Dry eyes are a common complication of blepharoplasty. They may develop due to changes in blinking or tear production.

Blepharoplasty is a cosmetic procedure in which a surgeon removes excess skin — and sometimes pieces of fat and muscle — from your eyelids. It’s also called an eyelid lift.

The American Society of Plastic Surgeons reported 325,112 blepharoplasties in the United States in 2020.

Dry eyes are common in the general population and are one of the most common complications of blepharoplasty. According to a 2020 research review, studies have reported dry eyes in up to 26.5% of people who undergo blepharoplasty.

Blepharoplasty may lead to eye dryness as a result of:

  • changes in tear composition
  • changes in your ability to blink due to swelling
  • inadequate tear coverage over the surface of your eyes

Let’s take a deeper look at the connection between blepharoplasty and dry eyes.

Dry eyes are one of the most common complications of blepharoplasty. Some studies have reported dry eyes occurring in more than a quarter of people who undergo this surgery. However, symptoms usually resolve within a few days or weeks.

Dry eye develops when tears inadequately cover the surface of your eyes or evaporate too quickly.

In the case of blepharoplasty, swelling can change the positions of your eyelids, which may affect the distribution of tears.

Along with removing excess skin, traditional blepharoplasty involves removing part of the orbicularis oculi muscle. This muscle helps you close your eye.

Removing part of this muscle contributes to the development of dry eyes by causing:

  • incomplete eye coverage when you blink
  • a decreased blinking rate
  • an incomplete blinking reflex

In recent years, doctors have become more conservative with the removal of muscle or fat tissue around the eye when performing blepharoplasties.

Undergoing blepharoplasty is known to make preexisting dryness worse.

Undergoing upper and lower eyelid blepharoplasties at the same time seems to increase the odds of developing dryness more than having surgery on just one eyelid.

If you have preexisting eye dryness, it’s a good idea to speak with a doctor before your surgery. Doctors often screen surgery candidates who are at the highest risk using Schirmer’s test. This test involves putting a paper filter inside your lower eyelid to measure the moisture.

Every surgery comes with some risk of complications. According to the American Society of Plastic Surgeons, potential complications of blepharoplasty include:

You may be able to prevent and treat dry eyes after your surgery by:

  • limiting swelling by elevating your head and applying a cold compress
  • preventing infection with antibiotic eye drops
  • reducing inflammation with steroid drops
  • using artificial tears throughout the day and at night as needed

If your eye dryness lasts longer than 3 months, your ophthalmologist may recommend plugging your tear ducts to keep your eyes lubricated.

In rare cases, your doctor may need to perform a second surgery to reposition your eyelid.

It’s a good idea to contact your surgeon if your dry eye symptoms persist for more than 2 weeks. It’s also important to contact your surgeon if:

  • you develop severe pain or other side effects
  • you’re unhappy with the results
  • you have any other concerning symptoms
Medical emergency

The most feared complication of a blepharoplasty is retrobulbar hematoma, in which blood is trapped behind your eyeball. Go to the nearest emergency room if you have:

  • severe eye pain
  • bulging of your eye
  • vision changes

Here are some frequently asked questions people have about blepharoplasty and dry eyes.

Why are my eyes so dry after surgery?

Swelling can cause changes in your ability to blink, which can lead to insufficient tear coverage of the surface of your eye. Removal of part of the muscle around your eye may lead to incomplete eye coverage when you blink.

How long do dry eyes last after blepharoplasty?

Dry eye symptoms should go away within days to weeks after the procedure. Research suggests that in almost everyone who has this surgery, symptoms resolve within 8 weeks.

Can I use dry eye drops after blepharoplasty?

Eye drops can help keep your eyes moist and prevent dryness. Your doctor will likely prescribe eye drops after your procedure to help reduce your risk of infection and minimize irritation.

Can eyelid surgery help dry eye?

Eyelid surgery may make dry eyes worse. If you’re already prone to dry eyes, it’s a good idea to talk with your surgeon about whether you’re a good candidate for this procedure before undergoing it.

Dry eye symptoms almost always go away within 8 weeks of surgery.

It’s a good idea to speak with your surgeon before your procedure about whether you are a good candidate. They can check the moisture level of your eyes and let you know whether you may have an increased risk of complications.