Magine: You will have eyelid surgery tomorrow morning. How would you feel? Anxious? Angry? Scared?

It is by no means strange that some patients eagerly await surgery, while others feel a little anxious. After all, eyes are a key organ for human beings, and the skin surrounding the eyes is sensitive. Any complication may result in very serious problems that will most likely have social implications. 

Here is a discussion of the major concerns of patients undergoing eyelid surgery as well as the true potential for these problems to occur.

1. I won't be able to close my eyes. Scientists, researchers and surgeons agree that it is rare for a patient to be unable to fully close their eyes after surgery.  When this happens, it is almost always temporary.  It is completely natural that the eyes are not completely closed for the first 2-4 weeks after upper blepharoplasty (aesthetic surgery of the eyelid). As these patients often fear, this does not happen due to excessive skin removal but to the edema-led swelling of the eyelid, and this swelling restricts eyelid movements. Rarely, it may take longer than 2-4 weeks for the eyelids to not close completely. This condition is the result of the hardening of the scar tissue, which we call scar contracture. Scar contractures will also resolve through the maturation of the scar tissue around month 3, and the eyelids will regain their former flexibility. In cases where too much skin is removed from the eyelid, it is possible that the eyes will not close permanently, but that is absolutely rare. No trained surgeon would consciously remove that much skin from the eyelid. Unfortunately, a few cases where the upper or lower eyelids cannot join completely, with a probability of one in a thousand, caused a great public stir.

2. My surgeon may cause damage to my eyes.  It is not unheard of for a fully trained, experienced plastic surgeon to surgically damage a patient's eye, but it is extremely rare. A standard blepharoplasty is performed solely on the eyelid, involving only little or no contact with the eye. However, by taking certain measures, we cover your eyes with a special gel to keep them moist and slippery during the surgery, and we protect the eyeball with special eye shields.

3. My eyes may appear asymmetrical after surgery.  Rarely, the patient may feel that their eyes are not symmetrical after surgery. First of all, the shape of the eyes is almost always different from each other before the surgery, but because we do not look carefully, we do not notice them in daily life. The asymmetries that disturb patients after surgery will be mostly observed when pre-operative photos are reviewed.  It is a good idea to objectively evaluate your own characteristics with your plastic surgeon prior to the procedure. Another issue is that eyelid surgery cannot be performed in exactly the same manner on the right and left. A vein bleeds a little longer on one side, and that side may appear swollen and more bruised. Again, lateral canthopexy and muscle suspension maneuvers may cause temporary slanting and deformities in the eye. However, these are deliberate overcorrections to prevent complications, and your surgeon will comfort you in this regard.

4. The shape of my eyes will change after surgery. After surgery, the shape of your eyes may change depending on various complications. It may sound strange when you first hear it, but in order to preserve the shape of your eyes in the long run and to prevent complications, your eyes may sometimes need to look too slanted for a while after the surgery, and there may be temporary skin bumps around the eyes. Taking such protective measures, particularly in patients in the risk group, considerably reduces the incidence of complications. Your surgeon will inform you about preventive measures and early results during the preoperative interview. It will take an average of 3 months after the surgery for your eyes to take their final shape, but in some special cases and risk groups, this may take up to 1 year.

5. I will have permanently dry eyes.  It is common for your eyes to feel drier than normal after surgery. This is why eye drops are recommended for healing.  Dry eyes usually resolve on their own within a few days to a few weeks. If you have dry eyes before the operation, you should definitely tell your surgeon about this because some surgical techniques should not be applied to patients suffering from dry eyes.

6. I will definitely not like the result. The main reason for dissatisfaction after blepharoplasty is the lack of communication.  Make sure you have a detailed conversation about the exact surgical plan that is tailored for you and ask all your questions. Read the informed consent forms carefully and discuss with your doctor any points you do not understand. Have clear goals and make sure your doctor gets them right. Implicit statements about your goals such as “I want to look less tired” are not enough. In addition, make sure you understand your surgeon's plan for managing complications and possible revisions.   All that needs to be done is often a little fine tuning. Review as many before and after photos as possible before the surgery and choose the service you want after seeing the results.

When you choose a plastic surgeon who is proficient in performing eyelid surgery, your chances of experiencing complications are also very low. Use your consultation time wisely.  To weigh your surgeon's blepharoplasty experience, ask how many eyelid procedures they perform each year and what measures they take to minimize risks. Investigate whether they have contributed to the medical literature in this area. See the before and after photos. Ask what complications look like, too. Ask for references from real patients who were operated by that surgeon. Don't be shy - meet and talk to some of them. If you are still not completely comfortable after doing your research and consulting with a qualified plastic surgeon, you can go and see another specialist, it will not be a shame for anyone. Think of the time, effort and money you spend on all this as a part of your investment in looking good.