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Upper Blepharoplasty Despite Severe Dry Eyes?

I'm a 32 year-old male suffering from severe dry eyes, but I want to get upper Blepharoplasty done to correct very droopy lids. Is there any way this could be done, if approached carefully enough, to ensure completely that my dry eye problem will not worsen after the procedure (of course, accepting that for the first weeks it will be worse inevitably)? Any answer would be greatly appreciated.

Asked 34 months ago by Christopher111 in Toronto

Tags:

upper eyelids droopy

Dry eye syndrome and upper eyelid surgery

Patients should be carefully evaluated for the cause of their dry eye syndrome. Often this is done inconjunction with an opthalmologist and a plastic surgeon, particularly one who specializes in surgery of the face and midface. If postsurgical changes from a lower eyelid surgery are to blame for a dry eye syndrome, there may be help available from a cheeklift procedure with or without canthal reconstruction. Plastic surgeons who specialize in the midface are particularly familiar with this... more

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Brent Moelleken, MD

Beverly Hills Plastic Surgeon

ASAPS ASPS

Blepharoplasty, Eyelid Surgery, Beverly Hills Blepharoplasty

I have performed Blepharoplasty for over 20 years and severe dry eye symptoms would be an absolute contra-indication for Upper Eyelid Blepharoplasty IMO. You might consider having the severe dry eye treated first using tear duct plugs at an Opthalmologist for resolution of some of the symptoms before having Blepharoplasty.

Francis R. Palmer, III, MD

Beverly Hills Facial Plastic Surgeon

Upper blepharoplasty despite severe dry eye

If you are going to have this procedure you must consult with your opthalmologist to determine the actual severity of the problem and whether anything else might be done to improve the condition, in my opinion. Punctal plugs, Restasis, Omega 3s, and other measures are often helpful for dry eye problems. Very conservative upper blepharoplasty can often be performed, but it may be prudent not to have muscle excised, as this will slow the blink reflex for awhile and will likely aggravate the... more

Harrison C. Putman III, MD

Peoria Facial Plastic Surgeon

A canthoplasty to tighten the lower eyelid may help dry eyes prior to upper blepharoplasty

The standard accepted policy is that upper blepharoplasty should not be done in patients who have dry eyes. If your lower eyelids are lax and expose an excessive area of your eyes and is contributing to the dry eye, then a canthoplasty to tighten the lower eyelid may lessen the dry eyes and make a minor upper blepharoplasty possible. You need to see an ophthamologist, have a tear test, and get his/her opinion on the cause of your dry eyes. If you do not have adequate tear production an... more

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Brooke R. Seckel, MD

Boston Plastic Surgeon

ASAPS ASPS

Dry eyes and blepharoplasty

If your physician recommends a blepharoplasty and not a ptosis repair, your dry eyes should not be affected as long as you are able to close your eyelids after the surgery. However, you mentioned that you have "droopy" eyelids, which suggests that you might be undergoing a ptosis repair.

John Pak, MD, PhD

Chicago Oculoplastic Surgeon

Dry eyes and eyelid surgery

It would be wrong to try to correct upper eyelid looseness with a history of dry eyes. This could only further increase the tendencies for eye corneal irritation and ulcerations. A proper evaluation by a Plastic Surgeon or Opthalmologist could give you some guidance about this. Good luck. Frank Rieger M.D.

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Francis (Frank) William Rieger, MD

Tampa Plastic Surgeon

ASPS

Dry eyes can be aggravated by upper blepharoplasty surgery

It is common for plastic surgeons to ask about dry eyes when contemplating doing upper blepharoplasty surgery on patients. I do agree that it is a relative contraindication and you need to balance your desire to have the surgery with the knowledge that it may make your condition worse. A quantification of the degree of the problem should be reviewed with a Schirmers test as well as the opinion of your opthalmologist regarding having the surgery done.

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Richard Gentile, MD

Cleveland Facial Plastic Surgeon

No gurantee but...

Dry eyes is a common problem mostly in women in their late 40's and 50's. Blepharoplasty,particularly lower, can worsen the problem, especially if the have a negative vector. Upper lid bleph holds less risk as long as no lacrimal gland manipulation is done. So no 100% guarantee but it can be done without worsening your condition.

Christopher L. Hess, MD

Fairfax Plastic Surgeon

ASPS

Not possible to "ensure completely" that you won't be worse

It should be possible to perform an upper blepharoplasty without worsening your symptoms as long as lid closure isn't compromised at all. But this cannot be guaranteed unfortunately.

Richard P. Rand, MD, FACS

Seattle Plastic Surgeon

ASAPS ASPS

Dry eye is only a relative contraindication to eyelid surgery.

Dear Christopher Dry eye syndrome is very common. It is not a reason to avoid eyelid surgery unless there is an exceptional circumstance. Among eyelid surgeons, only fellowship trained eye plastic surgeons are prepared to manage a dry eye and design eyelid surgery for you that is appropriate for your degree of dry eye. Dry eye needs to be actively managed and supported following eyelid surgery. If surgery is properly done, then once the eyes are healed eye comfort should return to... more

Kenneth D. Steinsapir, MD

Los Angeles Oculoplastic Surgeon

Be careful with blepharoplasty and dry eyes

As mentioned in the previous answers it is difficult to tell whether you are to undergo a blepharoplasty or a ptosis repair. If your description of "droopy eyes" is that you have redundant skin then a blepharoplasty will help. If you have low eyelid margins ie. the whole lid is droopy then you are likely to need a ptosis repair. Both can be done with dry eyes, but caution is the rule. Be evaluated by an ophthalmologist before surgery and make sure that your surgeon is aware... more

Edward Buckingham, MD

Austin Facial Plastic Surgeon

No Guarantees!

It can be safely done, however, no one can completely assure that your dry eyes won't be exacerbated. You may want to go to an opthomologist and discuss putting in silicone plugs into the tear ducts to maximize your tears at the same time. The dry eyes are more of a problem with the lower lids, and so do not get them both done at the same time. sek