Can eyes bleed after blepharoplasty? Postoperative consequences of blepharoplasty

Scars after blepharoplasty are the consequences of surgery to eliminate drooping upper eyelids, as well as bags, hernias and wen under the eyes. With age, the skin loses elasticity, thins and sags. These changes become especially noticeable on the face. Those who do not want to come to terms with such cosmetic defects resort to corrections made through surgical operations.

Blepharoplasty is plastic surgery of the eyelids. The surgery may concern the upper eyelids or the area under the eyes, but is performed simultaneously in both areas, that is, in a circular manner. Based on the location of the incision, the procedure is divided into the following types:

Bottom.

The incision is made along the natural sweet spot under the eye or on the inside of the lower eyelid. During the operation, the dermis is separated from the muscle, and the fatty hernias are removed along with excess skin.

Upper.

The skin is incised along the crease of the upper eyelid. The sagging area of skin is cut off, and the fatty formations underneath are excised.

Transconjunctival.

The place of dissection is the conjunctiva, that is, the inner part of the eyelid. The purpose of surgery is to remove bags under the eyes. This operation is used by elderly patients and young people with this cosmetic defect.

Canthoplasty.

The operation involves changing the shape of the eyes by tightening the canthal tendon and removing part of it. Excess skin may be removed. Correcting the corners of the eyes allows you to change their shape. Such operations are often performed on people of Asian nationality.

Canthopexy.

The purpose of the correction is to eliminate sagging of the lower eyelid. During the operation, unlike canthoplasty, the muscles and tendons are not separated from the bone. Often, in parallel with the lift, excess skin on the lower eyelid is also removed.

One of the main questions that concerns plastic surgeon clients is whether scars remain after blepharoplasty. Traces after cutting the skin and applying sutures always remain. Any operation involves the formation of scar tissue at the site of manipulation. However, the type of scars largely depends on several factors:

correct compliance with the doctor’s instructions regarding the care of sutures;
physiological characteristics of a person;
surgeon's professionalism.

In most cases, scars after eyelid surgery look like a light, thin strip in the fold of the skin of the eyes, the existence of which only the patient will know. Postoperative traces, thanks to a special technique, localization and direction of incisions become invisible. After complete healing, neither the color of the scar nor its relief indicate to the patient that the plastic surgery has been completed.

Scar healing time

Blepharoplasty surgery, like rhinoplasty, lasts no more than 2 hours. As soon as the patient has recovered from anesthesia, he can be sent home, accompanied by loved ones. On the second day after eyelid surgery, characteristic pain, swelling, redness, and hematomas appear. Symptoms are normal and are explained by damage to blood vessels and nerves. To eliminate them faster, surgeons recommend using cold compresses. During the first 3-4 days, you need to apply plastic bags with ice, wrapped in clean cloth, to your eyes.

Postoperative sutures are removed on days 4-6. Bruising and swelling subsides after 10-14 days.

Healing of the incision site goes through several stages:

The exudative phase lasts the first 5-7 days. This period is also called inflammatory. The eyelids are swollen and red. It is important to maintain seam hygiene and routine. Various types of stress are contraindicated for the patient; they can lead to suture dehiscence and bleeding. The eyes should be at rest and not subject to strain.
In the period from the 1st to the 4th week, granulation of the suture is observed. At the site of the scar, new tissue is formed with the formation of collagen and elastin fibers. The scar has a pink tint.
Scar formation occurs 1-3 months after surgery. The scar becomes denser. Scar tissue becomes lighter and smoother. This stage can manifest itself in the formation of keloid or hypertrophic scars under unfavorable conditions at the initial stage of their formation.
Full maturation of the scar is observed 4-10 months after surgery. The scar thickens, becomes white, smooth and unnoticeable.

Based on the information described above, it may seem that the formation of scar tissue and the maturation of the scar takes a long time. Healing, when all the doctor’s instructions are followed, goes unnoticed by others and the patient himself.

Scars after blepharoplasty on the lower eyelids are located along the eye under the ciliary edge and, when fully healed, do not differ from the rest of the skin. And with an improved technique (transconjunctival), there are no external scars, since they are located on the inside of the eyelid. The scars from lifting the upper sagging eyelids are hidden in the crease above the eye and are almost invisible after two weeks from the day of the intervention.

What to apply to the skin after blepharoplasty

To prevent the growth of connective tissue and help the scar to form smooth and elastic, plastic surgeons recommend using silicone-based gels and ointments, as well as silicone patches immediately after suture removal.

Effective drugs	Action
Contractubex	A cream based on allontoin, a substance that promotes rapid healing and restoration of damaged tissue. It softens and moisturizes connective tissue and relieves pain.
Gel Dermatix	The silicone-based product softens connective tissues, prevents the formation of rough and uneven scars, maintaining water balance.
Scarguard	Liquid product containing silicone. Application is done using a soft bristle brush. Drying on the eyelids, the medicine forms a film through which the moisture necessary to soften the scar is retained.
Kelofibrase	A cream with natural ingredients has an anti-inflammatory, moisturizing effect, improves blood circulation in the skin, maintains normal water balance, which promotes the resorption of scar tissue.
Zeraderm	Liniment is made on the basis of silicone. The ointment helps saturate the skin with oxygen, nourishes it with vitamins, and ensures rapid regeneration.
Sledotsid	Relieves inflammation of injured tissues and ensures their regeneration. To treat scars, the product should be applied at least 2 times a day and remain on the surface until completely absorbed.
Clearvin	The cream is plant-based and contains extracts of medicinal plants. Promotes recovery, nutrition, improves blood circulation in the skin.

How to prevent scars and speed up their healing

To prevent the formation of noticeable scars on the eyelids, it is very important to regularly treat the incision sites with absorbable gels and ointments in the first weeks after surgery. They will prevent connective tissue from growing. On the forums you can find women’s concerns about the occurrence of colloidal scars, and evidence of the appearance of subcutaneous lumps.

Colloidal scars that occur after blepharoplasty do not form due to thin skin and lack of fatty tissue. Scars may be noticeable for the first few months until the skin has fully recovered. There are negative reviews about this operation, but the authors emphasize the inexperience of the young surgeon. Physiotherapeutic procedures will help remove sloppy marks on your eyelids.

If a subcutaneous scar has formed after the lower blepharoplasty procedure, it should go away after 2-2.5 months. During this time, swelling, bruises, and subcutaneous lumps resolve, and postoperative marks become invisible.

Using decorative cosmetics will help hide scars on the eyelids, but they can only be used after the stitches have healed.

Blepharoplasty is widely and successfully practiced, being a relatively safe and effective plastic surgery. This involves surgically removing excess skin, fat and muscle tissue. However, the anatomy of the eyelid is complex and the risk of complications always exists.

During the preoperative evaluation, it is important to identify the patient's problems and perform a complete ocular examination. When planning upper blepharoplasty, the surgeon determines the amount of excess skin of the upper eyelids, the amount of excess or missing fat, and the position of the tear ducts. In preparation for lower blepharoplasty, the amount of excess skin is determined, the presence of fine wrinkles, and the amount and location of fat are noted.

When planning, they choose the method of performing the operation, and also decide on the need for additional procedures. It is the surgeon's responsibility to inform patients about the potential risks of surgery before the operation is performed.

Complications after blepharoplasty can range from minor to serious.

Hematomas and swelling

Consequences of blepharoplasty such as bruising and swelling are inevitable and are not complications.

In the postoperative period, cold compresses can be used for recovery. Compresses made from a mixture of water and ice should be used continuously for 3 days (except during meals or sleep). You should rest with your head positioned between 45 and 60 degrees from the horizontal position.

If all four eyelids undergo surgery at the same time, the eyelids may swell and remain closed for 24 to 48 hours. Patients should receive preoperative instruction regarding this possibility.

Rollers under the lower eyelids are a very common (and usually temporary) phenomenon after blepharoplasty. The cushion is formed by edematous tissue, the condition of which can last up to 1.5-2 months. In these cases, massage and physiotherapeutic rehabilitation procedures help.

Dehiscence of wound edges

After blepharoplasty, divergence of the wound edges is possible. The complication usually heals without causing any significant scarring. Dehiscence of a surgical wound can occur due to accidental trauma, poor healing, excessive stress on the suture, early suture removal, or as a result of infection. The complication often occurs in patients who accidentally rub their eyes while sleeping, raise their eyebrows excessively, or clench their eyelids. If the wound opens within the first 48 hours, it is cleaned and re-sutured.

Measures to minimize the wound and reduce the likelihood of wound dehiscence include appropriate selection of suture material and suture placement.

For upper blepharoplasty, non-absorbable suture material is preferred.

With absorbable sutures there is a risk of tissue reaction or wound dehiscence. Removal of sutures is recommended 5-7 days after surgery.

The conjunctival incision during transconjunctival lower blepharoplasty does not require sutures. Small wound dehiscence can be treated with antibiotics, but full dehiscence requires sutures to avoid scarring.

Scars and cysts

The skin on your eyelids heals better than any other skin on your body.

However, external eyelid wounds must be symmetrically located and carefully sutured. Significant scarring can be avoided by appropriate incision placement, minimal tissue manipulation, and proper selection of suture material.

If the incision line is slightly enlarged and redness persists for 4 weeks, massage and vitamin E creams will be helpful. Very rarely, steroid injections may be used. The formation of keloid scars on the eyelids is rare.

Isolated epithelial debris may form small whitish-yellow cysts along the suture line, which are incised or removed. They can atrophy on their own after 2-3 months. Pyogenic granulomas sometimes develop on conjunctival incisions. Treatment may include a short course of steroids.

Eyelid hypercorrection

Consequences of blepharoplasty can include aesthetic and functional complications resulting from excessive removal of skin and fat, as well as excessive scarring and adhesions associated with the aponeurosis of the levator palpebral muscle. Risk factors for overcorrection include:

previous eyelid injuries,
dermatological diseases leading to roughening of the skin,
Graves' disease.

Patients with large excess skin, low eyebrows, or after a previous brow lift or blepharoplasty are also at risk.

Accuracy of measurements avoids over-correction.

As a rule, the doctor should leave 10 mm of skin under the eyebrows above the eyelid incision to avoid lagophthalmos (incomplete closure of the eyelids).

Abnormalities of the lower eyelid position include scleral exposure, rounding of the lower eyelid contour, and ectropion (inversion of the eyelid). Transconjunctival fat resection should be used in younger patients who have little excess skin and whose skin is elastic enough to shrink spontaneously after surgery.

Asymmetry and ptosis

Preoperative identification of the existing eyelid crease and accurate measurements and marking of the planned upper blepharoplasty incision are critical to reducing the risk of postoperative eyelid crease asymmetry. The small degree of asymmetry disappears over time. Serious asymmetry requires surgical correction.

Blepharoptosis is a common consequence of upper blepharoplasty. Upper eyelid ptosis often occurs due to eyelid swelling, decreased function of the levator muscle due to swelling, and hematoma formation. In most of these cases, the position of the eyelids improves as the swelling and bruising resolve and the levator muscle resumes its preoperative function. Cases of persistent postoperative ptosis usually occur within 3-6 months, and spontaneous improvement may occur within a few months.

Chemosis and lagophthalmos

Chemosis is swelling of the conjunctiva and can be caused by inflammation of the transconjunctival incision or overactivity. For example, there is a known case where a patient felt so good after blepharoplasty that, upon arriving home, she bent down to pull out weeds, which caused severe chemosis. The complication can lead to dry cornea and conjunctiva, blurred vision and eye discomfort. Mild cases of chemosis often improve quickly with continued use of eye lubricants (artificial tears and eye ointments).

Incomplete closure of the eyelids (lagophthalmos) often occurs after correction of ptosis of the upper eyelids. Complications occur less frequently after conventional blepharoplasty. In most cases, mild postoperative lagophthalmos resolves within a few days or weeks after surgery. Excessive resection of the skin of the upper or lower eyelids can cause prolonged lagophthalmos. Poor eyelid closure can aggravate dry eyes and lead to keratoconjunctivitis. Intensive postoperative ocular lubrication (artificial tears, gels, ocular ointments) is critical for all patients with lagophthalmos.

Diplopia

Double vision after eyelid surgery is extremely rare but is still a known complication. The most common form of diplopia is caused by direct injection of a local anesthetic into the fat of the open conjunctiva (lower eyelid) or skin (upper eyelid). This is due to the faster and wider distribution of the local anesthetic agent affecting the cranial nerves. Particular attention should be paid to patients undergoing repeated blepharoplasty procedures.

Diplopia can occur when the eye muscles are damaged.

Injuries to the inferior oblique muscle or (less commonly) the inferior rectus muscle are the most serious causes of postoperative double vision after inferior blepharoplasty.

Patients sometimes complain of diplopia in one eye due to disruption of the tear film. This mild form of diplopia improves with blinking and resolves after a few days after surgery.

Orbital hemorrhage with vision loss

Catastrophic complications of blepharoplasty, including blindness, can occur due to retrobulbar hemorrhage.

Retrobulbar (orbital) hemorrhage leads to a sharp increase in intraorbital pressure, and the blood supply to the optic nerve is compromised.

Retrobulbar hemorrhage with loss of vision is a rare complication, with an estimated incidence of 1:2000 (0.05%) and permanent blindness in 1:10,000 (0.01%). Risk factors are:

hypertension,
taking anticoagulants or antiplatelet medications,
long complex operation,
repeated surgery through injured tissue.

Orbital hemorrhage usually occurs within the first 24 hours after surgery, but may occur within a week after surgery.

Exophthalmos (protrusion of the eyeball), limited ocular mobility, decreased visual acuity, and increased orbital tension are clinical signs of deep bleeding. The patient will suffer from asymmetric pain. Treatment should be carried out within the first 24-48 hours. Orbital hemorrhage requires surgery. Control of obvious sources of bleeding is important, but rapid reduction of orbital pressure is critical.

After blepharoplasty, it is necessary to avoid certain types of movements (straining during bowel movements, sudden coughing, bending forward, etc.), which cause a sharp increase in blood pressure and are the main risk factors for postoperative hemorrhage. Antihypertensive medications must be continued.

Hyperpigmentation

Hyperpigmentation occurs as a result of the slow resolution of bruises and the deposition of red blood cell breakdown products (hemosiderin), which causes the skin over the bruise to become stained. Careful hemostasis and evacuation of postoperative hematomas can reduce the likelihood of hyperpigmentation. Post-inflammatory pigmentary changes can also lead to darkening of the skin. Increased deposition of melanin is possible in the epidermis. Postoperative sun exposure is rarely a cause of hyperpigmentation, but glasses with UV protection are useful during surgical recovery.

Consequences after blepharoplasty are associated with trauma to the skin of the upper and lower eyelids after incisions, suturing or laser exposure.

In terms of time, there are early (develop within several days after surgery) and late complications.

Basic

These are complications that are a consequence of the impact of a traumatic factor on the skin and subcutaneous tissue of the eyelids.

These include:

Early

swelling– a physiological reaction to tissue injury, aimed at limiting inflammation, in which the liquid part of the blood leaves the vessels and the eyelid area increases in volume, develops almost immediately after the intervention;
bruises– are the result of microbruises, disappear on their own due to their resorption;
bleeding– the release of blood from vessels due to damage to their walls, depending on the caliber and location of the damaged vessel, there is subcutaneous hematoma(limited area of hemorrhage under the skin of the eyelids in the form of a tumor), tense hematoma(occurs with ongoing bleeding, in which tissue is stretched by blood) and retrobulbar hematoma(bleeding from a large vessel located in the tissue behind the eyeball);
eversion of the eyelid– a characteristic complication after excision of a large amount of subcutaneous tissue, characterized by mechanical deformation and incomplete closure of the eyelids, followed by dry eye.

Late

scarring– connective tissue cords that form at the incision site during wound healing and incomplete closure of its edges often occur when sutures are placed incorrectly or when a large and deep incision is made; scars can resolve on their own within several months;
seam dehiscence– occurs when they are applied incorrectly or the tissues are not strong, causing the suture material to cut through and the edges of the wound to separate, then scars may occur;
lacrimation - increased formation of tear fluid due to disruption of the lacrimal glands, goes away on its own;
"hot eyes"- excessive dryness of the mucous membrane of the eyeball with incomplete closure of the eyelids or blocking of the lacrimal canal with a feeling of “heat”, requires repeated plastic surgery, often happens after transconjunctival blepharoplasty due to damage to the lacrimal canal;
cyst– a cavity filled with liquid and limited by a connective tissue capsule, formed along the line of the postoperative suture, this is a benign formation that usually resolves on its own, sometimes it is removed surgically;
eye asymmetry– a consequence of deformation of the eye section after the formation of significant scars or improper sutures; this complication requires repeated plastic surgery;
blepharoptosis– drooping of the upper eyelids due to damage to the muscles and its ligaments, also occurs in elderly patients (ligament failure), correction is only surgical;
dry keratoconjunctivitis– inflammation of the conjunctiva of the eyes, due to their dryness, may not occur due to surgery; eye drops or artificial tears are used for treatment.

Possible

infection- a consequence of bacteria entering a postoperative wound, manifested by inflammatory processes with the possible formation of pus, this complication develops when the rules of antiseptics and asepsis are not observed during or after surgery, treatment consists of prescribing antibiotics (ceftriaxone) and washing the eyes and eyelids with antiseptic solutions (furacilin, chlorhexedine);
ectropion– inversion of the lower eyelids after blepharoplasty, which leads to their incomplete closure, increased dryness and keratosis of the sclera of the eyeball, treatment is only surgical, consisting of plastic surgery of the tissues and muscles of the lower eyelid;
diplopia– double vision, caused by damage to the muscles of the eyeball after surgery, treatment consists of mandatory surgical plastic surgery of the damaged muscles with restoration of their integrity;
blurred vision- a serious complication that has many causes in its occurrence, namely a tense hematoma, leading to deterioration in the nutrition of the retina, dry keratoconjunctivitis, which can cause the formation of an eyesore; all these reasons require immediate adequate treatment.

Laser blepharoplasty allows you to minimize late and possible complications, due to the virtual absence of significant trauma to the skin and subcutaneous tissue of the eyelids.

Early complications of blepharoplasty are minimal; with proper management of the postoperative period, they resolve on their own and do not require special treatment.

avoiding taking medications that reduce blood clotting (aspirin, acetylsalicylic acid);
avoiding physical activity after surgery;
a cold compress on the eyelids to prevent and reduce tissue swelling;
You cannot use makeup after surgery;
using special eye drops or artificial tears to prevent keratoconjunctivitis sicca;
the use of antiseptic solutions or ointments for the eyelids will eliminate infectious complications;
avoiding excessive insolation (exposure to sunlight) on postoperative wounds will make it possible to prevent most complications of blepharoplasty;
the effect of high temperatures on the skin of the eyelids after surgery can increase swelling, inflammation, and provoke late bleeding, so you should avoid visiting a bathhouse or sauna.

Preparatory stage in the prevention of complications

Before undergoing blepharoplasty, it is important to prepare properly and follow all the doctor’s recommendations, this will minimize the risk of complications:

passing all mandatory tests, consulting a therapist, and conducting additional research if necessary;
awareness of the development of possible complications;
avoiding drinking alcohol and smoking on the eve of surgery;
It is necessary to provide all the information to the doctor about previous diseases and current medications, since some of them (aspirin) can cause bleeding.

Photos of complications after eyelid correction

It is worth remembering that early major complications after blepharoplasty, especially swelling and bruising, always accompany the postoperative period. Therefore, it is important to follow all the doctor’s recommendations, be patient and not worry about them.

Frequently Asked Questions

Stages of scar healing after blepharoplasty

Postoperative scars go through a granulation phase in the first four weeks, during which new connective tissue with a newly formed vascular network is formed at the site of the incision.

A month after the operation, the incision site turns into a pink scar. In the subsequent period (1-1.5 months), the scar turns into a thin, white line that no longer protrudes above the surface of the skin.

If the scars smooth out too slowly, the excess growth of connective tissue is eliminated additionally.

Application of specialized cosmetics

During the rehabilitation period, the skin at the incision sites needs special care. The doctor may suggest special cosmetics that will speed up the healing process, help restore the skin, maintain the functionality of cells in the area of the incisions, and also reduce the possibility of the formation of unaesthetic scars.

In addition, special products will help reduce postoperative discomfort, shorten the rehabilitation period, and eliminate bruising. Special creams and gels contain healing, nourishing, protective elements that significantly improve the condition of damaged skin.

Silicone-based preparations are considered the most effective for the prevention and treatment of pathological scars. Vitamin complexes are often added to them: E to protect against antioxidants and regulate the natural balance of moisture in the skin, K to relieve redness and coenzyme Q-10 to renew cells. To protect against ultraviolet rays, zinc is also added to the composition.

Video: Blepharoplasty and complications after it

On the same topic

Discussion: 5 comments left.

Good evening. I was operated on for bags under my eyes, lower blepharoplasty. On the first day there was swelling and bags under the eyes, which actually didn’t surprise me. Then they started to go away, but a swelling appeared under the right eye, like a nut, 2 centimeters in diameter. I went to the doctor, examined him, and said it was a subcutaneous hematoma due to bleeding. He prescribed heparin ointment for its resorption and cold. Along the way, I found out that I was taking aspirin for a headache, which provoked this postoperative bleeding. Now everything is fine, if I have another operation, I will be more attentive to the recommendations regarding the postoperative period. And how I forgot about the ban on taking aspirin.

I had laser blepharoplasty done to reduce wrinkles around the eyes, otherwise the mesh was noticeable. There was practically no pain during the operation. But after that there is redness of the eyelids and their swelling. To tell the truth, I was a little worried, so they started applying cold. On day 3, the redness, swelling, and wrinkles went away. I'm glad I decided.

Hello. I had surgery for bags under my eyes; they were so bad that it felt like I wasn’t sleeping at all. The plastic surgeon said that it was necessary to remove a large amount of subcutaneous tissue from the lower eyelids. After the operation, at first everything was fine, but over time I began to notice some kind of burning sensation in my eyes. And dryness in them. After examination, they said that I had an eversion of my eyelids. Artificial tears were prescribed. It became easier. But I had to undergo another operation and underwent additional plastic surgery of the lower eyelids. Now that the swelling has subsided, it’s good, it doesn’t dry out the eyes.

Good afternoon The first day after blepharoplasty surgery seemed like a nightmare to me, although they warned me about the development of complications. I was afraid to look in the mirror - my eyelids were swollen, there were bruises under my eyes. I think this is how I fixed the bags under my eyes. The doctor prescribed cold application, forbade cosmetics and going out in the sun. After a few days the swelling went away. And only then did I notice the difference. Fortunately, the photo was taken before the operation.

We underwent lower eyelid blepharoplasty surgery. At first there was swelling and blueness under the eye at the surgery site. It even seemed that I looked worse than before this procedure. The doctor recommended applying cold. After a few days everything seemed to be back to normal. Frankly, I was scared at first, although the doctor warned me. But it’s one thing to hear, and another to see. Now everything is fine, the bags have really disappeared.

There is an opinion that blepharoplasty is a simple and safe operation that even a young surgeon can do. Believing this, patients sometimes refuse to spend a lot of time searching for an experienced specialist, and then face negative consequences after unsuccessful blepharoplasty. Conventionally, the latter are divided into two types: some simply spoil the appearance and can be eliminated, others worsen vision, threatening its complete loss.

Reasons

The most common causes of complications after blepharoplasty:

Individual characteristics. We are talking about allergies, the location of blood vessels, unforeseen circumstances in the process of scar formation (when the body itself reacted in an unexpected way).
Failure of the patient to comply with the doctor’s advice after and before the procedure.
General surgical risks. Any operation is a trauma, and even more so for the delicate and thinned area - the skin around the eyes. To minimize risks, you should undergo an examination and exclude the presence of contraindications.
Surgeon's mistakes. Unfortunately, young specialists sometimes underestimate blepharoplasty, forgetting that this is one of the most technically difficult manipulations.

It also happens that in the actual absence of complications, the patient remains dissatisfied with the result obtained. This is all due to physiological reasons (slow healing, formation of a rough scar), psychological reasons (inflated expectations from the operation).

Types of complications after blepharoplasty

Depending on how much time has passed since the operation, there are:

Early complications. They appear during the procedure or in a short time after its completion. They are hematomas, swelling, foci of inflammation due to infection.
Late. They appear after several weeks and sometimes months and are revealed by suture dehiscence, hyperpigmentation, blepharoptosis, and aesthetic problems.

In any case, treatment must be started immediately, otherwise serious and irreversible consequences cannot be avoided.

Main problems and ways to deal with them

Swelling, which appears in the first days after surgery, is not a complication after blepharoplasty. Swelling (pictured) is a common reaction of the body to injury. When they appear, the permeability of blood vessels increases, through the walls of which a larger volume of blood is removed, which, on the one hand, leads to swelling, and on the other hand, accelerates the healing process and eliminates inflammation.

Normally, swelling lasts from 2 to 7 days and is reduced thanks to anti-inflammatory ointments and gels prescribed by a physician. If swelling persists longer, then additional consultation with a surgeon is required to determine the cause. Otherwise, the condition threatens blurred vision, double vision, and headaches (if the swelling puts pressure on the organ of vision).

The main causes of persistent edema:

toxicoallergic conjunctivitis (most often due to medications that were instilled after surgery, and confirmation of this is itching, redness of the skin and whites of the eyes);
infection.

The basis of therapy is antiallergic drugs.

Hematomas

Being an accumulation of blood, hematomas appear immediately after injury or damage to the skin or after a few days. Conventionally, they are divided into three types:

Subcutaneous - simple, prone to self-resorption. Sometimes they require a puncture or removal of blood accumulation through incisions. The main thing is not to delay with the latter, if there are indications, since sealing of the eyelids and subcutaneous nodes may subsequently appear.
Tense - occur if a large vessel is damaged (it does not thrombose naturally) and blood constantly comes out of it, squeezing the tissue around it. The condition is accompanied by a feeling of fullness and numbness of the damaged area. The problem is solved by surgical intervention, in which the vessel is sutured.
Retrobulbar - represent hemorrhage into the orbit. This is a serious complication after blepharoplasty, which can cause visual impairment due to compression of small vessels that supply oxygen to the retina and optic nerve. In severe cases, possible: blindness, acute glaucoma. The condition manifests itself on the first day or on the 5th – 7th day and is accompanied by pain and protrusion of the eyeball. The reasons are the surgeon’s mistake or failure to follow his advice (bending over, physical activity). To avoid complications, doctors use instruments that seal vessels (electric knife, laser). Symptoms are relieved with drugs to reduce intraocular pressure, and if vision deteriorates, repeat surgery is performed.

To eliminate hematomas, decongestant infusion therapy can also be performed.

Infection

It is observed during surgery in a non-sterile operating room or in the presence of foci of inflammation in the patient (caries), when the infection enters the wound through the bloodstream. Accompanied by swelling, redness, increased body temperature, and less commonly, necrosis. Antibiotic therapy is used for treatment.

Scarring problems

With an individual predisposition to the appearance of keloid scars, rough scars and cysts appear. Small tumors are prone to self-resorption, others are eliminated surgically. At the initial stages, they are treated with ointments and hardware procedures; after six months, only peelings and laser resurfacing are effective.

This is a drooping of the upper eyelid in which the patient is unable to open the eye. Appears with swelling, but normally goes away quickly. If it persists for several weeks, it means that the surgeon made a mistake when he damaged the ligaments and muscle fibers. The defect is corrected during a repeat operation.

Lagophthalmos

A condition in which the eye does not close completely. It happens when the doctor removes too much skin or the patient is sent to the surgeon’s table without waiting for complete recovery from the previous plastic surgery. The complication leads to impaired hydration of the cornea, as a result of which it loses transparency. The outcome is blindness. Treatment involves the use of moisturizing drops and repeated surgery.

A consequence of lower blepharoplasty, in which the eye also does not close. It can be eliminated in two ways: gymnastics, massages to increase the tone of the circular muscle, or repeated surgery with skin grafting.

Another complication after lower blepharoplasty is called “round eye”. It occurs when the shape and cut of the palpebral fissure is deformed. Accompanied by lacrimation, dryness, redness. The eyes appear unnaturally bulging. Corrected with repeated surgery.

In addition to the positive aesthetic effect, blepharoplasty can also cause negative consequences. Let us consider in more detail what needs to be done in case of its possible complications.

What is it

Blepharoplasty is a surgical procedure to correct or change the shape of the eyelids. It can be aimed both at purely aesthetic rejuvenation of the patient and at correcting congenital (acquired) defects of the eyelids.

Blepharoplasty significantly tightens the upper and lower eyelids, making a person's gaze more open and lighter. After it, the number of wrinkles on the eyelids decreases, so the patient appears younger.

Blepharoplasty will help get rid of the following problems:

change the shape of the eyes;
change the shape of the eyes;
eliminate various eyelid defects;
tighten drooping eyelids;
eliminate the problem of bags under the eyes;
eliminate wrinkles under the eyes.

Indications

This operation is indicated for people in the following cases:

Having bags under the eyes.
Presence of wen under the eyes.
Severe wrinkles on the lower eyelid.
Sagging of the upper eyelid.
Having a “heavy” look.
The presence of various birth defects or pathologies of the eyelid.
Acquired (after injury, surgery or burn) eyelid defects.
Drooping of the corners of the eyes.
Excess flesh on the lower eyelids.

Contraindications

Before agreeing to this operation, you must remember the following contraindications to its implementation:

diabetes mellitus type 1 and 2;
the presence of an inflammatory process in the body, which is accompanied by high temperature;
acute or chronic respiratory diseases;
hepatitis;
severe infectious diseases;
presence of oncological pathologies;
pregnancy and breastfeeding;
the patient's age is up to eighteen years;
dry eye syndrome;
blood clotting disorder;
acute diseases of internal organs;
hypertension;
increased intracranial pressure;
dysfunction of the thyroid gland;
infectious diseases of the eyes or nose.

Photo: Before and after surgery

Early difficulties

Blepharoplasty can cause serious complications after surgery.

Let's take a closer look at each of these conditions and how you can cope with them.

Edema

Swelling of soft tissues is inherent in all surgical interventions without exception, which involve damage to the integrity of soft tissues.

When the patient has edema (in the affected area of the skin), vascular permeability increases, which leads to swelling.

This condition is considered normal after this operation. It lasts from two to seven days. Swelling can also cause blurred vision and headaches.

In order to get rid of them, you need to use anti-inflammatory ointments and gels, which will be prescribed by your doctor.

Hematoma

A hematoma can develop in the first hours after surgery or several days after it is performed.

There are three types of hematomas:

subcutaneous– characterized by the accumulation of ichor just under the top layer of skin due to impaired vascular function. It is eliminated using a catheter, which is inserted under the skin and pumps out excess fluid;
tense– accompanied by profuse subcutaneous bleeding. It must be urgently eliminated by restoring the affected vessel;
retrobulbar- This is the most dangerous hematoma that can develop due to damage to a large vessel. In this case, patients will experience an accumulation of blood under the eyeball. This can lead to blurred vision and pain. Such a hematoma is removed surgically.

Diplopia

Diplopia is expressed as a disruption of the motor muscles of the eye, which can occur after blepharoplasty.

Its symptoms appear almost immediately after the operation.

Most often, with diplopia, the work of the oblique muscle of the eye is disrupted. As a rule, this condition goes away on its own after 1-2 months.

Video: Preparing for surgery

Bleeding

Bleeding is the most common complication observed after blepharoplasty. It can also occur during the operation itself.

Frequent bleeding is explained by the fact that there are a lot of vessels and small capillaries in the eye, which, even with the slightest damage, can become severely damaged and bleed.

The danger with this condition is that the patient may lose too much blood, requiring additional plasma or blood transfusions. This in turn threatens blood poisoning.

Eversion of the lower eyelid

Because this operation can remove so much skin, patients sometimes experience lower eyelid inversion after the procedure. At the same time, the eye itself cannot close completely, which leads to its dryness.

In order to eliminate this condition, it is necessary:

perform additional surgery;
do a special massage for the eye to maintain and stretch muscle tone.

Infection of postoperative wounds

If sterility is violated during this surgical procedure, the patient runs the risk of infection in the wound.

This condition manifests itself in the form of an inflammatory process, high temperature and discharge of pus from the sutures.

It is important to know that infection requires immediate medical treatment, in particular strong antibiotics.

Also, if an infection gets into the wound, the latter will take much longer to heal.

Orbital hemorrhage

Orbital hemorrhage is considered the most terrible consequence of blepharoplasty, as it threatens complete loss of vision.

This complication can result from a surgeon’s mistake or performing surgery on a patient with the following contraindications:

hypertension;
taking anticoagulants or alcoholic beverages before surgery;
carrying out a long and complex operation.

This condition usually manifests itself within the first day after eyelid correction. It is very difficult to treat.

The most effective therapy is repeated surgery, but in severe cases there is no guarantee that lost vision will be restored.

Late complications after blepharoplasty surgery

After eyelid correction surgery (after 2-3) months, the patient may experience the following late complications:

Formation of too rough scars at the incision site. They may appear due to sutures coming apart or not properly suturing the wound itself. In this case, such scars will be very visible, so they need to be excised and stitched again. To prevent them from occurring, immediately after blepharoplasty they need to be lubricated with healing and absorbable ointments.
Blepharoptosis is severe heaviness of the skin in the upper eyelids. This complication is quite rare and is most often observed in elderly patients. It occurs due to a poorly performed operation. To eliminate blepharoptosis, it is necessary to perform repeated blepharoplasty.
The formation of eye asymmetry can occur due to unsuccessful suturing. This complication is eliminated by performing secondary blepharoplasty.
Dry keratoconjunctivitis is a fairly common companion to eye surgery. To treat it, you can use special eye drops.

To completely eliminate it, it is advisable to re-correct the eye shape.

Loss of vision is typical for elderly patients who agreed to surgery with high blood pressure, which provoked the appearance of a hematoma. Fortunately, such disastrous consequences are quite rare.
Seams coming apart. This usually happens when they are applied incorrectly during surgery. In this condition, the patient is at risk, because due to the divergence of the stitches, the wound may become infected or edema may develop. The best method for repairing suture dehiscence is to re-stitch the stitches, but this only increases the risk of large scar formation.
The appearance of tearing can occur when the tear points move outward, so the healed tissue will narrow the flow channels of the eyes.
A cyst is a non-cancerous formation that is separated from other tissues by a dense capsule. It can form on the seam of a wound. The cyst requires surgical removal, since it does not resolve on its own.
“Hot” or inflamed eyes occur in patients with frequent blepharoplasties. At the same time, their eyelids will not close tightly, which will lead to dryness and inflammation. Unfortunately, this condition can only be eliminated by repeated surgery.
Ectropion is one of the most common late complications. Its appearance is caused by the presence of open areas of the sclera, which led to deformation of the eyelids. To eliminate this condition, the patient needs to do special therapeutic exercises and eyelid massage.
Hyperpigmentation can occur when there is severe bruising and the deposition of red products from blood decomposition, causing the skin to become discolored. If this condition is not treated in time, the eyelids may darken.

What to do

Unfortunately, most complications from blepharoplasty require re-correction of the eyelids, but it is better to correct such defects immediately than to subsequently suffer from the symptoms of a failed operation.

Let us consider in more detail what needs to be done in case of individual complications:

If there is heavy bleeding, doctors must perform a puncture on the patient to remove excess blood.
If a large hematoma forms, it is recommended to remove the bleeding vessel, since if this is not done, then in the future the patient may have thickening of the eyelids and problems with normal closing of the eyes.
If a patient develops the most dangerous type of hematoma (retrobulbar), an urgent examination by an ophthalmologist is necessary. You also need to perform a procedure called tonometry, which consists of monitoring blood circulation in the retina. After this, the attending physician should prescribe decongestant therapy.

It is important to know that if this type of hematoma is not eliminated in time, the patient may experience loss of vision and thrombosis of the retinal arteries.

If the lower eyelid is everted, it is necessary to prescribe conservative treatment, which consists of applying supporting sutures and performing a special massage.
For eye inflammation, it is recommended to use anti-inflammatory drops.

Also, in case of infection of the wound and its suppuration, the patient should be prescribed the following groups of medications:

painkillers;
anti-inflammatory drugs;
decongestants;
antipyretic (analgesic) drugs;
antibacterial drugs (broad-spectrum antibiotics).

Is it possible to prevent the consequences

In order to prevent the development of the above complications, you should adhere to the following recommendations:

Choose a professional clinic and an experienced doctor to perform eyelid correction.
Do not perform blepharoplasty if at least one of the contraindications is present.
A week before surgery, do not take medications that can thin the blood, increase blood pressure, etc. It is also important not to drink any alcoholic beverages five days before surgery.
Before surgery, it is recommended that you consult with several doctors and get their opinion on whether you really need blepharoplasty.
After eyelid correction, it is very important to follow all the doctor’s advice and perform treatment procedures.

Unfortunately, it is impossible to predict, let alone prevent, all possible complications after this surgical intervention.

This is explained by the individuality of each individual organism and its unforeseen reaction to damage.

Only after weighing all the pros and cons can you make a final decision.