Question About Upper Eyelid Surgery-Blepharoplasty and Permanent Dry Eyes. Thank You!

I am reading alot on upper blephaoplasty and dry eyes. Can a person without dry eyes (never had an issue in my life/now 50 years old) end up with permanent dry eyes after this upper eyelid operation? If it can happen, so I am knowledgeable, what would have had to occur for this to happen/or what would cause this? I know through others how dry eyes are irritating, troublesome, and a nuisance. Thank You!

Doctor Answers 14

Permanent dry eyes after upper blepharoplasty

There is a very small chance, approximately 2% to 3%, that performing a blepharoplasty can make current dry eyes even drier.  Nobody really knows the mechanism, however, it is thought that removal of the orbicularis oculi muscle contributes to this.  When patients have dry eyes, we never remove a portion of the muscle during the upper blepharoplasty procedure.

Seattle Facial Plastic Surgeon
4.8 out of 5 stars 143 reviews

Yes it is possible, but unlikely.

Dry eye symptoms after blepharoplasty is common, but 95+% of patients suffer from these symptoms temporarily.

Rarely, patients that are borderline dry eye but without symptoms, may tip over to a dry eye state after surgery. As mentioned by Dr. Prendiville in a well written response, a skin only excision is an excellent technique that would maximally preserve your eyelid closure muscles [orbicularis].

A.J. Amadi, MD
Seattle Oculoplastic Surgeon
5.0 out of 5 stars 37 reviews

It's not common

Hi 77929anon

Its uncommon for someone to develop this if they have not had this before after surgery.

Commonly this can be as a result of lower eyelid surgery or damage to the tear glands which is very uncommon for an experienced surgeon. In most cases where this occurs, it tends to be transient and will recover fully.

All the best with your journey to some great results

Dry eyes after eyelid surgery

Most patients that do not have a problem with dry eyes prior to eyelid surgery will not have a problem after their procedure. Individuals that wear contact lenses or who have certain auto immune problems may be at higher risk. I suggest you discuss your concerns with your surgeon and perhaps have a test to measure the effectiveness of your tear production. If you have marginal tear production a limited approach may be beneficial.

Andrew Goldberg, MD
Fairfax Plastic Surgeon
4.7 out of 5 stars 9 reviews

Dry eyes after eyelid surgery

At your age, I would recommend an evaluation with your ophthalmologist or an oculoplastic surgeon who specializes in eyelid surgery before surgery to make sure you don't have any signs and symptoms of dry eyes as you may not be aware. Though dry eyes after eyelid surgery is usually self limiting and improves with time and artificial tears, in rare instances, patients can have significant problems afterwards: if there is weak eyelid closure, or inability to close the eyes, or undiagnosed dry eyes to name a few.

Malena Amato, MD
Austin Oculoplastic Surgeon
5.0 out of 5 stars 2 reviews

Dry Eyes Following Blepharoplasty

A 50 year old who has no symptoms has a low chance of having dry eyes as of right now. There are a host of medical conditions that can have a person develop dry eyes in their lifetime. Some simple tests in the office before your surgery can assess your tear production and help guide you as to whether or not you are at any risk for developing dry eyes in the future. Other surgical technique considerations exist but they are remote problems in experienced hands.

Paul Vanek, MD
Cleveland Plastic Surgeon
4.8 out of 5 stars 30 reviews

Dry eyes following upper eyelid surgery is a risk of the procedure

Dry eyes following upper eyelid surgery is a risk of the procedure. There are several reasons why this can occur, but some of the more common reasons includ over-resection of the eyelid skin that leads to incomplete closure of the eyelid. Also the eyelid glands will sometimes become less effective at moisturizing the eye after surgery-- this condition usually resolves on its own. Be sure to consult with a specialist in upper eyelid surgery to address all your concerns prior to surgery.

James Chan, MD
Portland Facial Plastic Surgeon
4.9 out of 5 stars 58 reviews

Dry Eyes after Upper Eyelid Surgery

    Dry eye symptoms after upper eyelid surgery are usually self-limited.  I have not seen this after surgery for any longer than about 3 weeks.  However, I usually only remove skin and perhaps the nasal fat pad, if necessary.  I do not remove any of the muscle.

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 492 reviews

Dry eyes after blepharoplasty

Patients that undergo eyelid surgery can often have temporary dry eyes or irritation; even patients with no prior history of dry eyes can have such symptoms.  It is important to have a thorough evaluation of your eyes and eyelids prior to any eyelid surgery to assess for risk factors that can place you at an increased risk for temporary or even long-term risk for having dry eyes. 

Christopher I. Zoumalan, MD, FACS
Beverly Hills Oculoplastic Surgeon
5.0 out of 5 stars 102 reviews

Dry eyes after blepharoplasty

Upper blepharoplasty, if done aggressively, can cause the eyelids not to blink well and the eyes may not close completely, thereby causing dry eyes.  It is important to be evaluated for dry eyes prior to surgery and the surgery be done conservatively by an experienced surgeon (i.e. oculoplastic surgeon).

Mehryar (Ray) Taban, MD, FACS
Beverly Hills Oculoplastic Surgeon
4.9 out of 5 stars 72 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.