Management of Cosmetic Eyelid Surgery Complications

Abstract

There is a broad spectrum of complications that can occur following cosmetic eyelid surgery. The experienced eyelid surgeon should be able to avoid most serious complications through proper patient selection, a comprehensive preoperative assessment and surgical plan, meticulous surgical technique, and appropriate postoperative care. The aesthetic eyelid surgeon must counsel a patient contemplating blepharoplasty surgery regarding typical expectations including edema, eyelid numbness, dry eyes, and mild blurred vision. Patients must also be aware of the risks and the signs of serious complications such as infection, hematoma, or severe vision loss. Oculofacial surgeons must be capable of managing these adverse outcomes. The management of these urgent complications as well as other significant postoperative problems including diplopia, lagophthalmos, eyelid malposition, severe chemosis and edema, crease abnormalities, and wound dehiscence is outlined in this review.

Antibiotic Prophylaxis in Blepharoplasty: Review of the Current Literature

“…2 There have been limited reports of methicillin-resistant S aureus infection involving the ocular region, but the rate of infection of this type is hypothesized to be increasing. 3 In general surgery, the value of antibiotic prophylaxis is well-established. Bowater et al 4 found antibiotic prophylaxis to be an effective intervention for preventing postoperative wound infections in a meta-analysis involving 250 clinical trials in over 23 different types of surgery.…”

“…The rate of postsurgical orbital hemorrhage in this setting is estimated to be 0.05%, with permanent vision loss estimated at 0.01%. 3 Vision loss due to postseptal orbital cellulitis is also of concern.…”

The Evolution of Looks and Expectations of Asian Eyelid and Eye Appearance

“…Despite double-eyelid plasty, levator aponeurotic surgery, eyebrow lifting, epicanthoplasty, and lateral canthoplasty, some East Asian patients are often dissatisfied with their outcomes and request further surgery; they desire less of a small, slanted look and a more refreshed, open, larger vertical palpebral aperture, particularly in the lateral half. 21 Often, this dissatisfaction is caused by lower eyelid descent with aging or as an unwanted complication after blepharoplastyan increased scleral show and widened palpebral fissure Fig. 7 Step-by-step anterior views of the lowering the lower eyelid procedure.…”

Topical rebamipide improves the ocular surface in mild lagophthalmos

“…The main causes of lagophthalmos are facial nerve palsy, trauma, eyelid surgery, senile ectropion, and Graves’ ophthalmopathy. An incomplete blink and lagophthalmos frequently occur after upper eyelid ptosis correction, and occur less often following upper and lower blepharoplasty surgery 2. One of the goals when treating lagophthalmos is to prevent exposure keratitis.…”