Is Upper and Lower Eye Lid Surgery Dangerous for a Person Who Has a Dry Eye Condition and High Blood Pressure?

The plastic surgeon needs to be careful not to remove too much skin and risk incomplete eyelid closure.  Experienced plastic surgeons do this anyway.  So dry eyes itself is not necessarily a deal-breaker.  Your blood pressure should be controlled with medication (if it is not then getting it lowered should be your first priority), so it is not necessarily a problem either.  I've attached a link to this part of my website in case you want to read more.

As long as blood pressure is under control, eyelid surgery is safe.  Conservative blepharoplasty should not make the eyes more dry but ptosis surgery can.  Please see an oculoplastic surgeon if you have any of these problems.

It is not dangerous to do a conservative blepharoplasty in patients with dry eyes. Most patients are already on eye drops such as Restasis. It is important for them to know that surgery might cause worsening of the dryness and they might have to use their eye drops more frequently.

Blood pressure is not an issue as long as it is well controlled by medication.

Regards

Dr. J

Disclaimer: This answer is not intended to give a medical opinion and does not substitute for medical advice. The information presented in this posting is for patients’ education only. As always, I encourage you to see your personal physician for further evaluation of your individual case.

1. High blood pressure:  It depends on how high the blood pressure is. People with high blood pressure are at slightly higher risk for bleeding. With surgery around the eyes, this can be dangerous because it could compromise your vision. You doctor needs to know how high your blood pressure is, how well controlled it is with medication or otherwise.

It is not an absolute contraindication to surgery, but certainly needs to be looked into.

 

2. Dry eyes:  An Oculoplastics surgeon is both an Ophthalmologist and a cosmetic surgeon that specializes in facial surgery as it pertains to the eyes, so your best bet is to be evaluated by on an Oculoplastics surgeon that will determine your risk.

Again depending on the degree of dry eye, your may or may not be a candidate for surgery, and there are certain techniques of surgery that may minimize the risks of exacerbating dry eye [i.e., transconjunctival lower bleph, skin only upper bleph, etc]

 

Every patient is different in terms of their symptoms and potential risks, and even then different patients have different levels of risk accepting behaviour.







If you decide to explore this further, I would recommend consultation with an ASOPRS trained Oculoplastics surgeon. You can find one close to you on the ASOPRS dot org website.

First, I'll address your question in regards to high blood pressure.  Having high blood pressure would not necessarily make it impossible or even more dangerous to have upper and/or lower eyelid surgery.  There are a few factors involved, such as the cause of the high blood pressure, whether it's being treated or not, and how high it is.  Your overall medical condition would also be important.  You would need to have a medical evaluation to determine if it would be safe to proceed with any blepharoplasty surgery with your high blood pressure.  

In regards to the dry eye problem, you would need to see an ophthalmologist to have this evaluated before having your eyelid surgery.  It is actually the upper eyelid portion of the surgery that would mainly be the issue with dry eyes.  The eye evaluation would be necessary to determine if you would be able to have the eyelid surgery.   

Before performing blepharoplasty I always ask my patients about a history of dry eyes. This is important because if the patient is requesting an aggressive  upper eyelid skin removal, a condition called lagopthalmos resulting in worse dry eyes may occur.  Since many middle aged or older patients seeking eyelid surgery already have minor dry eye problems they are told blepharoplasty might worsen their condition. In reality this rarely occurs. Hypertension is a common medical condition that could certainly contribute to excessive bleeding during or after surgery. As long as it is well controlled on medication, it's not dangerous for these patients to have blepharoplasty.

If you suffer from dry eye syndrome, eyelid surgery could be dangerous, especially the upper lid if too much skin and muscle are removed. The eye may not close completely. Lower lid surgery, if overdone can create a problem of scleral show or worse ectropion with the same result. A very experienced plastic surgeon may be willing to discuss your options. As far as your blood pressure is concerned, your internal or family doctor would need to clear you for surgery.

 The reality is that Eyelid Surgery whether upper/lower or both surely won't make your dry eye better and could make it worse.  High blood pressure places you at increased risk of post-op bleeding that can place pressure on the optic nerve if it occurs in upper eyelid surgery.  Hope this helps.