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Will Bleph Effect Dry Eyes Problem?

Male 59 years considering Quad Bleph. I have had dry eye problems for several years, would this procedure effect that one way or the other? Thanks, Rob

let me know if additional information is required

Asked 37 months ago by robjl in Ridgefield,CT

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age 55-64 male dry eyes

See an ophthalmologist

Rob, If you have dry eyes and you are considering blepharoplasty, it may be helpful to have an ophthalmologic exam prior to your surgery. While certain procedures can help, it is also possible that blepharoplasty could worsen the symptoms. Just make sure you explore all your options before having surgery.

David Shafer, MD

New York Plastic Surgeon

ASPS

More related to the extent of dry eye that you have

Blepharoplasty will certainly not make your dry eye better. However, you may have to increase your use of artifical tears for several weeks; your ultimate need for the tears may not significantly change once you've recovered from surgery. I've done several patients with this problem and all have returned to their pre-op use of the tears.

Alexander M. Guba, MD

Baltimore Plastic Surgeon

ASAPS ASPS

Dry eyes and blepharoplasty

Undergoing either upper or lower blepharoplasty can exacerbate existing dry eye symptoms. Before any plastic surgery is performed, a thorough evaluation by an ophthalmologist is warranted to assess the severity and possible cause of your symptoms. That will allow a dialogue between you and your surgeon about the safety of undergoing blepharoplasty.

Thomas A Lamperti, MD

Seattle Facial Plastic Surgeon

Blepharoplasty for Dry Eye Patients

The fact is that a sizable minority of patients having functional upper lid Blepharoplasty in their 60's have some degree of dry eye issues. The reason for this is that baseline tear production naturally decreases with age. In fact, many patients present with what they describe as "wet eyes". This relates to decreased baseline tear production, which stimulates occasional reflexive tearing. Truly significant functional dry eye issues tend to... more

Stephen Prendiville, MD

Fort Myers Facial Plastic Surgeon

Eyelid surgery might aggravate dry eye syndrome.

Eyelid surgery can aggravate dry eyes especially in the short term. I have my patients see an ophthamologist prior to any surgery to evaluate the magnitude of the problem and the plan to treat problems if surgery is performed. Occasionally the ophthamologist will advise against surgery.

Vincent N. Zubowicz, MD

Atlanta Plastic Surgeon

ASAPS ASPS

Blepharoplasty can make dry eyes worse.

Hi. I wouldn't say absolutely that you cannot have blepharoplasty done, but you need to be very careful. It must be done conservatively, by a real expert, and the lower lids need to be perfectly supported. I would consult two different ophthalmologists.

George J. Beraka, MD

Manhattan Plastic Surgeon

ASAPS ASPS

Blepharoplasty should not be done on patients with Dry Eyes Syndrome

Dry eyes are a serious contraindication for blepharoplasty. Excess skin is removed during blepharoplasty which tends to open the eye, exposing the eye to more air which has a drying effect and can make dry eyes worse. Serious dry eyes can lead to damage to the cornea a very serious condition. Lower blepharoplasty done through an external eyelid incsion is a particular risk. Often the incision weakens the eyelid, a condition called ectropion in which the lower eyelid droops down in a sad... more

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Brooke R. Seckel, MD

Boston Plastic Surgeon

ASAPS ASPS

Consult your ophthalmologist

There is a 2% to 3% chance that performing a blepharoplasty will indeed make your dry eyes worse. Make sure that a portion of the orbicularis oculi muscle on the upper lids is not removed. Check with your ophthalmologist and document the amount of dryness in your eyes and give some consideration to both eye drops and silicone ductal plugs, which can help with the dry eye.

Doctor's Website

William Portuese, MD

Seattle Facial Plastic Surgeon

Dry eyes is a warning

You can dry eyes for many different reasons. But if dry eyes is a result of a functional problem with your eyelids then these problems should be evaluated and treated. If you have dry eyes because you produce small amounts of tears, then any surgery should be minimal to avoid any pulling on the upper or lower eyelids. In this case, less is more!

Robert M. Freund, MD

New York Plastic Surgeon

ASPS

Preop Opthalmology evaluation for dry eyes essential

Taking a history regarding dry eyes and performing a Schirmer's test on physical exam are important parts of evaluating patients seeking blepharoplasty. That is because blepharoplasty may worsen existing dry eyes or cause it in patients who didn't have it before surgery. The opthalmologist should rule out any diseases contributing to dry eyes and can prescribe a regimen to minimize the problem before surgery. The surgery itself may need to be more limited in aesthetic goals so that ocular... more

Edmund Fisher, MD

Los Angeles Facial Plastic Surgeon

Blepharoplasty and dry eyes

Blepharoplasty can affect dry eyes, so this is something you need to discuss in details with your surgeon. If too much skin is removed on the top, you might not be able to close your eyes, making them even drier, leading to exposure keratitis, and potentially more problems. Similarly, if too much skin or muscle are removed on the bottom without proper realignment and suspension techniques, your eyes appearance and health might be adversely affected. Oculoplastic surgeons are usually well... more

Stella Desyatnikova, MD

Seattle Facial Plastic Surgeon

Avoid dry eyes after blepharoplasty

Dry eyes following blepharoplasty can be a bad problem and should be avoided if at all possible. There are several points to consider: 1. Discuss your dry eye problem with your plastic surgeon and be sure that he understands the degree of your dryness. 2. It may be advisable to see your ophthalmologist prior to your procedure to check the degree of your eye dryness. There is a test called a Schrimer’s test that can be done to determine how you are producing tears. 3. It is... more

Jeffrey Zwiren, MD

Atlanta Plastic Surgeon

ASPS

Blepharoplasty could make it worse

One of the problems you can have post bleph is dry eyes. So, if you already have it, you might find it is a little worse or it could be the same after. At least, since I assume you already use drops, you might need more and you might need to use an ointment at bedtime.

William B. Rosenblatt, MD

New York Plastic Surgeon

ASAPS ASPS

Dry Eyes (Sicca) May Worsen From Eyelid Surgery (Blepharoplasty)

Every eyelid surgery candidate should have a full ophthalmic exam prior to under going this rejuvenating procedure. As an Ocular Plastic Surgeon I examine and review several aspects of the patient's eyes prior to surgery. It may not be enough for your cosmetic surgeon to only look at your eyes at a distance. The eyelids and eyes must be checked for several conditions that could effect your happiness in regard to your surgical outcome. Your physician must check the height, contour, and... more

Mark Berkowitz, MD

Sterling Heights Oculoplastic Surgeon

Need to be careful, but it might not be an absolute contra-indication

There is some data to show that blepharoplasty may not be as contraindicated for patients with subjective or proven dry eyes. Although I agree with previous commentators that caution is the watchword, there is data out (Archives of Facial Plastic Surgery Vol 6 march/april 2004 pg 101-4.) that suggests it is not as dangerous or taboo as we have come to think as plastic surgeons. This particular article examined 67 patient who also had dry eyes and underwent blepharoplasty. 25 of these... more

Vineet Mehan, MD

Washington DC Plastic Surgeon

Blepharoplasty effect on dry eyes depends on several factors

Usually a patient with dry eye syndrome needs to be approached cautiously when considering blepharoplasty, as the tearing mechanism can be affected. Patients with borderline dry eye problems can become worse, making them dependent on eye drops and ointment. However, it really depends on what is specifically done as your "quad bleph" procedure, and your surgeon should do a complete analysis of your tearing mechanism, production and drainage, as well as your specific anatomy perhaps... more

Robin T.W. Yuan, MD

Beverly Hills Plastic Surgeon

ASPS

It very well could make it worse! Caution advised.

Discuss this with your surgeon. I would also advise seeing an opthalomologist to get a diagnosis, a treatment if needed, and some advice regarding surgical technique modification. Generally speaking, the lower lid tends to be the most problematic, due it is pulled on by gravity, and swelling. The muscles don't tend to work well for at least a few weeks. In many cases, eyelid suspension is used to prevent dry eye. You may need silicone plugs in the tear ducts to keep the eyes moist. In... more

Scott E. Kasden, MD

Dallas Plastic Surgeon

ASAPS ASPS

Could make it worse except in one case!

In general Quad bleph will not improve dry eyes and could make your dry eye condition worse. Any patient with dry eye is a relative contraindication for blepharoplasty or at least the plastic surgeon need to proceed with extreme caution. However, there is one condition that might benefit from lower bleph if the desired effect is to raise the lower lid to cover a greater portion of the cornea. It must include a canthopexy or canthoplasty to maneuver the ligaments that support the lower lid.... more