1 Management of Complications of Aesthetic Eyelid Procedures
Summary
Complications are inevitable in any surgery. We list the common complications likely to be encountered in eyelid surgery that will be discussed in the following chapters.
1.1 Introduction
Despite the rise of injectables, which have had a profound effect on facial rejuvenation including the periorbital area, blepharoplasty remains a popular procedure. According to the annual procedural statistics compiled by the American Society for Aesthetic Plastic Surgery, blepharoplasty is the fifth most popular procedure in women and third most popular in men.
Although facial rejuvenation is no longer solely in the surgical domain, we feel that the results of surgical procedures are longer lasting and more cost effective in the long run, with results that surpass those of nonsurgical procedures. Noninvasive procedures including injectables have proven safe, effective, and, at least in the short term, less expensive than surgery. These are office procedures with minimal down time and limited morbidity. Complications related to nonsurgical procedures are included in this text.
Complications following blepharoplasty may be as minor as a noticeable scar or as devastating as visual loss or anything in between. Most of the complications in between are related to lid malposition and its consequences. Typically, the complications are obvious and clearly visible, but, occasionally, despite an acceptable or good aesthetic result, eyelid dysfunction leads to exposure problems and symptoms. Even mild alteration in eyelid position and function following surgery may result in symptoms.
Complications can occur early or late, and are either unfavorable aesthetic results or functional problems. The two categories are not mustually exclusive and may have to be dealt with simultaneously.
Complications following Blepharoplasty
Unfavorable Aesthetic Results
Unacceptable scar.
Residual skin access.
Overresection or underresection of fat.
Overresection or underresection of orbicularis oculi muscle
Changes in eye shape.
Eyelid symmetry.
Overinjection of fat.
Functional Problems
Chemosis.
Hematoma.
Exposure problems.
Infection.
Lid retraction.
Ptosis of the upper eyelid.
Muscle palsy (most commonly the inferior oblique muscle).
Loss of vision.
Paresthesias of the eyelid.
Refractive changes.
(Adapted from Nahai F, ed. The Art of Aesthetic Surgery: Principles and Techniques. 2nd ed. New York, NY: Thieme; 2010.)
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