From the FDA Drug Label
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From the Research
Cosmetic eyelid surgery and levator palpebrae procedures in healthy women carry significant risks, including blindness, infection, and dry eye syndrome, although these complications are relatively uncommon. The most concerning complications of these procedures include:
- Blindness, which can result from retrobulbar hemorrhage causing compression of the optic nerve, occurring in approximately 1 in 25,000 cases
- Infection, which may progress to orbital cellulitis if untreated
- Significant scarring that can cause eyelid retraction or ectropion (outward turning of the eyelid)
- Asymmetry requiring revision surgery
- Dry eye syndrome that may become permanent
- Ptosis (drooping eyelid) can occur if the levator muscle is inadvertently damaged during surgery
- Anesthesia complications, while rare in healthy individuals, include adverse reactions to medications and, extremely rarely, cardiac or respiratory events
These risks are minimized when procedures are performed by experienced oculoplastic surgeons who thoroughly evaluate patients beforehand to identify any pre-existing conditions that might increase complication rates, such as dry eye syndrome, thyroid eye disease, or bleeding disorders 1. According to a study published in the Journal francais d'ophtalmologie, the risk/benefit ratio of cosmetic eyelid surgery is one of the best in facial cosmetic surgery, but it is essential to have a perfect knowledge of anatomy and relevant skills and experience to perform these procedures safely 1.
The management of complications following cosmetic eyelid surgery is crucial, and experienced surgeons should be able to avoid most serious complications through proper patient selection, comprehensive preoperative assessment, and meticulous surgical technique 2, 3. A study published in the Journal of clinical and diagnostic research found that the modified Cutler-Beard procedure using autogenous auricular cartilage is an effective procedure for repair of large upper eyelid defects, with acceptable functional and cosmetic results 4. Another study published in Ophthalmic plastic and reconstructive surgery found that supramaximal levator resection is an effective procedure for unilateral congenital ptosis, but it can result in mild contour abnormalities and lash ptosis 5.
In summary, while cosmetic eyelid surgery and levator palpebrae procedures carry significant risks, these can be minimized with proper patient selection, thorough evaluation, and meticulous surgical technique. It is essential to prioritize the patient's safety and well-being by choosing an experienced oculoplastic surgeon and carefully weighing the potential risks and benefits of these procedures.