Blepharoplasty (eyelid rejuvenation surgery) is one of the most common facial cosmetic surgeries. According to the American Society of Plastic Surgeons procedural statistics for 2008, nearly 200,000 such surgeries were performed. Lasik (corrective vision) surgery is done even more frequently with roughly one million done as of last year. It should be no surprise, then, that these two eye-related procedures can cross paths in the same patient. Either someone has had Lasik and presents sometime after for blepharoplasty or one has had blepharoplasty and is now interested in vision correction.
This raises the question of how one impacts the other and does it pose a problem? Blepharoplasty and Lasik are compatible procedures that can, and often are, done in the same patient. But they are never done together. They must be staged and timed so they do not create functional eye problems.
Blepharoplasty can interfere with eyelid closure with the potential for a temporary period of eye dryness as a result. The blink reflex is slowed and the loose amount of eyelid skin and laxity has been removed. In short, the safety net for competent eyelid closure has been reduced even if it is only temporary. This can be revealed when one sleeps where only a small crack of opening between the eyelids can cause lack of adequate eyeball lubrication. This is evidenced by crusty eyelids in the morning and a feeling of dry or itchy eyes.
LASIK is an elective laser eye surgery that reshapes the cornea (front surface of the eye) to improve vision. It is the most popular vision correction procedure performed in the United States and worldwide. LASIK can correct a wide range of nearsightedness (myopia), farsightedness (hyperopia) and astigmatism. Dry eye is not an uncommon problem after Lasik and an estimated 20% of patients having the procedure suffer some temporary period with it.
While Blepharoplasty and Lasik can be done before or after each other, there should be a sufficient time period between them. If blepharoplasty has been done first, one should wait until their eyelids are completely healed and that any symptoms of dry eye are completely resolved or do not exist. Usually this should be at least a three month waiting period. It will also depend on what type of blepharoplasty has been performed. The issue is really the lower blepharoplasty. ‘Low-risk’ lower blepharoplasties include those done through a transconjunctival approach (inside the eyelid with no external skin excision) and pinch and peel techniques where minimal lower eyelid skin is removed.
If Lasik is initially performed, one should wait at least 6 months (if not longer) before undergoing a blepharoplasty. This time is need to ensure that the cornea has healed properly and to protect it from any stress from potential dryness. One’s ophthalmologist should be consulted to get clearance for a blepharoplasty procedure.
Barry L. Eppley, M.D., D.M.D.
Indianapolis, Indiana