Will Blepharoplasty Affect my Previous Lasik Surgery?

Question

I just have my Lasik done in Jan 09, currently planning for the upper blepharoplasty in May 09? It is around 4 months interval. What are the risks that I should be aware of? What is the worst complication?

Richard Baxter, MD · Answer

In general, there are no major problems with blepharoplasty after lasik. However, dry eye syndrome is beleived to be more common, particularly after lower eyelid bleph following lasik. The usual recommendation is to wait 6 months.

Andrew Miller, MD · Answer

There is a very small chance that your prescription can change ever so slightly after blepharoplasty and this is due to a change in tear film. If your eyes are dry, you want to be cautious after LASIK, because blepharoplasty too soon after can have this effect. If your eyes are well lubricated, then there shouldn't be a problem.

David Shafer, MD, FACS · Answer

You should be fine. You just need to make sure that the surgeon and the anesthesiologist are both aware that you have had LASIK surgery, so they can take extra precaution to keep your eyes lubricated and protected.

Kenneth D. Steinsapir, MD · Answer

Dear Tingmm,
Lasik causes dry eye by cutting the sensory nerves to the corneal surface when the flap is lifted. It takes time for this to resolve.
The eyelid surgery can also exacerbate dry eye. A properly done eyelid surgery will have a minimum impact on the dry eye situation. Having said that, you need a proper assessment of the condition of the eyes prior to eyelid surgery. If your cosmetic surgeon is not prepared to assess and manage the dry eye condition, you will need assessment by a general ophthalmologist which could be your refractive surgeon. The timing of the eyelid surgery should be deferred to whoever will be responsible for managing the eyes.
What it the worst that could happen is the closure of the eyelids could be compromised by the eyelid surgery in a setting where there is reduced corneal sensitivity following Lasik. This could lead to corneal break down after eyelid surgery. This can initiate a melting syndrome of the cornea, or a frank corneal ulcer which is a baterial infection. For these reasons, it is worth your while to take your time, and heal from the lasik prior to undertaking eyelid surgery and not proceed with eyelid surgery until cleared by your ophthalmologist.

Julian De Silva, MD · Answer

Blepharoplasty, helps improve the shape of the eyelids by rejuvenating their appearance. Immediately after blepharoplasty surgery the eyes may feel dry as a consequence of swelling and reduced blinking.Laser refractive surgery improves the refractive properties of the eyes, and involves making a flap in the front window (termed cornea) in the eye, followed by laser treatment, the surgery often results in some dryness immediately after the surgery and contact lenses are often placed over the eyes to aid recovery in the short-term period.Although blepharoplasty is surgery on the eyelid only and there is no surgery on the eye itself, both the different techniques can lead to dryness immediately after the procedure. I recommend that they are completed a minimum of 6 weeks to 3 months interval between the different procedures.

Hisham Seify, MD, PhD, FACS · Answer

Lasik surgery could increase your chances of having dry eye syndrome if you undergo lower lid surgery.  If you have no symptoms of dryness now you should be fine with an upper bleph. Make sure you inform your plastic surgeon regarding the lasik surgery.More conservative skin removal is always safer in this case.

Kenneth R. Francis, MD, FACS · Answer

Lasik surgery will cause your cornea to dry somewhat. It takes several months to heal and return to your normal tear film. Follow up with your Lasik surgeon for a clearance to proceed with blepharoplasty. Good luck!

Christopher L. Hess, MD · Answer

Dry eye syndrome is a common problem that can occur.  It is more common in women who are in their 40's or 50's, pleople who have a negative vector (ask your surgeon what that means), and after lower lid bleph.
So go ahead but get all of your questions answered by your surgeon.

George J. Beraka, MD (retired) · Answer

Hi.
In New York City, we have done a number of  blepharoplasty in patients who had previous Lasik surgery, and we have not had any problems.  But check with your ophthalmologist.

Brooke R. Seckel, MD, FACS (retired) · Answer

In my opinion it is safe to have upper blepharoplasty 5 months after Lasik surgery.
I am careful to not over resect or remove too much upper eyelid skin to be certain that the patient will have good eye closure after upper blepharoplasty in order to maintain adequate moisture of the eye and cornea.
All experienced eyelid surgeons are aware of this issue and take great care to protect the cornea with scleral shields and do conservative upper eyelid skin resection especially in Lasik patients who have had laser modification of the cornea.
Find a board certified plastic surgeon who is experienced in eyelid surgery and openly discuss your concerns. With an experienced eyelid surgeon you should be fine.

Will Blepharoplasty Affect my Previous Lasik Surgery?

Answers (11)

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