I have dry eyes. Can I go through with upper and lower blepharoplasty?

The lower blepharoplasty zal be performed from the inside of the eyes, can that be a problem or more painful? Do I have to see an optician to decide on whether I should go through upper and lower blepharoplasty?

Doctor Answers 7

Dry eyes and blepharoplasty

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Proceed with caution but can be done conservatively by an experienced surgeon. Prior to surgery the causes of the dryness should be evaluated and treated.

Sacramento Facial Plastic Surgeon

I have dry eyes. Can I go through with upper and lower blepharoplasty?

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Thank you for your question.  Dry eyes is generally considered a contraindication to having a blepharoplasty.  Removing excess skin from the upper lids can cause lid retraction and worse dryness.  The lower blepharoplasty can change the position of the lower eyelid resolving and scleral show and worsening of your dry eyes.  The transverse conjunctival technique is less risky but an inverse examination is necessary to give you proper advice.  You need to be evaluated for MPE at is morphologically prone eyes which have a higher risk of ectropion and dry eye postop.

Eyelid surgery with dry eyes

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Ii is very important to proceed with caution when undergoing a blepharoplasty with dry eyes. It's probably best to go to your physician ophthalmologist to document the extent of the dryness. It's also important not to have a strip of muscle taken from the upper lids. A conservative  upper eyelid blepharoplasty skin removal can be accomplished with minimal risk. A trans conjunctival approach for the lower lids can accomplish fat deposit removal from inside the lower-lids. For more information and many examples, please see the link and the video below

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 158 reviews

Blepharoplasty and Dry Eyes

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If you haven't already done so, you should have your eyes evaluated for dryness by an ophthalmologist (medical doctor specializing in eye diseases and surgery), or by an oculoplastic surgeon/oculofacial plastic surgeon/ophthalmic plastic surgeon. These are all names for the same ophthalmology plastic surgery subspecialty. They will use a microscope called a slit lamp to evaluate the surface of your eye for dryness. They will also perform a Schirmer's Test of baseline tear production. Additionally they will evaluate you for other conditions which may cause similar symptoms and be associated, such as blepharitis or meibomian gland dysfunction. They will then treat these conditions and maximize your eye health status. Once that's done, you can be advised by that doctor whether blepharoplasty is wise or not.

Daniel Lensink, MD
Redding Oculoplastic Surgeon
5.0 out of 5 stars 4 reviews

Eyelid surgery with dry eyes.

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Any dry eye condition is a red flag for eyelid surgery. Thought the risk can be low depending on the procedure, for some a brighter open appearance can cause more exposure and irritation. A good place to start might be with an ophthalmologist who can assess tear film adequacy and test for adequate tear production. 

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 44 reviews

Blepharoplasty and risk of dry eyes

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See an oculoplastic surgeon for evaluation of blepharoplasty.  Transconjunctival lower blepharoplasty is a very safe technique (with experienced surgeon) and it will NOT cause dry eyes.  Same holds true for conservative upper blepharoplasty.

Mehryar (Ray) Taban, MD, FACS
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 91 reviews

Opticians do not make these decisions.

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An ophthalmologist is a surgeon who graduated from medical school and then completed a residency in ophthalmology.  They can assess your dry eye and may recommend surgery or no surgery based on the severity of your dry eye.  Blepharoplasty will make dry eye worse.  For some individuals, their dry eye is so severe, blepharoplasty should not be undertaken.  This is rare.  For some individuals a very conservative blepharoplasty can be performed but this type of service is seldom performed by non-ophthalmology trained eyelid surgeons.  The key is not violating the orbicularis oculi muscle.  That means a skin only upper blepharoplasty and a transconjunctival lower blepharoplasty.

Kenneth D. Steinsapir, MD
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 26 reviews

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.