Monday, January 25, 2021

After Eyelid Surgery, I Can't Close My Eyes – Help!

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Eyelid plastic surgery, also known as blepharoplasty, is normally a very safe and rewarding procedure that will leave you looking and feeling great. It is of the utmost importance that you choose a surgeon who specializes in cosmetic eyelid surgery to make sure you receive the best treatment possible. However, there is always the small possibility that something may go wrong in any surgery, and you should know what to do if you experience complications.

This is a rare problem, but a very serious one if you truly suffer from it. Temporary swelling is a normal response to surgery, and this may mean that closing your eyes takes some extra effort and your eyes are dryer than usual. If you have dry eye after eyelid surgery, be sure to use eye drops as instructed by your doctor to improve your eye irritation. Since swelling is temporary, such a problem should resolve itself soon and your lid will rapidly return to normal functionality.

After about six weeks, your post-surgery swelling should have subsided and your dry eye symptoms should abate. However, sometimes overaggressive surgery can cause long-term damage that may even worsen existing dry eye symptoms. This can happen when too much upper eyelid skin and/or muscle is removed, meaning that your eyes may not fully close at night when you are relaxed and not thinking about them. Fortunately this is a concern that can be addressed as long as you are sure to see a doctor about this problem. If you can't close your eyelids all the way whether awake or when sleeping, then it is advisable to be assessed by an ophthalmologist or a fellowship trained eyelid plastic surgeon, which is a board certified ophthalmologist specially trained in eyelid plastic surgery.

What kind of treatment do I need?

This depends on the exact nature of your problem and unique individual circumstances. It's possible that surgery damage to the same nerves that supply the muscle you use to close your eye, thus weakening your blink reflex. This can occur when skin and muscle are removed at the time of eyelid surgery. The result is that you may not be blinking with enough speed or force to completely close the eye. This means that your lids won't be able to properly move tears around your eye surface to keep it moist.

The first treatment method here is to increase eye drop frequency, and perhaps use an ophthalmic ointment depending on what your doctor prescribes. Your surgeon may recommend temporarily using a plug to close the tear drains to help keep your eyes moist. When these measures are not adequate to restore eye comfort, it is time to consider reconstructive eyelid surgery. Your original surgeon will probably be eager to resolve your concerns. When possible, we recommend that you seek assistance from your original surgeon. However, if you are no longer comfortable with your eye plastic surgeon or are concerned that your need surpasses his or her skill set, it's a good idea to seek multiple opinions.

This is especially important when your surgeon is not an eye plastic surgeon but is train in some other surgical specialty. The first task of the second opinion consultation is to determine what is the basis for the problem and if all the appropriate medical steps have been taken to improve eye comfort. You will likely have a range of options depending on the severity of your problem. In some cases, you may need eyelid reconstruction to help you fix eyelid surgery. The objective of any solution is to make the eyelids meet with ease and enable sufficient closure force to help spread tears over your corneal surface.

You Need an Experienced Oculofacial Plastic Surgeon

Your surgeon should always work with care and operate conservatively to minimize the risks of surgery complications from occurring and to ensure natural results. It's true that prevention is the best treatment, but if you're already suffering the effects of a previous overaggressive eyelid surgery, then you need a solution to reverse damage you've already incurred. Now is the time to find a doctor with a specialty, background, training, and experience in fixing eyelid surgery.

If your relationship with your surgeon has deteriorated for any reason or you are concerned about your doctor's abilities in this particular area of specialization, we urge you to exercise your best judgment and seek a second or third opinion. This is a good idea even if you have been told in the past that there is nothing wrong or nothing that can be done. There are times when it makes sense to move on to a physician who dedicates a major portion of their practice to reconstructive eyelid surgery to correct previous treatment.

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