplasty should be aware of the possible complications and understand how to minimize them. The authors summarize known the complications of this procedure for the blepharoplasty surgeon and offer the treatment strategies when they occur.

Keywords::

• blepharoplasty
• chemosis
• complication
• eyelid malposition
• lagophthalmos

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.

Key issues

• Patient selection and thorough pre-operative assessment, including a frank discussion regarding complications and feasible outcomes will enhance both patient and surgeon satisfaction.

• Assessing for pre-existing ptosis prior to surgery allows patients with ptosis to be informed of management options for ptosis prior to undergoing blepharoplasty.

• Surgeons need to ensure that there is a minimum of 20 mm of skin between the eyelid margin and the brow in order to minimize the risk of permanent lagophthalmos following surgery.

• Patients with lower eyelid laxity should be considered for lower eyelid tightening procedures at the time of their lower eyelid blepharoplasty to minimize the risk of post-operative eyelid malposition.

• Hemorrhages following blepharoplasty are usually preseptal and resolve without intervention. The surgeon should always be mindful of the possibility of retrobulbar hemorrhage and intervene quickly if a retrobulbar hemorrhage is suspected.

• With meticulous surgical technique, blepharoplasty incisions can heal with little to no scarring; lubricating ointment, avoidance of ultraviolet light and silicone-based scar gels can all improve the overall appearance of blepharoplasty incisions.