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Pressure Dressings After Transconjuctival Blepharoplasty?

asked 3 years ago by Annabel V. in London, UK
Latest answer by William Portuese, MD
Question viewed 794 times
Tags: eyelids, healing

I am about to have lower transconjuctival Blepharoplasty with fat removal. My surgeon recommends that tight compresses should be used for at least 12 hours post-op. I have read a medical paper that recommends no pressure dressings as they increase intraorbital pressure and prevent early detection of bleeding. Any views on this? Feeling quite anxious about the surgery!

Annabel

13 answers to Pressure Dressings After Transconjuctival Blepharoplasty?

Pressure dressings

There should be no reason to use a pressure dressing underneath the eyes after lower eyelid surgery. Perhaps your surgeon just meant cold compresses, not compressive dressings per se. If bleeding should occur, it might be trapped in a tight space, or go unrecognized. This could lead to very damaging pressure on the eyeball and optic nerve. Usually doctors recommend ice, elevation, decreased activity postoperatively. Surgery should be carefully performed, to minimize bleeding. The... more

Brent Moelleken, MD
Beverly Hills Plastic Surgeon

www.drbrent.com

Not necessary.

There is no need to put pressure dressings after transconjunctival blepharoplasty. It will increase intraorbital pressure and will prevent early detection of a hematoma around the eyelids. Patients usually just wear sunglasses to hide the bruising and swelling that occurs with the procedure.

William Portuese, MD
Seattle Facial Plastic Surgeon

www.seattlefacial.com

Not appropriate

The information you have is correct. There is absolutely no use for pressure dressing in eyelid surgery. Fat removal must be done carefully to avoid any bleeding. Bleeding can lead to significant problems. So all surgeons who do eyelid surgery must be 100% sure that the field is dry at the end of the case. I have never heard of this before so I would be suspicious.

Christopher L. Hess, MD
Fairfax Plastic Surgeon

Pressure dressings have no role in eyelid surgery.

Hi! Pressure is neither effective nor safe in the eyes. The outcome is determined only by how the surgery is done. With blepharoplasty in NYC, we use cold compresses, elevating the head, and Arnica and Bromolein, to minimize bruising and sweelling.

George J. Beraka, MD
Manhattan Plastic Surgeon

Many different ways to minimize bleeding

There are many other ways to minimize bleeding around the eye other than pressure that tend to be preferred by surgeons. Some of these include: Avoidance of blood thinner medications preoperatively Good intraoperative technique and hemostasis Control of blood pressure Pain management Head elevation Ice compresses etc.

Otto Joseph Placik, MD
Chicago Plastic Surgeon

I have a difference of opinion

Having read my well-trained and experienced colleagues comments, I agree with the basics of what they have said. However, I suspect that what your surgeon may have proposed, and what I frequently do myself, is to place a moist cotton dental roll on the lower eyelids with a horizontal piece of paper tape to hold it for about 24 hours. This provides a minimal amount of pressure and seems to decrease the amount of bruising. The incision with a transconjunctival lower eyelid blepharoplasty is... more

Darrick E. Antell, MD
Manhattan Plastic Surgeon

Please cancel your surgery and find a surgeon who makes sense!

Dear Annabel There is absolutely no reason to patch the eyes after blepharoplasty. Patching will not prevent orbital bleeding after eyelid surgery but it will make it more likely that you can go blind if your suffer bleeding following surgery. A very important sign that prompts immediate post operative re-assessment by the surgeon is loss of vision after surgery. If your eyes are patched after you cosmetic eyelid surgery, you will never know if there is a problem with the vision. I... more

Kenneth D. Steinsapir, MD
Los Angeles Oculoplastic Surgeon

Definitely avoid pressure after this procedure

Swelling after a transconjunctival Blepharoplasty should be minimal and bleeding negligible so there is really no reason for a dressing. Perhaps you misunderstood the surgeon in that we always recommend ice compresses for the first 12 hours after surgery.

S. Randolph Waldman, MD
Lexington Facial Plastic Surgeon

Cancel surgery if you are anxious or uncertain about Blepharoplasty

I do transconjunctival blepharoplasty exclusively (have for 14 years--2400 cases) and have never used compression dressings. I would worry that compression could interfere with blood supply to the eyelid and also worry about the effect on intraocular pressure. I do use a small steri-strip tape support for the lower eyelid but it exerts no pressure. You sound anxious and uncertain. I recommend that you cancel your surgery until you are comfortable and confident in your doctor. Uncertainties... more

Brooke R. Seckel, MD
Boston Plastic Surgeon

www.drseckel.com

Pressure dressings ineffective for lids

Any pressure applied to the lids will get transmitted to the eyeball and surrounding soft tissue structures such as blood vessels and nerves. It would be hard to imagine enough pressure being applied to the fat compartment where the surgery takes place to stem any bleeding problem that isn't great enough to cause potential harm to the surrounding orbital structures. Post-op bleeding is controlled by meticulous intra-operative technique. Post-op swelling is best controlled by simple light... more

Robin T.W. Yuan, MD
Beverly Hills Plastic Surgeon

Compression dressings may help after Blepharoplasty

Peronsally, I do not use compression dressings but it may be a good idea to try to help reduce swelling. I think using an ice pack works better. You are correct that anything that raises intraorbital pressure after surgery could potentially affect your vision, but if you are healthy, do not have hypertension and are not in any blood thinners, you should be at minimal risk.

Samson Lee, MD
Seattle Facial Plastic Surgeon

I never use pressure dressings on eyes.

I do transconjuctival blephs all the time and have NEVER used a pressure dressing. One of the few cases of blindness I have heard of used a pressure dressing. It masks problems, I personally would not use it.

William B. Rosenblatt, MD
New York Plastic Surgeon

Transconjunctival Blepharoplasty shouldn't require pressure dressing

A well performed transconjunctival blepharoplasty should not require an external pressure dressing. The fat can be removed meticulously with excellent control of bleeding if done correctly. Any pressure on the area may also affect the globe (eye).