Karan Chopra™ M.D.

Common blepharoplasty
mistakes surgeons make
with eyelid surgery


The eyes are usually one of the first areas in the face to show signs of aging with the appearance of droopy or sagging skin. The eyes are also very important when it comes to non-verbal communication. These natural signs of aging can easily make your face have a constant look of fatigue, exhaustion, and sadness even when you aren’t trying to convey these emotions at all. If you’re searching for long-term solutions for aging around the eyes, you might want to look into blepharoplasty or eyelid lift surgery. Eyelid Surgery is a very delicate operation and you will want to do everything possible to avoid Blepharoplasty mistakes.

A talented and experienced Miami plastic surgeon, such as Dr. Karan Chopra, will consider your eye structure and specific aging concerns to give you the best blepharoplasty experience and meet your aesthetic expectations post-operation.

What is Blepharoplasty?

Blepharoplasty focuses on removing excess skin and sometimes fat from the eyelids to get rid of droopy eyelids, large eye bags, and the peripheral vision problems that this excess skin and fat may cause. Blepharoplasty is a surgical procedure that focuses on the eyes and their surroundings and this surgery should be carried out by delicate and experienced hands.

Blepharoplasty is a type of surgical procedure performed on the eyelids to remove excess skin and sometimes, fat from the eyelids. Blepharoplasty, which is mostly done for cosmetic purposes, will help improve the appearance of your eyelids by eliminating droopy or sagging eyelids. Blepharoplasty can also help to improve vision problems in older individuals caused by extremely sagging eyelid

Blepharoplasty is usually considered by individuals who wish to:

Lift and correct sagging upper eyelid skin;
Eliminate excess skin around the eyelids causing eye wrinkles, and droopiness;
Reduce and improve the appearance of eye bags and dark circles under the eyes.

Blepharoplasty will only improve the appearance of your eyelids and will not affect other facial wrinkles or make any difference to your eyebrows. Depending on your needs and aesthetic expectations, blepharoplasty surgery can be carried out with other similar procedures. These procedures may include:

Skin resurfacing techniques;
A forehead lift;
Facelift or mini facelift.

Four Blepharoplasty Mistakes – What are the Biggest Mistakes Surgeons can make with Eyelid Surgery?

Before you carry on with blepharoplasty surgery, it is important to understand that this procedure is complex. Blepharoplasty deals with the eyes and the structures surrounding them, so an unskilled or inexperienced surgeon can make mistakes.

Blepharoplasty mistakes1

1.  Inability to Fully Close Your Eyes Afterwards

The inability to fully close your eyes, also known as lagophthalmos, after blepharoplasty surgery is probably the most concerning and problematic complication of this procedure. The skin of the eyelid, which is the thinnest skin in the entire body, is extremely delicate and requires a high level of skill. The occurrence of lagophthalmos after blepharoplasty surgery is mostly caused by the removal of too much skin from the eyelid.

The inability to fully close your eyes after blepharoplasty surgery can also be caused by damage to the nerves of the eyelid that are responsible for their opening and closing. Other causes of lagophthalmos after blepharoplasty may include:

Failure to address preoperative eyelid laxity (looseness of the eyelid) before the surgery;
Incisions made in the wrong places;
Deeper tissue scarring;
Damage to the orbicularis oculi, the muscle which is responsible for opening and closing the eyelids.

Lack of full eyelid closure after blepharoplasty surgery can increase the risk of irritation in your cornea due to its constant exposure. Lagophthalmos after blepharoplasty also tends to be very challenging and uncomfortable as your eyes may constantly feel dry and irritated.

In some cases, the patients can close their eyes after their eyelids have healed completely but in other extreme cases, lagophthalmos after blepharoplasty persists even after the eyelids have healed. In these extreme cases, you may have to undergo additional surgery to help address this concern. While you wait for your eyelids to heal completely and possibly achieve full eye closure, it is important to protect your eyes with lubricating eye drops and ointments recommended by your surgeon.

2. Significant Asymmetry

The appearance of asymmetrical eyelids is another mistake that can occur after blepharoplasty surgery. This mistake is more common when the surgery is carried out by a plastic surgeon that lacks enough experience and skill required for the procedure. It is important to note that every single individual has a form of facial asymmetry and that is completely normal. However, significant eyelid asymmetry after blepharoplasty surgery is often caused by the failure of the surgeon to properly carry out the necessary eyelid measurements before the surgery.  Inaccurate eyelid measurements before surgery can cause incisions to be placed in the wrong locations, ultimately leading to significant asymmetry post-operation.

In some cases, significant asymmetry after blepharoplasty surgery is temporary and your eyelids may return to their normal positions after they have healed completely. Temporary asymmetry of the eyelids after surgery can be caused by over-excitement of your eyelid tissues during the procedure or can simply be due to your eye’s natural reaction to the surgery. You should consult your plastic surgeon if you notice any form of facial asymmetry that wasn’t there before your operation. Your surgeon may ask you to wait for about 6-12 months for observation before considering any other procedure to fix the asymmetry. This time frame will give your eyelids enough time to heal and return to their original positions if the asymmetry was temporary and brought about by natural causes. Revision blepharoplasty might be recommended in cases where the eyelids fail to return to their original positions after complete healing.

3. Excessive Scarring and Bruising

While excessive scarring and bruising after blepharoplasty surgery is a very valid concern, this issue does not necessarily imply the work of a poorly skilled surgeon. Everyone’s body has its own reaction to different kinds of surgery and you might be among those who bruise more easily than others. However, excessive scarring and bruising after blepharoplasty surgery can be reduced or avoided if your plastic surgeon has enough experience to work with your specific skin type. Individuals with skin types that bruise easily should seek out highly skilled and experienced plastic surgeons with delicate techniques, such as Dr. Karan Chopra, as the more aggressive and inexperienced surgeons will ultimately cause excessive bruising and unnecessary scarring even without trying. You can try to determine how skilled and experienced your plastic surgeon is by checking out the before and after pictures of their previous patients.

In most cases, the bruising after blepharoplasty surgery will clear out on its own after a while. Excessive bruising, however, may extend your general recovery time and leave you with unsatisfactory aesthetic results.

Depending on the extent of your scarring, you may be able to improve its appearance by applying scar creams or vitamin E to your incision site. In extreme cases of scarring after blepharoplasty surgery, a scar revision surgery might be the only solution. You will have to wait for a minimum of 6 months before considering a scar revision surgery to give your eyelids enough time to heal.

4. Excessive Fat Removal

Although blepharoplasty surgery generally involves the removal of excess skin and fat from the eyelids to improve their appearance, a plastic surgeon can take too much fat from the eyelids. Taking out way too much fat during blepharoplasty surgery is a common mistake among inexperienced surgeons and this error can cause your eyelids to have a hollowed or sunken appearance. Excessive fat removal during blepharoplasty will instantly create unnatural depressions to form in your eyelids, leaving you with a very aged appearance and reversing any form of progress you might have had with your facial rejuvenation journey.

Correcting the excessive removal of fat from your eyelids is very unpredictable and can be difficult in some cases. Some plastic surgeons may decide to use a specific filler to restore volume to the eyelids and give them a more youthful appearance. Other surgeons may recommend revision eyelid surgery that involves fat grafting to the area where excess fat has been removed to restore a more natural soft tissue volume. Regardless of the correctional procedure you decide to go for, you should remember to get a second opinion from an experienced surgeon who specializes in correcting this problem.

What are the Risks and Possible Complications of Blepharoplasty surgery that can be caused by Blepharoplasty mistakes?

Scarring after blepharoplasty

Regardless of the skill and experience of your plastic surgeon, you should note that there are some risks and possible complications that may arise after your blepharoplasty surgery. Although these complications and unfavorable results from blepharoplasty are rare, it is still important to have them in mind before you proceed with the surgery.

  • Dry eyes and abnormal discoloration of the eyelids;
  • Numbness of the eyelashes and eyelids;
  • Sensitivity to bright light;
  • Difficulty in closing the eyes completely;
  • Loss of vision which may or may not be temporary;
  • Bleeding from the incision site;
  • Infection in the incision site;
  • Swelling and bruising around the eyes;
  • Need for revision surgery;
  • Consistent pain around the eyes even after complete healing of the incision site;
  • Unfavorable scarring;
  • Reaction to anesthesia;
    Lid lag, a static condition that causes the upper eyelid to be higher than normal when looking down;
  • Ectropion, a condition that causes the lower eyelids to turn outwards and droop away from the eyes.

What is Revision Blepharoplasty?

Revision blepharoplasty also referred to as revision eyelid surgery, is a secondary blepharoplasty procedure carried out to correct or improve on any complications or mistakes that may have occurred during or after an initial blepharoplasty surgery. Revision blepharoplasty may be recommended to patients who are unsatisfied with the results of their initial blepharoplasty procedure.

Revision eyelid surgery can be carried out to correct several mistakes and complications from your initial surgery including lagophthalmos, lower eyelid retraction, sunken eye appearance, significant asymmetry, dry eyes, eye irritation, and excessive scarring.


Blepharoplasty mistakes

How long should I wait after my initial blepharoplasty surgery before considering a revision surgery?

You should wait for about 6 months to a year before considering a revision eyelid surgery. This is because some of your concerns may be temporary and can improve on their own after a while. You do not want to take your body through the stress of another surgery for a minor blepharoplasty side effect that would have improved on its own. It is also advisable to wait for this time frame so that your eyelids and the incision sites can heal properly before any other correctional procedure.


Is revision eyelid surgery a safe procedure?

Revision eyelid surgery is a safe procedure when carried out by a highly skilled plastic surgeon with enough experience in revision blepharoplasty to rectify any blepharoplasty mistakes. The skin of the eyelid is very thin and delicate and so, every revision surgery in that area should be carried out with care and attention.


Does revision blepharoplasty cause additional scarring?

Depending on the issue you wish to correct and the extent of the scarring after your initial surgery, a revision eyelid surgery might cause additional scarring. However, a highly experienced surgeon, like Dr. Karan Chopra will work with your previous scars and specific issues to give you the best possible result.


Should I expect some bruising and swelling after my revision eyelid surgery?

It is normal to experience moderate bruising and swelling after a revision eyelid surgery.


How long do I need to stay in the hospital after my revision eyelid surgery?

Under normal circumstances, you should be able to go home a few hours after the surgery. It is recommended that you have someone pick you up from the hospital after the procedure and assist you in your daily activities for a few days.

Further Reading about Facial Plastic
Surgery Procedures

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