If you have done your research and chosen a reputable doctor who specializes in oculofacial plastic surgery, you are likely to achieve satisfactory results. While it is true that you should not fear having surgery performed by a qualified professional, it is also true that sometimes there are complications, and if you are the unfortunate one experiencing complications, you need help soon.
The best doctors not only know how to give you great surgical results, they also know how to correct complications should they arise. Occasionally, complications from the surgery may arise, requiring correction beyond the skill of the original surgeon, or the doctor-patient relationship may break down, and this is when you need to seek a second opinion. Fortunately, these circumstances are unusual.
Do I need help right away?
Many people are naturally concerned about how their surgery will heal when in reality things will be fine. This is the case for most anxious patients, as we discussed in a recent post. However, everyone must admit that sometimes something can go wrong, as in any medical procedure and even in any professional field. It is important to understand that these are the times when you need your surgeon the most. Don’t wait for your next appointment. Call your surgeon. If you feel like you are having a true emergency, go to an emergency room or call 911. Someone may call your surgeon later to let them know what is happening. It is much better to be seen for something that turns out not to be serious than to miss something important. A skilled doctor should know how to respond in such unusual situations, and fortunately such doctors are available. The key is to handle the situation with grace, speed and efficiency.
After blepharoplasty surgery, these conditions are not normal:
1. Bleeding. In general, any bleeding should cause concern. While it doesn’t take a lot of blood to look like a lot, it’s not normal to have any visible bleeding after surgery. It can be caused by a number of reasons, most commonly activity after surgery. If you experience this, call your surgeon, discuss the situation, and follow their instructions.
2. A bruise that expands on the eyelids. This is usually a sign that you are bleeding inside the eyelid where the surgery was done. Again, this is rare but needs immediate attention. Call your surgeon immediately. If you have any trouble contacting the surgeon, go to an emergency room, especially if there is pain and vision changes.
3. Pain that is not relieved by pain relievers prescribed for use after surgery. The most common reason this might happen is deciding that you don’t really need to take pain medicine after surgery. Then hours later it’s all gone and no wonder it hurts. At this point, it can take literally two hours for oral pain relievers to return you to a pain-free state. While the truth is that many patients actually feel comfortable after surgery without medication, but never one. This is perhaps one of the most common reasons patients call after surgery. However, there are situations after surgery where pain occurs even with prescribed medications or days after surgery when there should be no pain. Bread is a very important sign. It may represent a lack of pain medication right after surgery, an expanding bruise, or days later the first symptoms of an infection. Share your concerns with your surgeon and pick up the phone.
4. Loss of vision. Bleeding behind the eyes can cause permanent vision loss. This is uncommon, estimated to occur in 1 in 300,000 eyelid cases. Quick steps can save vision. But immediate attention is necessary. Call your surgeon immediately or 911.
5. New pain, swelling, and redness in the surgical area two or more days after surgery. These may be signs of an early infection. Again, don’t wait for your next visit. Call your surgeon to discuss the situation.
Concerns that are significant but not as urgent
It is normal to experience some bruising and swelling during the healing process, but on rare occasions this can be serious and affect the outcome. Severe bruising can lead to excessive swelling, which can stretch the eyelid as it heals and alter the final results. Your doctor can help you understand what kind of bruising is expected and what kind is excessive.
If your eyes look droopy or heavy after surgery, you are experiencing one of the most common complications of surgery called ptosis or blepharoptosis which occurs when the tendon of the upper eyelid slips. This can happen if it is cut during surgery, but sometimes it can happen on its own and the effect is intensified by severe swelling. It is very common for the upper eyelids to feel heavy after surgery due to swelling. This does not mean that your surgery is a failure. Most commonly, this heaviness resolves over a period of several weeks, allowing the lid to return to its proper height without intervention. In some cases, the swelling can take a long time to go away. For this reason, it’s usually a good idea to simply give the eyelid time to heal. If the heaviness does not resolve in a period of 6 to 12 months, corrective surgery is appropriate. Although you may only notice heaviness in one eye, reconstructive surgery may be needed in both eyes. The eye plastic surgeon will closely evaluate you for subtle ptosis of the other eye to determine the best method to correct the eyelids.
Some cosmetic surgery textbooks instruct medical students to place the upper lid crease too high, and through no fault of their own, some new practitioners may erroneously follow this advice that they could only have known to avoid through further experience. A crease is usually easy to raise, but one that is too high can be difficult to lower and requires the most careful and experienced care to resolve through further surgery. It is best to avoid this situation by finding a doctor who understands that the crease is commonly placed too high, but if you are reading this now because it is too late and you are not satisfied with your surgery, then it is a good idea to seek another doctor’s opinion. who can discuss with you the best course of action.
Other complications that can arise are loose skin that does not hold makeup or drooping eyelashes. These problems can be resolved by properly tightening the skin and adjusting the amount of skin present. This procedure is called tethering blepharoplasty and can be performed under local anesthesia in the office. Sometimes the eyebrows seem to droop after upper eyelid surgery. When told about the possibility before surgery, this is an expected effect. The result may be satisfactory, or a forehead lift may be necessary to reposition the brows. It’s post-operative surprises that can erode trust in your surgeon. An experienced surgeon anticipates these types of problems and informs you in advance. He or she can help you decide if brow treatment is needed instead of or in conjunction with additional eyelid surgery.
It is much easier to correct an underperforming cosmetic surgery than it is to undo an overly aggressive one. One does not need to be tight to have a great surgical result. Think about it, when was the last time you saw a model looking like she stuck her head in a wind tunnel? By optimizing the surgical plan, it is possible to obtain extremely natural results that give no indication that they were achieved by cosmetic surgery.
If your friends and loved ones think you look worse, or you’re just not happy with the results, or don’t trust your current doctor, you should seek a second opinion from someone who specializes in correcting previous surgeries. At best, the doctor can reassure you that things are going well, or repair your relationship with your former surgeon. If early action needs to be taken to correct a problem, a consultation with another doctor can help you decide what to do.
