What is blepharoplasty?

Blepharoplasty is a type of cosmetic surgery that focuses on the eyelids. It aims to remove excess skin, fat or muscle from the upper and/or lower eyelids. This procedure can be performed for medical reasons such as correcting impaired vision or for cosmetic purposes, such as rejuvenating the eye area.

There are two main types:

• Upper eyelid surgery, which removes excess skin that may be hanging over the lashes or affecting the visual field.
• Lower eyelid surgery, which typically targets puffiness, sagging or dark circles under the eyes.

Blepharoplasty surgery can also be combined with procedures such as a brow lift or skin tightening treatments. It is essential that the surgical approach matches the patient’s individual anatomy and goals.

Understanding blepharoplasty risks

While eyelid surgery is often successful, it is not without risk. Blepharoplasty risks include both common and rare complications, some of which may cause physical discomfort or aesthetic dissatisfaction.

Common complications following eyelid surgery

People who undergo blepharoplasty may experience a variety of complications, some of which may require corrective treatment. The most frequently reported issues include:

• Dry eyes, especially in the early stages of recovery.
• Blurred vision, usually temporary but distressing nonetheless.
• Skin discolouration or uneven pigmentation.
• Residual excess skin or an uneven appearance following surgery.
• Drooping of the lower lid, leading to visible sclera (eye white).
• Asymmetrical results, particularly in upper and lower eyelids.
• Persistent swelling or bruising, which may affect the healing process.

Rare but serious eyelid surgery risks

While many issues are mild or temporary, more serious complications can occur, though they are extremely rare. These include:

• Blood clots developing near the surgical site.
• Decreased tear production, which may lead to long-term dry eyes.
• Injury to the eye muscles or underlying tissues.
• Fat removal errors, which may cause hollowing or shadowing.
• Loss of skin sensation due to nerve damage.
• Damage to deeper tissues, especially during aggressive fat or skin removal.
• Eyelid malposition, which can impair eye closure and require further surgery.
• Inability to close eyes (lagophthalmos), which is caused by the removal of too much skin

These risks highlight the importance of carefully selecting a surgeon, disclosing full medical history, including any thyroid eye disease or use of herbal supplements and following all post-operative care instructions.

Blepharoplasty recovery: what to expect

Recovering from blepharoplasty generally takes about a week to ten days, although swelling and bruising may persist longer. During this period, it’s important to follow aftercare instructions closely to aid healing and reduce swelling.

Most surgeons will recommend:

• Applying antibiotic ointment and using prescribed eye drops.
• Avoiding contact lenses and using cold compresses.
• Sleeping with the head elevated to improve circulation.
• Avoiding strenuous activity and exposure to sun or wind.

Proper care of the surgical site, including monitoring for signs of infection or skin discolouration, helps minimise the risk of further complications. The use of suture strips and close observation of the upper and lower lids are also key during this stage.

When blepharoplasty surgery goes wrong

Despite best efforts, eyelid surgery can sometimes result in undesirable outcomes. Signs that something may have gone wrong include:

• Continued discomfort or blurred vision beyond the expected recovery period.
• Visible asymmetry between the upper and lower eyelids.
• Pulling of the lower lid away from the eyeball (ectropion).
• Excess skin remaining or uneven removal.
• Changes in tear production or eye closure.
• Removal of too much skin, leading to an inability to close the eyes (lagophthalmos)

In such cases, further surgery may be needed to correct the problem. However, when the initial procedure was performed negligently - such as failure to assess the patient’s visual field, inadequate preoperative planning or poor technique - there may also be grounds for a compensation claim.

When could blepharoplasty surgery be due to negligence?

For a blepharoplasty procedure to be considered negligent, it must be shown that the surgeon or medical team failed to meet the expected standard of care, and that this failure directly resulted in harm. This legal responsibility is known as the duty of care, and it applies before, during, and after surgery.

Negligence can arise at any point throughout the surgical journey. Below are some of the most common ways this duty may be breached:

Before surgery

• Informed consent must be properly obtained: you should be fully informed about all material risks, benefits and alternative options associated with eyelid surgery. If a surgeon fails to explain the risks of the procedure - such as dry eyes, blurred vision or the need for further surgery - and these occur without warning, this could amount to negligence.
• Thorough patient assessment is essential: before proceeding with surgery, a surgeon should take a complete medical history and assess whether you are a suitable candidate. Performing blepharoplasty without recognising conditions such as severe dry eyes, high blood pressure or thyroid eye disease - or proceeding without addressing them - may be considered a serious failure in duty of care.

During surgery

• The agreed surgical plan must be followed: surgeons have a responsibility to carry out the procedure in accordance with what was discussed and agreed during your initial consultation. Any deviation from the planned treatment without clinical justification - such as removing more tissue than intended, or making incisions in the wrong area - may lead to poor outcomes and form the basis of a claim.
• The surgical method must be appropriate and executed correctly: a qualified plastic or oculoplastic surgeon should apply a safe and suitable surgical technique that reflects best practice. Errors such as removing too much fat or skin, damaging underlying tissues or eye muscles or making incisions outside the natural fold of the eyelid can result in complications that could have been avoided with proper care.

After surgery

• Clear aftercare instructions must be provided: following surgery, patients should be given detailed advice on wound care, prescribed eye drops, activity limitations and signs of complications. Failure to provide this guidance can result in infection, poor healing or prolonged discomfort.
• Complications must be recognised and addressed quickly: if you report symptoms such as signs of infection, your surgeon has a duty to respond appropriately. Ignoring these issues, or failing to arrange follow-up treatment when necessary, may significantly worsen the outcome and could be considered negligent.

If your blepharoplasty procedure has led to physical or emotional harm due to a failure in duty of care at any of these stages, you may be entitled to claim compensation. At Cosmetic Surgery Solicitors, we can help assess your experience and guide you through the next steps with clarity and care.