Upper eyelid surgery, also known as upper blepharoplasty, consistently ranks as one of the most popular facial surgeries, especially for men and women over the age of 40. Unlike many other plastic surgeries, however, upper eyelid surgery has unique risks.
Though a highly skilled and experienced board certified plastic surgeon can consistently achieve quality results with blepharoplasty, the potential complications of upper eyelid surgery can affect not only the appearance of the eyes but their function as well. Unfortunately, for this reason, some patients may end up with poor outcomes from surgery — a problem that typically must be corrected by another surgeon with another surgical procedure.
Botched upper eyelid surgery is a challenging procedure. Our practice is outfitted to handle the correction of most botched eyelid surgeries.
Why Get Upper Eyelid Surgery?
Most patients who are interested in upper eyelid surgery are concerned about hooded upper eyelids and/or upper eyelid fat prolapse. Both of these problems are generally the result of aging but can also simply be related to an individual’s genetics. When these issues occur, not only can they cause an unattractive appearance, but they can also obstruct the vision of the individual.
Upper eyelid surgery removes or repositions the skin, fat, and tissue along the upper eyelid, making the eyes appear brighter and improving vision.
What Are the Potential Complications of Upper Eyelid Surgery?
As with any surgery, it is possible for blepharoplasty to lead to a range of rare, but potential, complications that are simply related to enduring surgery. For example, excessive bleeding, infection, loss of skin sensation, persistent swelling and bruising, unfavorable scarring, and anesthesia risks are all rare but possible risks during or directly after surgery.
In addition to these risks, there are also additional potential complications, which are directly related to blepharoplasty, in particular. For example, potential vision related complications following upper eyelid surgery include difficulty closing one’s eyes, excessive dryness of the eyes, numbness around the eyelash area, a rolling outward of the eyelid, special sensitivity to bright lights or sunlight, and even, potentially, changes in vision such as blindness.
Again, these risks are rare. When we do see a botched eyelid surgery, it’s generally more likely that the issues are related to the aesthetic appearance of the patient’s eye area. For example, patients may feel that they have a hollow upper eyelid after surgery, or they may feel that their upper eyelid crease is too low or too high.
Alternatively, patients can sometimes experience difficulty actually closing their upper eyelids, which can lead to further complications such as exposed eyes and severely dry eyes. And finally, patients may struggle with persistent ptosis, which is when the upper eyelid continues to droop over the patient’s field of vision.
Fixing Botched Upper Eyelid Surgery
In many ways, revision eyelid surgery (eyelid surgeries performed for a second or third time after an initial eyelid surgery, which failed for some reason) are far more complicated than initial eyelid surgeries.
Certainly, any cosmetic eyelid surgery comes with some risks for an unfavorable outcome. But the eyes are such a noticeable and focused-on part of the face that even a slight error can cause issues.
For example, some surgeons may remove a bit too much skin from the upper eyelid in an initial droopy eyelid surgery. This can cause lasting problems and will usually require revision eyelid surgery to correct. Google some eyelid surgery before and after photos, and you may see this occasionally.
So, how is a botched eyelid procedure actually fixed?
This really depends on what the patient is struggling with, what they originally went to see a plastic surgeon for prior to their first upper eyelid surgery, and the anatomy of the patient’s eye area. Because blepharoplasty patients are typically older, it’s important to specifically take this into consideration as we examine you for revision eyelid surgery.
For example, the skin around the eye is already thin and delicate. But as you age, it becomes thinner and more delicate.
This means that it can’t be messed with too much before it begins to scar irreparably. If we’re fixing a botched eyelid surgery, we need to keep this in mind and do our best to avoid agitating the skin, muscle, tissue, and fat beyond what is absolutely necessary.
Another common complication for revision surgery to fix botched upper eyelid surgery is that sometimes, the patient’s had too much skin removed from the upper eyelid, and therefore, their eyelids have trouble closing. Essentially, there is a skin shortage on the upper lid.
The real problem is that it is much harder to add tissue back to the eye area than it is to take it away. In other words, when the original surgeon was performing the procedure, they should have taken the “less is more” approach.
Surgeons should aim to remove as little tissue, skin, and fat as possible because you can always have an additional surgery to remove more. But if you remove too much in the beginning, it’s much more difficult to put it back on.
This issue often leads to patients requiring multiple eyelid surgeries, which again, can be very harmful to the eye area and pose many risks. We want to avoid this as much as possible.
How to Qualify for Eyelid Surgery
Patients who want to qualify for blepharoplasty (or blepharoplasty revision) should be in good physical health. Typically, patients have issues with the upper eye area such as upper eyelid ptosis, hollow upper eyelids, drooping lids, poor eyelid scarring, or lids that are difficult to close.
In order to qualify for eyelid surgery coverage through Medicare or an insurance company, patients usually need to prove a visually significant obstruction or similarly relevant issue that makes a blepharoplasty procedure medically necessary. Some sources may reference a minimum upper field of vision loss of 30 percent (12 degrees).
Contact Us to Schedule a Consultation
Whether you have hooded upper eyelids, under eye bags, ptosis, or other eyelid related complications because of a botched eyelid surgery, a revision eyelid surgery can improve your situation.
The one thing patients need to keep in mind when considering this procedure, however, is that it requires a particularly skilled hand and unique experience. It’s also important to look for a board certified plastic surgeon. Otherwise, eyelid surgeries sometimes do not go as planned, and then revision eyelid surgery will usually be necessary.
If you are interested in upper eyelid surgery, contact our office today to schedule a blepharoplasty consultation appointment with board certified plastic surgeon Dr. Raja Mohan.