Complications in blepharoplasty: how to avoid and manage them

Abstract

Complications in blepharoplasty are uncommon and, when they occur, they are usually mild and transient, such as hematomas and chemosis. However, sometimes they can be severe, such as blindness, or they might require surgical correction, such as ectropion.

Objective: To evaluate the results and complications of transcutaneous blepharoplasty performed in the same procedure, discussing how to treat and how to avoid them.

Methods: A retrospective study of 200 medical records of consecutive patients that underwent transcutaneous blepharoplasty from January 2007 to January 2009. The variables analyzed were age, gender, complications, clinical outcome, patient satisfaction, and photographic documentation.

Results: The incidence of complications was 9.5% (19 patients). The complications were 1 hematoma, 12 cases of chemosis and 13 patients who underwent canthoplasty, 6 patients with malposition of the lower eyelid (5 retractions and 1 ectropion). Medical treatment was performed in 12 patients and revision surgery in 7 cases of all the patients who had complications.

Conclusions: We demonstrated that blepharoplasty is a procedure with a high satisfaction and a low complication rate, and it is an excellent surgical procedure, when properly indicated.

Graph 1

Graph showing the distribution of the main complications happened to patients submitted to blepharoplasty.

Figure 1

Patient with bilateral chemosis after blepharoplasty with canthoplasty.

Figure 2

Patient with left lower eyelid malpositioning after blepharoplasty caused by retraction.

Figure 3

Patient with left lower eyelid malpositioning after blepharoplasty caused by retraction.

Figure 4

Patient with lower eyelid malpositioning after blepharoplasty caused by ectropion. Below: postoperative picture after correction by means of canthoplasty with the tarsal strip and skin grafting.