Is Blepharoplasty Safe w/ Herpes Simplex?

Question

want to undergo lower lid blepharoplasty . i suffer from recurrent herpes simplex , is it safe to undergo surgery . will stitch line develop herpes post surgery ,please clear doubts

Toby Mayer, MD · Answer

In 35 years of eyelid surgery I have never seen this. Tell your surgeon and he will give you an antiviral medication to use.

Nima Shemirani, MD · Answer

Dear anon7853,

	There are different types of herpes viruses.  Herpes simplex (or HSV) is mainly found in the lips as cold sores.  Herpes zoster (or varicella, aka the chicken pox virus) can affect any number of nerves throughout the body.  If you have simplex, it should not affect your surgery.  If you have had shingles (herpes zoster) around the eye, then this is more of an issue.  Please talk to your surgeon to come up with an effective pre-operative plan.

	Best,
	Nima Shemirani

Mehryar (Ray) Taban, MD, FACS · Answer

The short answer is it is very unlikely that herpes simplex can affect lower transconjuctival blepharoplasty.  Majority of people have herpes simplex in the body/nerves, and I have never seen a herpes simplex outbreak or related problem in patients undergoing eyelid surgery.

	Dr Taban

Kenneth D. Steinsapir, MD · Answer

Anon

	May suffer from a long term recurrent infection of the eye by the herpes simplex virus.  This is the viruses than produces cold sores that typically affect the lips.  However, it is also possible for the nerves that supply the eye to be involved.  This created a situation where recurrent bouts of herpes damage the affected cornea with scarring.  In severe cases, a corneal transplant can be necessary.  For most though, the herpes just affects the lips or base of the nose.  In either case, the stress of a facial surgery including eyelid surgery can facilitate the development of a cold sore.  Generally it is a good idea to provide prophylactic antiviral coverage after surgery to reduce the risk of a herpes break out.  In dealing with individuals with long term cornea involvement, considerations are more complex because these eyes can be significantly compromised so the wisdom of eyelid surgery must be carefully considered on a case by case basis and specific recommendation can only be make based on a detailed personal consutlation.

William Portuese, MD · Answer

It is best to have herpes simplex not present during a blepharoplasty. It is safest to not have an active breakout at the time of blepharoplasty surgery so as not to get the active herpetic simplex infection into the cornea of the eyeball.

Sam Goldberger, MD · Answer

Hi Anon. Most probably, blepharoplasty can be safely performed in recurrent herpes simplex. Does your herpes simplex affect your eyes? If so, then further examination and information would be needed. Good luck.

Steven Wallach, MD · Answer

It is more common to get a herpes outbreak form a procedure around the mouth like a peel or injectable filler. But to be safe you may want to take antivirals before the procedure to minimize the risk.

Francis R. Palmer, III, MD (retired) · Answer

Herpes outbreaks are certainly a cause for concern when performing any type of facial surgery, eye surgery or skin resurfacing. IMHO, there's always a risk that the area operated upon, in this case the eyelids, could be effected in part with the herpes simplex virus and I would recommend that my patient go on prphylaxlsis anti-viral for a week or two before and after the procedure.

Anifat Balogun, MD - Account Suspended · Answer

It is safe to undergo lower lid blepharoplasty with a history of recurrent herpes simplex. It would be unusual for lesions to develop at your incision line after surgery. 

	I recommend that you speak to your surgeon about your complete medical history and this specific concern. You will likely need to be on an antiviral regimen just before and after your surgery.

Michael Elam, MD (retired) · Answer

There should be no complications with herpes simplex and blepharoplasty. Tell your surgeon and he or she may put you on an antiviral medication like Valtrex or Zovirax. The surgeries that are most effected by herpes are lasers around the mouth and sometimes Juvederm or Restylane or other fillers in the lip area. I ask all of my patients prior to any procedure during their history and physical if they suffer from herpes simplex so that we may properly plan the course of treatment. Best regards!

Is Blepharoplasty Safe w/ Herpes Simplex?

Answers (11)

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