Eyelid Surgery: Q&A

Ask a Question

I'm 60 and Want Upper and Lower Eyes Done, but Suffer from Severe Dry Eye. What Procedures Do You Recommend?

I've wanted to do my eyes for years. I have droopy uppers and the bulging bags on the lowers. My skin is extremely thin. I've read that patients that suffer from severe dry eye condition cannot have certain procedures. what would be best approach for me?

Tags:

age 55-64 dry eyes

Comment on this

16 Doctor Answers | Asked by Roxanne60 in Los Angeles

Doctor Answers (16)
Community Comments (0)

Conservative Eyelid Procedures for Dry Eye Sufferers

In a patient with dry eyes, skin only upper blepharoplasty and transconjunctival fat removal or transposition with or without fat grafting to the tear trough and surroundin landscape may produce the results needed without altering dry eye status.

Eyelid surgery for patient with dry eyes

There is an extremely small chance that dry eyes can be made drier with an upper blepharoplasty. It is important not to remove any orbicularis oculi muscle from the upper lids in dry eyed patients. It is however, acceptable to conservatively remove excess skin and fat on the uppers and a transconjunctival fat removal on the lowers with minimal risk of making dry eyes worse.

Blepharoplasty with Dry Eyes

If you have severe dry eyes, do not have a blepharoplasty performed unless cleared by an opthamologist. Patients with dry eyes when having blepharoplasty need a more conservative version of the procedure.

History of Dry Eyes

If you have a history of severe dry eyes and are on Restasis or other medications, I would not recommend doing blepharoplasty unless you have had operative clearance with your Opthamologist. Even then, I would perform a very conservative upper blepharoplasty and not consider doing a lower blepharoplasty in most patients. Normally patients after blepharoplasty, without having a history of dry eyes, will have dry eyes for 4-6 weeks after blepharoplasty.

Rod J. Rohrich, MD

10 reviews

Dallas Plastic Surgeon

Eyelid surgery and dry eyes

Blepharoplasty in patients with symptoms of dry eyes should be approached with great caution. Even though some surgeons will not operate on patients with dry eyes, I routinely will offer blepharoplasty for some well selected patients with dry eyes. There are a number of issues to consider – you should be evaluated and properly optimized for dry eyes prior to blepharoplasty; your aesthetic and functional eyelid anatomy has to be properly assessed and diagnosed so that a well chosen type of... more

Dry eyes and blepharoplasties

Can be done but you have to be willing to accept the probable need for extra care for keeping your eyes lubricated whether it be through eye drops, gels when you sleep and even the silicone plugs mentioned by Dr. Sowder. If you're willing to accept the anticpated outcomes, blepharoplasties could be done for you. You should discuss your concerns thoroughly with your chosen surgeon.

Curtis Wong, MD

7 reviews

Redding Plastic Surgeon

Bleph and dry eye

I would make sure you had explored all options for dry eye including punctal plugs. These are little silicone plugs that are put into the small ducts that drain the tears into the nasal cavity. They are usually well tolerated and they may improve your condition enough for you to have a very conservative blepharoplasty. It is very, very important that your plastic surgeon communicates with your ophthalmologist. If you have tried everything and your dry eye is still... more

I'm 60 and Want Upper and Lower Eyes Done, but Suffer from Severe Dry Eye. What Procedures Do You Recommend?

IMHO, severe dry eye is a contraindication for upper and lower eyelid surgery toegther and maybe a contraindication for having either separately. While it is possible that either, upper or lower, eyelid surgery could make your dry eye worse, it's unlikely that either would improve that condition. I would have you think long and hard about eyelid surgery if your dry eye is severe. Sorry, that I don't have better news.

Can blepharoplasty be performed in patients with dry eyes?

Upper and lower blepharoplasty can be safely done in patients with dry eyes if performed conservatively and using techniques that won't alter eyelid closure. See an oculoplastic surgeon for evaluation.

Dry Eye Prior to Blepharopladty

There are several considerations regarding your dry eyes and Blepharoplasty. First, what is the cause of the dry eyes? Have you had them evaluated? Can the dry eyes be improved? Secondly, can the dry eyes be improved with modification of a Blepharoplasty procedure? Thirdly, if neither of these are possible, are you OK with increased dryness for a while after the Blepharoplasty? You need a consult with an experienced Blepharoplasty surgeon and perhaps an Ophthalmologist.

I'm 60 and Want Upper and Lower Eyes Done, but Suffer from Severe Dry Eye. What Procedures Do You Recommend?

You raise an important question. Should blepharoplasty be performed when someone has dry eyes. Oculoplastic surgeons deal with this all the time, both counseling patients before surgery as to whether they are appropriate candidates and dealing with the consequences once surgery has been performed in a previously undiagnosed dry eye. You really should see an Oculoplastic surgeon to evaluate you and see whether you are a candidate for surgery, and if you are, to see if any... more

Sam Goldberger, MD

12 reviews

Beverly Hills Oculoplastic Surgeon

www.neweyelids.com

Dry eye problems with blepharoplasty surgery

You are correct that a dry eye condition can be made worse with a upper and lower eyelid blepharoplasty. It is important that you work with your ophthalmologist to determine the cause of your dry eye and improve it medically prior to considering blepharoplasty. It may be suggested that you only do one set of lids at a time. Do the uppers first followed in 3 - 4 months by the lower eyelids. All efforts should be made to keep your condition under control and avoid corneal... more

Blepharoplasty in patient with dry eye condition

Blepharoplasty is usually possible in patients with dry eye condition. In fact, a cheek lift can often reduce a patient's dry eye condition, particularly if the dry eye condition is associated with malposition of the lower eyelid, which is often corrected during a cheek lift.

Is blepharoplasty safe in someone with dry eyes?

Blepharoplasty can be safely performed in someone with dry eyes. However, the keys are to be evaluated by an ophthalmologist who can get to the bottom of your dry eyes issue before surgery and begin proper treatment of your condition if it is severe. During the procedure, I tend to be more conservative in patients who have dry eyes in order to minimize the risk of worsening the underlying dry eye problems. The best place to start would be with a dry eye consultation which would likely take... more

Roxanne, it very much depends on your dry eye.

While dry eye is not uniformly a contraindication to eyelid surgery, certain eyelid surgeries are much more damaging to the function of the eyelids than others. Unfortunately, many of these procedures are routinely performed by eyelid surgeons. It is best if you work with a surgeon who has the skills, training and equipment to assess and personally determine how your dry eye status might affect your tolerance to eyelid surgery. Unfortunately this means that general plastic... more

Kenneth D. Steinsapir, MD

8 reviews

Los Angeles Oculoplastic Surgeon

Upper and lower eyelid surgery with dry eyes.

I would not consider having dry eyes an absolute contraindication to having eyelid surgery. It sometimes is possible although the procedure may have to be altered a little. It would be important for you to first be evaluated by an ophthalmologist to determine the cause and extent of your dry eye condition. Once this is done, it could be determined if you are a candidate for eyelid surgery or not. The dry eye condition is more of an issue with the upper eyelids than... more