Eyelid Surgery Nightmares: How to avoid them

There is a lot of information on the web for and against having eyelid surgery. The few patients that have serious complications often stand out the most as they tend to be very vocal about what went wrong. One thing that often isn’t communicated well about eyelid surgery, however, is the roll that the patient played in some of these difficulties. There is no doubt some malpractice that goes on, but you as a patient can do a lot to avoid these problems by knowing a few things beforehand.

Understanding eyelid surgery risks

Most patients will take the time to understand the risk of their eyelid surgery, however, I am often surprised at how many patients never ask about what can go wrong in surgery. I try to take time with each patient and describe the most common problems that can happen, but there are always unanticipated set backs that can happen to anyone. Covering every one of these in our short time during a consultation isn’t always possible. Educating yourself and being comfortable with the risks are very important before agreeing to any surgery. For example, one of the most common complications or setbacks that we see in surgery is significant bleeding after surgery. This often happens because patients do not adequately educate themselves about the medicines they are taking that can cause their blood to be thinner that normal. Very often on the day of surgery, despite having had handouts and a lecture about the dangers of blood thinners, patients show up having not stopped any of the blood thinning medications and still wanting to proceed with eyelid surgery. It has become our policy to not proceed due to the possible complications. Very often, patients will not admit to using these medicines until after the surgery. One of the worst offenders is baby aspirin. For some reason, many people don’t even think of this a medication. Aspirin happens to be one of the most potent blood thinners people are taking and in my experience causes some of the most significant bleeding complications during eyelid surgery. Telling your doctor every medication you take, whether over the counter or prescription, no matter how insignificant you may think it is, is very important to having safe surgery.

“Perfection is the enemy of good”

This old adage is something many of us live by in plastic surgery. Too often, after surgery people will over analyze their appearance in the mirror and pick apart every small problem in detail that they feel the surgery did not correct. I have patients that come back week after week wanting every little bump attended to. Most of them when confronted with their pre-op photos can see the asymmetries and imperfections that we were dealing with. Imperfections and asymmetry are a natural part of our face and will not be completely corrected with surgery. Most of the true plastic surgery nightmares that I’ve heard about relate to people asking for repeat and revision procedures. The compounding problems that all of the scarring creates are generally what cause the most problems. Recently in the news, a patient was suing their doctor for not being able to close her eyes after eyelid surgery. The patient had multiple eyelid surgeries before and asked for another touch up for a small problem that she perceived. Unfortunately, the surgeon performed the procedure and I’m sure later regretted having acquiesced to the woman’s request. Trusting your surgeon when they say enough is enough is a good thing. They’ve seen a lot more bad outcomes than you could ever be aware of and their judgment should be heeded.

Patience is virtue after eyelid surgery

Lastly, patience is the most difficult part of any plastic surgical procedure. I find that when I see patients within a few days of surgery they tend to be much more tense than when I see them several weeks after surgery. Just seeing the improvement over time settles their worries more than any reassurance I can give them. True healing takes anywhere from 6 months to a year. Very few patients actually hear this when I explain it to them. After a few weeks they very often ask why they don’t look better, or if they’ll ever look normal again. Educating yourself on a realistic time frame of recovery after surgery can reduce postoperative anxiety. The take home message is educating yourself fully before taking the plunge into eyelid surgery. These are elective procedures and you need to be ready to accept the good results with the bad.