Before having cosmetic surgery

Steps to take before having cosmetic eyelid surgery


You should have a consultation with your oculoplastic surgeon. He/she will examine your eyelids and face and ask about your general health and any allergies and medications, especially aspirin and other over the counter tablets, and whether you smoke. You may be required to undergo a general health check by your general practitioner, including heart and blood tests. Your vision will be tested and the health of the eyelids, the tear film and the front of the eyes checked. Your retina may also be checked.

The whole face will be examined and the condition of the skin noted, and the position of the eyebrows and eyelids will be measured. Pre-operative photographs are taken as a baseline for comparison with the results after surgery.

You will be advised whether just the eyelids or the eyebrows too need operating on and whether botulinum toxin injection or other non-surgical treatment is recommended. You will be advised what tablets to stop before the surgery and given an information sheet about your operation and the post-surgery lid care.

What are the possible complications of blepharoplasty?

Serious complications are rare but may occur even in the hands of trained and experienced surgeons. Every effort is made to minimize the risk of complications. In the unlikely event of a complication, which can affect your vision, oculoplastic surgeons are trained to manage this. You need to help by stopping aspirin, clopidrogel and non-steroidal anti-inflammatory tablets two weeks before your surgery if your physician or GP will allow this, in order to reduce the risk of bleeding during and after surgery.

  • Sunken appearance – a sunken-looking “cadaveric” eye appearance can occur if too much fatty tissue is removed
  • Asymmetry – a minimally uneven skin crease or lid height may be noticeable if there is asymmetrical swelling, more marked on one side than the other. If asymmetry is present after two weeks, it may persist and require later secondary surgery
  • Scar – rare as the incisions are hidden in the natural skin folds
  • Need for repeat surgery – patients should be warned of the need for further surgery if an optimum result is not achieved.
  • Eyelid and cheek swelling and bruising – May be noticeable for up to 6 weeks)
  • Blurred vision – For a few hours or overnight, due to surface ocular drying during the procedure, from effect of the local anaesthesia and ointment instilled. If this persists more than 24 hours, inform your oculoplastic surgeon
  • Watery eyes – Reflex tearing may occur for 24 – 48 hours due to mild ocular discomfort and surface dryness
  • Dry gritty eyes – This may occur for the initial two to three weeks after surgery due to reduced blinking. You will be prescribed artificial tears during the day (e.g. Hypromellose, Systane or Viscotears) and an ointment at night (e.g. Lacrilube or Simple Eye Ointment) to prevent this. Topical antibiotics such as Chloramphenicol are used for 1 week if surgery has been done from inside the eyelid.
  • Scratched surface of the eye – Minor injury to the eye surface can result in pain for 24 hours. If it persists or is severe, your oculoplastic surgeon must be informed.
  • Bruising behind the eye – Bleeding behind the eye is rare but can cause the eye to go blind. This is an Ophthalmic Emergency which Oculoplastic Surgeons are trained to prevent and manage. Oculoplastic surgeons are trained to prevent and manage this (repetition).
  • Wound infection – This is rare, but can result in failure of the procedure
  • Acute glaucoma – Rraised pressure within the eye with nausea, vomiting and blurred painful red eye. Specific treatment must be given and review by an ophthalmologist is necessary (does this occur in an oculoplastic setting?)
  • Incomplete eyelid closure – For a day or two after surgery the eyelids will feel stiff and not entirely cover the surface of the eye when closed. It usually settles in days – associated discomfort is eased by lubricant drops and ointment.