Eyelid Surgery Risks – What You Should Know

Reviewed by Darrick E. Antell, MD

Like all surgeries, eyelid surgery (blepharoplasty) confers its share of risks. The good news is that serious complications following eyelid surgery are rare and can usually be minimized, if not eliminated, by carefully choosing a board-certified plastic surgeon and following his or her pre- and postoperative instructions.

Your eyelid surgery risk profile is based on the type of eyelid surgery you undergo and whether it is done as a standalone procedure or in combination with another procedure, such as a brow lift or neck lift. Combining procedures often increases their risks. Other factors, such as your surgeon's experience, your personal health history and how well you adhere you to your pre- and postoperative instructions, will also play a role.

Certain underlying medical conditions may increase your risk for eyelid surgery complications. These include thyroid problems such as hypothyroidism or Graves' disease, dry eye syndrome, circulatory disorders, high blood pressure, myasthenia gravis (a neuromuscular disorder marked by weakness of voluntary muscles), diabetes, a detached retina or glaucoma (high intraocular pressure within the eye). Your surgeon may require a physical exam and preoperative tests to ensure that you are healthy enough to undergo eyelid surgery.

General Surgical Risks

Some risks of eyelid surgery are general to all surgeries, including:

  • Anesthesia complications
  • Infection
  • Poor scarring
  • Pooling of blood beneath the skin (hematoma) that may clot
  • Unfavorable healing
  • Fluid accumulation under the skin (seroma)
  • Numbness
  • Pain
  • Skin discoloration
  • Deep vein thrombosis (a blood clot, most often in the leg, that can become deadly if it travels to the lungs or other areas)
  • Heart and lung complications
  • Death

Some of these risks can be mitigated. For example, you can minimize your risk of infection after eyelid surgery by taking antibiotics as prescribed and following your surgeon's instructions on how to care for your incisions. Signs of an infection may include discharge from your incision areas and a temperature over 101 degrees Fahrenheit. If you notice any of these signs, call your surgeon immediately.

The best way to minimize your risk of developing a potentially fatal blood clot after surgery is to walk around as soon as you are able, which helps boost circulation.

Eyelid Surgery-Specific Risks

Certain risks are more specific to eyelid surgery. These include:

  • Dry eyes (usually temporary)
  • Temporary inability to close your eyes
  • Ectropion or lid lag (the pulling down of your lower eyelid) and related eye irritation
  • Entropion (the pulling inward of the edges of your eyelid) and related irritation caused by eyelashes rubbing against your eyeball
  • Blindness (exceedingly rare)
  • Double or blurred vision
  • Temporary swelling at the corners of the eyelids
  • Tiny whiteheads on the eyelids
  • Asymmetry of the eyes
  • Sagging of the eyelids
  • Blinking problems
  • Difficulty keeping your eyes closed while asleep
  • Sunken eyes, which may occur if your surgeon removes all or too much of the fat pads under your eyes
  • Dissatisfaction with the cosmetic results

Some of these complications may require revision eyelid surgery.

Eyelid Surgery Risks: Protect Yourself and Your Eyes

Minimizing your risk of eyelid surgery complications starts with full disclosure. Tell your surgeon and anesthesiologist about your personal and family medical history, including all the medications you take. This includes prescription medication, over-the-counter products and dietary or herbal supplements. It is also important that you tell your medical team about any eye or vision problems you have. Be honest about your smoking and alcohol use. Smoking can impede your healing and increase your risk for complications. Alcohol also adds to the risks of your eyelid surgery. If you smoke, talk to your surgeon about how to quit smoking before you book your eyelid surgery.

Choosing a Board-Certified Plastic Surgeon for Your Blepharoplasty

Choosing a board-certified plastic surgeon can also help assure your safety and ensure a smooth eyelid surgery recovery. Ask about your risk profile along with the procedure details and eyelid surgery prices during your consultation and preoperative visits. Start your search for the right surgeon now.

For information about risks associated with other facial procedures, please visit our pages on facelift risks, rhinoplasty risks and otoplasty risks.

About the Reviewer of This Article

Darrick E. Antell, MD, is an educational spokesperson for the American Society of Plastic Surgeons. He is a board-certified plastic and reconstructive surgeon who has been in private practice for more than 20 years in New York City. Dr. Antell is a member of the American Society for Aesthetic Plastic Surgery and the American Society of Plastic Surgeons. He is also a Fellow of the American College of Surgeons. Dr. Antell received his general surgery training at Stanford University Medical Center and his specialty training in plastic/reconstructive surgery at the New York Hospital/Cornell Medical Center and the Memorial Sloan-Kettering Cancer Center in New York City.