How_common_is_Chemosis_after_Eyelid_Surgery_and_what_can_be_done_about_it
13 Oct

How common is Chemosis after Eyelid Surgery and what can be done about it?

Chemosis can happen after eyelid surgery. Chemosis is the jelly like swelling (edema) of the conjunctiva that lines the inner aspect of the eyelid. In this blog I’ll discuss the best treatment options for chemosis as well as how common it is.

Most of the time, chemosis appears on a small area on the outer corner of the sclera (the white part of the eye). As a result of dry eye following surgery the conjunctiva becomes irritated and swells, this increases exposure of the conjunctiva as it can billow out of the eyelid like jelly. Often the area swells so much that you can't close the eye properly. Even though there can be tearing that runs down your cheeks, the real underlying problem is dryness and irritation of the eyes.

When can chemosis occur?

Chemosis can happen with any surgery around the eyes.

Surgical procedures can disrupt the lymphatic drainage of the eyelids. And the fluid does not drain properly. If enough of the channels are blocked following eyelid surgery, the fluid will drain very slowly and the chemosis will persist.

Chemosis develops most commonly if lower blepharoplasty (eyelid surgery) has been part of the procedure (in about 5-10% of patients). If only the upper lids have been operated on, it is very rare. If additional procedures have been performed such as canthopexy (tightening of the corners of the eyelids), canthoplasty (tightening of the lower eyelid) or midface lift, then chemosis may be more common. Pre-existing problems with dry eye can also contribute to the problem. Another possible cause of chemosis may be an allergy to the eye drops or lubricant used after surgery.

How long does chemosis last?

Mild chemosis after blepharoplasty will settle down, but sometimes it can take several months.

How to treat chemosis

The simplest approach to resolving chemosis due to dry eye is ‘aggressive dry eye management’. Artificial tears should be used at least every hour during the day. It should be ensured that the eyes are closing fully at night and the affected eye should be covered with a bland ophthalmic ointment. If the eye is not fully closing, it should be covered with an eye patch for compression or with plastic wrap to keep it moist. Additional measures may be needed such as steroid drops or oral steroids. Antibiotics are useful if there has been any damage to the surface of the eye, in order to prevent infection from occurring. In particularly difficult cases, sometimes the eyelid (in order to heal) needs to be temporarily closed using a tarsorrhaphy stitch, alternatively surgical revision may be required.

Your plastic surgeon should be your first contact. Let your Plastic Surgeon decide if a consultation with an ophthalmologist may be warranted to rule out other problems. 

There has never been a better time to have cosmetic eyelid surgery

With modern techniques and recent technological advancements, eyelid surgery has become safe, effective and capable of delivering results that you always wanted with minimal pain, discomfort and downtime. A skilled and capable plastic surgeon who uses modern techniques can offer you better and longer lasting results while the specialist anaesthetist ensures your safety and comfort in a modern hospital.

As with any medical procedure, it is important to seek the advice of a skilled professional capable of addressing your concern. Since each person's anatomy and response to surgery and healing is different, an evaluation by a plastic surgeon can help you explore all options and determine the appropriate approach that addresses your concerns.

Tips on how to choose the right plastic surgeon for eyelid surgery

In Australia you should seek out a FRACS Plastic Surgeon. The FRACS Plastic Surgeon has 5 key attributes amongst others:

  1. Is fully qualified in Plastic Surgery including Cosmetic and Reconstructive Surgery
  2. Is trained by the Royal Australasian College of Surgeons (RACS) which is the only College in Australia authorised by the Australian Medical Council (AMC) to train Surgeons
  3. Is registered as a Specialist Plastic Surgeon with the National Medical Board of Australia
  4. Is recognised as a ‘Specialist in his or her field’ by Medicare Australia
  5. Is a member of the Australian Society of Plastic Surgeons (ASPS) and the Australian Society of Aesthetic Plastic Surgeons (ASAPS)

If you need additional information to assist you in deciding whether cosmetic surgery is the right option for you, send me a quick email at info@naveensomia.com.au and I will happily assist you.

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Dr Naveen Somia MBBS, PhD, FRACS

Dr. Naveen Somia is a Sydney Plastic Surgeon who listens to his patients, understands their problems and works alongside them to help achieve their aesthetic goals by applying his skills and years of experience in Plastic and Cosmetic Surgery. A published author on Plastic and Cosmetic Surgery, Naveen’s blog is aimed at helping you make the right choices and stay safe in your quest to look your personal best.