I just have my Lasik done in Jan 09, currently planning for the upper blepharoplasty in May 09? It is around 4 months interval. What are the risks that I should be aware of? What is the worst complication?
Will Blepharoplasty Affect my Previous Lasik Surgery?
Doctor Answers (10)
No major risks but a few things to be aware of
In general, there are no major problems with blepharoplasty after lasik. However, dry eye syndrome is beleived to be more common, particularly after lower eyelid bleph following lasik. The usual recommendation is to wait 6 months.
Usually there is no problem with blepharoplasty after Lasik
There is a very small chance that your prescription can change ever so slightly after blepharoplasty and this is due to a change in tear film. If your eyes are dry, you want to be cautious after LASIK, because blepharoplasty too soon after can have this effect. If your eyes are well lubricated, then there shouldn't be a problem.
Proceed when Lasik surgeon assesses it's safe
A question more commonly asked nowadays, but there are few scientific papers that address when it safe to proceed and what complications may be more prevalent if blepharoplasty is done too soon. If your eyes are "not dry" and your lasik surgeon gives you the go ahead, it is most likely safe to proceed. The actual blepharoplasty surgery will not affect the lasik surgery but the timing of such is important to avoid eye complications or side effects.
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Few precautions for Blepharoplasty
Lasik surgery could increase your chances of having dry eye syndrome if you undergo lower lid surgery. If you have no symptoms of dryness now you should be fine with an upper bleph. Make sure you inform your plastic surgeon regarding the lasik surgery.More conservative skin removal is always safer in this case.
Beware of dry eye syndrome
Lasik surgery will cause your cornea to dry somewhat. It takes several months to heal and return to your normal tear film. Follow up with your Lasik surgeon for a clearance to proceed with blepharoplasty. Good luck!
You should be fine
You should be fine. You just need to make sure that the surgeon and the anesthesiologist are both aware that you have had LASIK surgery, so they can take extra precaution to keep your eyes lubricated and protected.
Dry eye syndrome is a common problem that can occur. It is more common in women who are in their 40's or 50's, pleople who have a negative vector (ask your surgeon what that means), and after lower lid bleph.
So go ahead but get all of your questions answered by your surgeon.
Both Blepharoplasty and Lasik cause dry eye
Lasik causes dry eye by cutting the sensory nerves to the corneal surface when the flap is lifted. It takes time for this to resolve.
The eyelid surgery can also exacerbate dry eye. A properly done eyelid surgery will have a minimum impact on the dry eye situation. Having said that, you need a proper assessment of the condition of the eyes prior to eyelid surgery. If your cosmetic surgeon is not prepared to assess and manage the dry eye condition, you will need assessment by a general ophthalmologist which could be your refractive surgeon. The timing of the eyelid surgery should be deferred to whoever will be responsible for managing the eyes.
What it the worst that could happen is the closure of the eyelids could be compromised by the eyelid surgery in a setting where there is reduced corneal sensitivity following Lasik. This could lead to corneal break down after eyelid surgery. This can initiate a melting syndrome of the cornea, or a frank corneal ulcer which is a baterial infection. For these reasons, it is worth your while to take your time, and heal from the lasik prior to undertaking eyelid surgery and not proceed with eyelid surgery until cleared by your ophthalmologist.
OK to have Blepharoplasty after Lasik.
In New York City, we have done a number of blepharoplasty in patients who had previous Lasik surgery, and we have not had any problems. But check with your ophthalmologist.
Worst complication of blepharoplasty after Lasik surgery would be dry eye-but rare
In my opinion it is safe to have upper blepharoplasty 5 months after Lasik surgery.
I am careful to not over resect or remove too much upper eyelid skin to be certain that the patient will have good eye closure after upper blepharoplasty in order to maintain adequate moisture of the eye and cornea.
All experienced eyelid surgeons are aware of this issue and take great care to protect the cornea with scleral shields and do conservative upper eyelid skin resection especially in Lasik patients who have had laser modification of the cornea.
Find a board certified plastic surgeon who is experienced in eyelid surgery and openly discuss your concerns. With an experienced eyelid surgeon you should be fine.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.