Although all operations have some risk the chance that something serious will go wrong in a blepharoplasty is small. Nevertheless there are a number of potentially serious complications or problems. Always remember that even though a complication may be unusual it can still happen to you. Ask yourself, "How would I feel if this problem happened to me?".This is a list of some of the possible problems.
Pain and tenderness: pain after surgery is variable and for some people may be more severe. Most people say they have very little discomfort. Increasing pain may be a sign of a major problem.
Swelling: most patients have swelling for about a month to six weeks after surgery. This is often most marked in the lower lids and on the cheek.
Bruising: bruising is common on the eyelids and in more severe cases it extends onto the surrounding skin. If there is bleeding it may be worse. Some patients experience bruising that extends on to the surface of the eye.
Bleeding or hematoma: the area around the eye has a rich blood supply. Bleeding after surgery can be significant especially if it goes behind then eye.
Infection: this can be a serious problem. If bleeding occurs then infection may develop in a hematoma.
Thick scar formation: sometimes excess scar can form. This is more common in those genetically prone to heavy scar. Scar revision is sometimes helpful but some scars cannot be improved.
Numbness or change in feeling: unusual feeling or numbness in the area of surgery may last for many months.
Ectropion: pulling down of the lower eyelid, or ectropion,can occur after surgery. This is usually temporary and due to swelling. In some cases it may be permanent due to scar formation or removal of excess skin.
Lagophthalmos or inablty to close the eyes. The eyelid skin is very flexible and if an excess is removed the upper eyelid may not close well and even stay open, especially at night. This can cause ulcers on the surface of the eye and even damage vision.
Blurring of vision: blurred or double vision is common for the first few days after surgery. In rare cases it may persist, especially if there has been damage to the small muscle that move the eye.a
Difficulty closing the eye:in the first few days after surgery many patients cannot completely close their eyes. This is especially so at night. The eye can become red and inflammed The eye can be protected using ointment. If excess skin is removed or there is an underlying problem, such as thyroid disease, the problem can be permanent and lead to serious problems such as ulceration of the surface of the eye.
Asymmetry of incision:the surgeon tries to place the incision in the natural crease. After surgery patients may notice that there is some asymmetry of the scars. This usually becomes less evident as the scars fade.
Dryness of the eyes:some patients find that the eyes are more dry after surgery. This is especially true if preexisting dryness exists or in dry climates.
Tearing: scarring or injury to the tear ducts may cause persistent tearing after surgery.
Pigment and skin changes:patient who already have dark skin around the eyes may sometimes find this is more noticeable after surgery. Similarly small blood vessels , telangiectasia, may also may be made more noticeable.
Miliary cysts: small grease collections, called miliary cysts, may develop along the incision. These may resolve on their own but often require unroofing with a needle.
Eyelid ptosis: although rare it is possible to damage the muscle which opens and raises the eye, causing an abnormal appearance and function.
Abnormal appearance: excess removal of fat can lead to a skeletal appearance. If the scar contracts in an abnormal fashion the shape of the eye can change.
Abnormal reaction to the stitches: the body may react against some stitches.
Wound dehiscence or separation: it is unusual for the scar to heal slowly or for some separation to develop Although rarely a major problem it may lead to a heavier scar and slower recovery This much more common in people with diabetes and smokers.
Serious and life threatening problems: a blepharoplasty is a surgical operation and has the risks of all surgery including blood clots in the legs, lung problems, pulmonary embolus and even death. These are exceptionally rare in this surgery. Blindness is a theoretical but very unlikely and rare risk.