Cosmetic blepharoplasty is currently the most commonly performed surgical procedure on the face in the United States. Most of the time, eyelid surgery (blepharoplasty) successfully removes puffs and excess skin, and when necessary, addresses drooping of the eyelids and cleans up the eyelid creases. It can be done on both the upper and lower eyelids. Once healed, it instantaneously rejuvenates appearance.
The surgery is performed by plastic surgeons, facial plastic surgeons, eye plastic surgeons, dermatologists, and cosmetic surgeons—and others. Eye plastic surgeons generally are the surgeons that are called upon to address issues related to undesirable outcomes.
While the majority of these procedures go beautifully, in our practice we see a fair number of patients — locally –and from across the country– whose surgery has been “unsuccessful” leaving the patient with a botched eyelid surgery.
Unsuccessful eyelid surgery can range from the preparation that precedes the surgery, to the small details that are neglected at the time of the original work, to healing issues in the postoperative period.
What are the signs of a botched eyelid surgery?
We commonly see the following problems in our practice:
- Dry irritated eyes from over aggressive removal of upper eyelid skin
- Dry, irritated eyes that are pulled down from over aggressive removal of lower eyelid skin or postoperative scarring.
- Decreased blinking or inability to close the eyes completely with the need for continual instillation of artificial tears.
- Overexcision of fat pockets—patients are too hollow
- Underexcision of fat pockets—residual puffs are still there
- Drooping upper eyelids that went either undiagnosed, untreated, or were injured at the time of the surgery because of failure to recognize the deep anatomy of the eyelids
- Irregularities of the upper eyelid crease
- Changes in skin color
- Lump, bumps, and residual excesses of skin
- A persistent appearance of bruising
- Failure of the original surgeon to recognize adjacent aesthetic eyelid issues such as drooping of the brows or cheeks.
Botched surgery can also be surgery that provided you with an unexpected change in your appearance. For example, you might emerge from your surgery looking hollow and cadaver-like—overhollowed. Or you might have a pulling down of the lower eyelids that makes you look sad or puppy-like.
Is a botched eyelid surgery my fault?
When untoward outcomes occur, a surgeon can blame it on your healing –– shifting the blame to you. Sometimes this is valid, as when a patient fails to heed instructions and takes the wrong medications or is overly active in the immediate postoperative period—or, against our advice, sleeps with their dog and gets an infection. We all heal differently. In fact, in the postoperative period, most patients will experience some of the issues mentioned above, but they are transient. If the problems remain, then your surgeon should develop a plan with you for how to address your issues from a management and a timing standpoint.
But a lot of times, blaming it on the way you healed is a cop-out on the part of the surgeon. I just saw a patient who was told by her surgeon—in front of her family—that the reason her surgery failed on three separate occasions was because she was Italian!
Your surgeon needs to enlist you in your postoperative care, whether this means doing massage, going for injections, or undergoing healing light or laser treatments. You need to be compliant with instructions because while the surgeon and the surgery itself is important, you are critical to the recovery process.
Seeing another specialist can often also help the original surgeon develop a plan.
So, can my botched eyelid surgery be fixed?
In our practice, we have experience treating all the above complications and have lectured and have presented nationally on how to avoid, recognize, and treat complications. We’ve developed techniques for treating botched blepharoplasty eyelid surgery that are now commonly employed.
Rest assured that virtually all the complications listed above can be addressed in the right hands!