Does upper eyelid blepharoplasty surgery cause dry eye? Or make current dry eye much more worse?

My general eye doctor suggested me to have a blepharoplasty surgery. But I was told it could hurt tear glands and cause dry eye later. Is this true? What's the chance (%) could cause dry eye problem after surgery? Any other major side effects for the surgery?

Doctor Answers 13

Dry eye after blepharoplasty?

It is not common but certainly possible for your eyes to become "dry" at least temporarily after upper blepharoplasty (or "dryer" if you already have dry eye), but this is not because of damage to the tear-producing gland. It is more related to  weakened musculature and swelling of the eyelids related to the surgery. If done by an experience eyelid specialist, this should not be severe and should mainly be a temporary issue. Using lubricating drops prior to and after surgery will generally help with this problem (especially if you have a pre-existing dry eye problem).

An even rarer yet more extreme complication after blepharoplasty is the inability to fully close the eyes due to the excessive excision of skin (+/- muscle). This could cause a potentially dangerous "dry eye".

Your best bet is to do your homework and go to a surgeon who specializes in eyelid surgery and has done a lot of these procedures with proven results (ie, an oculoplastic surgeon).

Philadelphia Oculoplastic Surgeon
5.0 out of 5 stars 3 reviews

Dry eyes after upper bleph

To develop a permanent dry eye problem after upper lid blepharoplasty is possible, but not likely, especially if a dry eye problem was not present before the procedure.

When the incision is made for surgery it typically cuts into the orbicularis muscle which is responsible for eye closure. This disrupts the nerves that stimulate the muscle so eyelid closure is almost always weaker right after surgery.  This resolves with time, although rarely it may remain weaker.  This altered closure will result in dry eye symptoms.  Patients may require artificial tears in the early postoperative period to feel better, and in the vast majority of patients it gets better with time.

Indeed however if too much skin is removed eyelid closure will always be incomplete.  This is a far more serious problem.

Alan B. Brackup, MD, FACS
Philadelphia Oculoplastic Surgeon
5.0 out of 5 stars 22 reviews

Upper eyelids and dry eyes

Dry eyes after blepharoplasty is a potential complication. It occurs less so with upper blepharoplasty. If a patient has some dry eyes before surgery, I usually get a clearance note from an ophthalmologist  prior to proceeding with surgery to make sure its ok.

The ophthalmologist will check to see how severe the dry eye is and whats causing it. Surgery can be done conservatively to minimize the risks and optimize the results. 

Dilip D. Madnani, MD, FACS
New York Facial Plastic Surgeon
4.9 out of 5 stars 72 reviews

Dry eyes after blepharoplasty

Hello.  Upper blepharoplasty will usually cause temporary dry eyes, but this problem will resolve in vast majority of patients.  The temporary dry eye is caused by eyelid swelling that then results in lagopththalmos (a gap when you close your eyes).  Frequent use of eye drops in the initial postoperative period and lacrilube at light will help.  After complete healing, you should be fine.  Also, it's important to know that if a patient has preexisting dry eye problem, the risk of dry eyes after surgery (sometimes permanaent) may be a little higher. Your surgeon should be more conservative in patients with dry eye problems.  Other potential complications include scar irregularities, infection, bleeding; very rare complications include eye injuries resulting in double vision and blindness.  If you are serious about this surgery, then I recommend you consult an experienced surgeon and discuss the procedure in detail.  Best regards.

Kenneth Yu, MD
San Antonio Facial Plastic Surgeon
5.0 out of 5 stars 5 reviews

Dry eyes after a blepharoplasty procedure

There is a very rare chance that dry eyes can become more dry after a blepharoplasty procedure. When  surgeons know that patients have pre-existing dry eyes, they tend to be very conservative on the to amount of skin removal and  do not remove any orbicular is oculi muscle either

William Portuese, MD
Seattle Facial Plastic Surgeon
4.7 out of 5 stars 126 reviews

Dry eye

If you have dry eye to begin with, the surgery may aggravate it a bit.  Frequent use of saline drops during the healing period may help.  Best to discuss with your surgeon.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 24 reviews

Upper blepharoplasty and dry eyes

Recent studies have shown that upper eyelid blepharoplasty does not cause a dry eye.  The surgery is done above the tear glands and should not damage them.  In the early post-op period, there can be issues with dryness due to the swelling and inflammation.  This will improve as the swelling subsides and usually artificial tear drops are sufficient to help with this.  If your surgeon removes too much skin so that you can't close your eyes then you will have a dry eye.  See an oculoplastic surgeon since they specialize in eyelid surgery.  

John J. Martin, Jr., MD
Coral Gables Oculoplastic Surgeon
5.0 out of 5 stars 24 reviews

Upper lid blepharoplasty does not cause dry eye syndrome but can temporarily aggravated.

A well executed upper lid operation will not cause dry eye syndrome. Because of swelling and temporarily aberrant dear distribution it can be aggravated in the short aftermath. Lower eyelid surgery is more likely to create a problem than upper eyelid.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.9 out of 5 stars 32 reviews

Upper blepharoplasty and dry eyes

Upper blepharoplasty can cause significant problems with dry eyes if too much skin or muscle is removed.  It will often worsen dry eyes in the first few months after surgery and patients often benefit from frequent eye drop lubrication and gels at night if they are bothered by these symptoms.  Almost always this will resolve with time.  

Mark Glasgold, MD
Highland Park Facial Plastic Surgeon
4.5 out of 5 stars 39 reviews

Upper lid blepharoplasty and dry eyes

Thanks for posting your question. An upper lid blepharoplasty is very rewarding and easy to recover from. Done properly it does not cause dry eye syndrome. One may temporarily have dry eye symptoms during the acute healing time due to swelling of the lid. That is the reason why patients are instructed to use artificial tears and lubricant at night. If one already has a pre existing dry eye syndrome then a conservative bleph may be perform or perhaps not performed at all depending on what your eye doctor recommends. Tear duct injury would be highly unlikely with a skilled surgeon. 

Raymond E. Lee, MD
Orange County Facial Plastic Surgeon
5.0 out of 5 stars 71 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.