Anxiety about potential vision loss from lower blepharoplasty (Photo)

Question

I’m scheduled with an Oculoplastic surgeon (25+ yrs exp) for upper bleph and lower bleph (transconjunctival laser) with CO2 laser resurfacing. The risk of permanent vision impact (2x vision, blindness) is causing me to panic and reconsider the lowers. I’m terrified I’ll lose my vision and never forgive myself. Would love thoughts on less risky alts to treat lower fat (even if only partial improvement) and/or reassurance on safety of the scheduled procedure. I’m 44 and generally in good health.

Brian K. Machida, MD, FACS · Answer

The risk of blindness is always present but is rare in lower blepharoplasty. If you have no bleeding risk, the surgery can be done with minimal risk of blindness, especially since your doctor is oculoplastic with 25 years of experience.

Thomas Spalla, MD · Answer

While you are right to have concerns about risks of elective surgery, those risks are very low. The overall incidence of visual loss following blepharoplasty is 0.0052% (five of 100,000 cases, or one in 20,000). Permanent visual loss is 0.0033% (three in 100,000, or one in 30,000) and temporary visual loss at 0.0019% (two in 100,000, or one in 50,000). While I can't say what was responsible for these issues, I can confidently say, I've never seen a case of any of these from elective blepharoplasty. With an experienced surgeon, I would suspect the rates are even lower. I've never personally worked with a single surgeon who doesn't stress over their patient's utmost well-being and safety during surgery. Discuss your concerns with your surgeon, and let them provide you with needed reassurance.

William Portuese, MD · Answer

Vision, loss and blindness is exceedingly rare during a eyelid surgery procedure for either the upper eyelids or the lower eyelids. Based on this one photograph, you do not appear to have any wrinkles in your lower lids, and therefore you could probably just skip the laser treatment on your lower lids, which would lower your risk profile having a laser procedure next to your eye. In our practice, we remove the fat bags on the lower lids through a trans conjunctival approach on the inside of lower lids. No external incisions. are required.

Mats Hagstrom, MD (license on probation) · Answer

Complication rates need to be put in context of not the most serious complication, but rather the frequency.
The most serious complication of any surgical procedure is death.
That doesn’t happen very often for elective cosmetic surgery.
Neither does blindness.
Maybe ask yourself why you are having such high anxiety for this procedure when driving (1/10,000/year fatality) a car is so much more dangerous. 
No one has to have cosmetic surgery. In my opinion bad aesthetic outcomes are what patients should primarily be concerned about because being disfigured happens much more frequently and is in many ways preventable by being diligent about provider selection, 
Best,
Mats Hagström MD

Anxiety about potential vision loss from lower blepharoplasty (Photo)

Answers (4)

Answer: FEAR

Answer: FEAR

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Anxiety about potential vision loss from lower blepharoplasty (Photo)

Answers (4)

Answer: FEAR

Answer: FEAR

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Everything you need to know about Eyelid Surgery

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