• The Surgical Blepharoplasty as opposed to laser re-surfacing of the eyelid (marketed by some as "Laser Blepharoplasty") addresses excess fat ("Bagginess") and skin of the upper and lower eyelids.
• It is true that laser re-surfacing procedures address skin excess to a minor extent. The heat of the laser actually shrinks the skin. For patients with a good deal of skin excess however this is not adequate.
• The surgical procedure accomplishes its goals via incisions in the upper eyelid crease ("Upper Blepharoplasty") and/or beneath the lower eyelid lashes or inside the lower eyelid ("Lower Blepharoplasty"). Some surgeons have used the Transconjunctival (through the eyelid) approach to avoid the incision beneath the lower lid lashes and added laser re-surfacing of the lower eyelid to address the fine wrinkling seen in the skin here.
• The bottom line here is that the procedure can be varied to suit the patient's particular eyelid anatomy and goals.

The Procedure and Post-operative Care

Complications

Dry eyes are not uncommonly seen after surgery. As people age, their lacrimal glands tend to tear less. This can be made worse (usually temporarily) by the surgery. Artificial tears can be used for a few weeks as needed as most cases resolve with time.

Ectropion is seen in cases in which the lower eyelid is too lax pre-operatively or too much skin is removed in the surgery. It can also happen in laser re-surfacing as a function of the heat treatment. It appears as an outwardly turned lower eyelid. It can sometimes resolve with time (a few months) or may require corrective surgery.

Asymmetry is always possible and frequently pre-operatively visible. I will discuss with patients pre-operatively that this can be addressed during the operation, but absolute symmetry is impossible and unnatural. This is where patient expectations come in. Those patients will less than realistic expectations are those for which an operation may not be warranted.

Other more serious complications occur extremely rarely. Bleeding in a worse case scenario can cause blindness. Cases of this are reported once a year or so in the journals (extremely rare), but underscore the importance of absolutely avoiding pain relievers such as Aspirin, Motrin, Ibuprofen, etc.. These medications should be discontinued at least 7-10 days prior to surgery as they increase the tendency to bleed.

Please note that this information (as well as that on all my pages) is offered freely to individuals considering cosmetic surgery. No rights are granted and it is not to be reprinted or copied without the author's prior written consent. Understand that some of the information presented may be a matter of professional opinion. Although efforts have been made to assure accuracy, no guarantees are expressed or implied.