Please Give me Advice: Blepharoplasty (photo)

I am planning to have blep on my upper eyelids but want to know the risks beforehand... A surgeon told me there is no risk of going blind because of the anatomy of the eye this can only occur from lower blep..... Is this true?

Also please tell me can I have it done without going to sleep I am very scared of being put to sleep never been under anesthesia, thanks

Doctor Answers 20

Please Give me Advice: Blepharoplasty

Upper eyelid surgery is easily accomplished with local anesthesia and is quite safe. Having said that I would strongly discourage you from undergoing the procedure. Your eyes are extremely attractive as they are and I think you have much more to lose than to gain with surgery.

Portland Plastic Surgeon
5.0 out of 5 stars 27 reviews

Is an Upper Blepharoplasty necessary?

As plastic surgeons, we only want to perform surgery when the benefit of surgery outweighs the risks.  Your photos show you to be a very attractive and youthful woman.  So I don't immediately see the "benefit" of doing a blepharoplasty on you.  Is it for asymmetry of the upper eyelid folds?  If so, that is a fairly easy procedure to perform under local anesthesia.  Blindness is an extremely rare complication of blepharoplasty surgery due to a retrobulbar hematoma.  This can be associated with either upper or lower bleph.  The real risk in this procedure, is whether the mild improvement in an already beautiful lid will satisfy you.  I would strongly recommend discussing this with your physician.

Gilbert Lee, MD
San Diego Plastic Surgeon
4.8 out of 5 stars 22 reviews

Upper Blepharplasty Advice

Since you have no indications for upper eyelid surgery, I would advise you not to do it.  Aesthetic facial plastic surgery is designed to address aging changes or anatomical findings that can be improved with surgery. Since you will not have improvement with surgery, upper eyelid Blepharoplasty is actually contraindicated. Blindness is an exceedingly rare complication from upper eyelid Blepharoplasty; the incidence per year in this country is probably close to zero. I have never seen it or heard about case reports in training or in practice.

Stephen Prendiville, MD
Fort Myers Facial Plastic Surgeon
4.8 out of 5 stars 93 reviews

Blindness is not a concern.

Though there have been reported cases of blindness from blepharoplasty, the risk is essentially zero when only skin is removed, which is usually the case.

Blepharoplasty is very commonly performed under only local anesthesia very safely.

Having alleviated your concerns, I tend to agree, that based on your photos, you currently do not have a need for upper blepharoplasty. Your eyes are very natural and youthful appearing, and you do not want to hollow your eyes at such an early age.

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

Risk of Upper Eyelid Surgery or Blepharoplasty

All surgery has some risk. Upper eyelid surgery risk includes but not limited to asymmetry, dry eyes, scarring, bleeding, or infection. Fortunately, these risks are low. The risk of blindness, while theoretically possible, is essentially unheard of. Upper eyelid surgery may also be performed via local anesthesia, in the office while you are awake. Selection of the anesthesia type is based on the procedure, surgeon, and patient. Based on the photographs provided, I don't think you need blepharoplasty. Eyelid plastic surgery is not appropriate for you at this time. Only after a comprehensive evaluation can a plastic surgeon help determine appropriate options for you. Best of luck.


Dr. Chaboki

Houtan Chaboki, MD
Washington DC Facial Plastic Surgeon
4.9 out of 5 stars 85 reviews

Upper bleph not needed.

I agree with all of the other surgeons' comments in that you do not appear to need an upper bleph and risks are usually very limited.


If you desire a little lift of the brow to open the eye, some neuromodulator like Botox, Dysport would give a few millimeters lift without surgery.

Brian J. Lee, MD
Fort Wayne Plastic Surgeon
5.0 out of 5 stars 12 reviews

Your potential surgeon is either ignorant or being intentionally deceptive.

The risk of going blind as a result of cosmetic eyelid surgery is approximately one case in 30,000.  Rare but definitely not zero.  Upper eyelid surgery can result in vision threatening hemorrhage just as is associated with lower eyelid surgery.

Surgeons who perform cosmetic eyelid surgery under general anesthesia do so at a significant disadvantage to themselves and their patients.  This is especially so for the upper eyelid because having the patient open and close the eyes during surgery created an opportunity to fine tune the surgery by assessing the effects of surgery in real time.  Upper eyelid surgery can be very comfortably performed under local anesthesia or light intravenous sedation.

I noticed that a couple of respondents to this question state that you don't need eyelid surgery.  The truth is that it is hard to precisely know why you need eyelid surgery without a personal consultation.  Your  photos suggest bilateral brow ptosis which will not be benefited by upper eyelid surgery.  However, you also manifest subtle bilateral upper eyelid ptosis and this could be improved by a very precise anchor blepharoplasty.  Please understand that this type of upper eyelid surgery must be performed under local anesthesia so that you can open and close the eyes during surgery.

I recommend that weight the small risk of having eyelid surgery before you decide if it is right for you.   You should seek additional consultations and avoid eyelid surgery under general anesthesia.

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

Blepharoplasty under Local Anesthesia

Blepharoplasty can be done under local anesthesia. General is not necessary unless a patient is anxious. Blindness is a very rare risk, and would be unlikely with an upper lid blepharoplasty that is confined to skin and muscle only. It is thought to be related to bleeding deeper in the orbit. Although blepharoplasty in general is a safe operation, it is subject to complications, and because your eyes look normal, there is no reason for you to have the operation.  It is unclear what benefit it could give you.

Robert M. Lowen, MD
Mountain View Plastic Surgeon
5.0 out of 5 stars 48 reviews

Blepharoplasty Advice

In looking at your photographs you appear to have a youthful appearance to your eyes and do not appear to need any eyelid surgery.  Eyelid surgery can be done using local anesthesia with sedation and general anesthesia can be avoided.  The risk of blindness following eyelid surgery is due to the risk of a retro-orbital hematoma (bleeding behind the eye) and this can occur with either upper or lower eyelid surgery.

Michael Sundine, MD
Orange County Plastic Surgeon
5.0 out of 5 stars 18 reviews

Eyelid surgery, anesthesia & precautions.

It is healthy to have a concern about any surgery and anesthesia. These are not casual decisions for the patient or the surgeon. When considering upper eyelid surgery, this often can be performed under local anesthesia perhaps supplemented with some oral Valium (diazepam) or similar relaxant which can be taken before we even begin. But even when sedation or other deeper anesthesia is utilized, these are considered very safe in a healthy person when performed by a well -trained board certified anesthesiologist or anesthetist.  Vital signs are carefully monitored throughout the procedure.  However, not every patient who requests surgery, including upper blepharoplasty surgery, is suitable for this procedure. When eyes are already attractive it would be foolhardy to try to improve on what Mother Nature has already provided!  :)

Donn R. Chatham, MD
Louisville Facial Plastic Surgeon
5.0 out of 5 stars 69 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.