Complications of Eyelid Surgery

While complications after eyelid and facial surgery are fortunately quite uncommon, we feel that it is important for our patients to know that Dr. Kass; as a uniquely trained, triple board certified, oculofacial plastic surgeon; is qualified to address any problems which can occur. In fact, Dr. Kass has written numerous articles dealing with the treatment of complications of eyelid and facial surgery. Because of his unique training and expertise, and the numerous lectures he has given at prestigious international conferences, Dr. Kass is referred patients from all over the world who are unhappy with the results of their surgery performed elsewhere.

Complications after cosmetic eyelid surgery are uncommon but can include dry eyes, tearing, excess scarring, inability to close the eyes, rounded or sad eyes, eyelid retraction, and other eyelid and facial malpositions.

If you are unhappy with the results of your eyelid surgery, you may wish to contact Dr. Kass for a consultation today to learn what he can do to help you.

Dry Eyes

Dry eye symptoms occur most commonly after eyelid surgery and fortunately, are usually temporary. Treatment includes reassurance, over the counter lubricating drops, gels, ointment, frequent blinking, and in some cases, Restasis (prescription eye drop specifically approved to treat dry eyes). If this problem persists, other treatments may be necessary.

Tearing

Tearing also occurs commonly early after eyelid surgery. After the eyelid has been lifted, this may cause your eye not to close all the way while blinking, or even remain open while sleeping. This can lead to reflex oversecretion of tears. Fortunately, this is usually temporary and may resolve completely after several months. Treatment may be the same as that employed for dry eyes and may also include digital massage. Rarely, surgical revision may be required.

Excess Scarring

Scarring is another common complication of cosmetic eyelid surgery. While any skin incision leaves a scar, some tend to be more prominent than others. After eyelid surgery, and once your sutures have been removed, Dr. Kass may suggest rubbing scar cream or vitamin E into the incision site to help reduce scaring. Should a serious thick scar appear, Dr. Kass also carries prescription strength scar gel in his office. We have found most patients prefer this scar gel and are pleased with the results they receive from it. In extreme cases, a scar revision may be performed, however, most doctors prefer to wait six months or even a full year after your original procedure to see how the skin fully heals before considering scar revision surgery.

Inability to Close the Eyes

It is not uncommon for patients not to close the eyes fully right after surgery. In Dr. Kass’ opinion, this often resolves with time and with patience. While awaiting for improvement, the eyes can be protected with lubricating drops and ointments. In the rare occasions that this condition persists, additional surgery can be used to address this issue and to achieve full eyelid closure.

Rounded or Sad Eyes and Eyelid Retraction

When evaluating eyelid asymmetry, it is important to remember that no face is perfectly symmetric. One side is NEVER a mirror image of the other and it would look odd if it was. One eye is slightly larger than the other, one’s eyebrow may be higher than the other, and one ear may be lower than the other. Although some patients may fixate on these normal asymmetries, it is likely that the differences are so minor that they go unnoticed by others.

During eyelid surgery, Dr. Kass tries to address asymmetries which are of concern to the patient. After eyelid surgery, most asymmetry is temporary, and it is usually due to the fact that one eye ALWAYS heals at a different rate that the other. Because of this, Dr. Kass believes it is important to be patient and to keep faith in your eyelid surgeon when assessing the results postoperatively. Follow up continually with your doctor because in most cases the asymmetry will heal on its own. Only after 6-12 months have elapsed from the original surgery will Dr. Kass even consider whether additional surgery might be necessary to help a patient to achieve the desired results.

In rare cases, extreme swelling can cause ectropion, scleral show and change of eyelid shape (round or sad eyes), entropion and ptosis. Ectropion is when the lower lid pulls outward away from the eyeball, possibly causing scleral show, sad or rounded eyes, change in eyelid shape, eyelid retraction, and soreness and redness to appear. In the great majority of cases, and once all of the swelling subsides, the eyelid will return to its normal position. It is important to wait a full six months before assessing the results of eyelid surgery and eyelid malpositions. Surgical reposition of the eyelid is rarely necessary for patients who wait these six months. The same is true if entropion should occur. Swelling in the upper lid may result in incomplete eyelid closure or may cause the eyelid to appear droopy (known as ptosis). As with the lower eyelid, usually this will clear up on its own. However, if after 6 months the problems persist, corrective surgery can be used to reposition the lid and improve symmetry.

Conclusion

It is important to do your research before considering eyelid surgery, and weighing all of the possible post operative complications and outcomes. Dr. Kass always states during the interview process, that no doctor can promise you that you will have a perfect outcome. There is an unpredictability to any surgical procedure no matter who is the surgeon. But by choosing an experienced, fully trained, triple board certified, internationally renown, triple Board Certified Cosmetic and Oculofacial Plastic Surgeon, you will have given yourself the greatest chance of achieving a highly successful result. Why not choose a surgeon who so many other surgeons choose to treat their patients who develop the uncommon problems after eyelid and facial surgery?