Blepharoplasty abroad: understanding the risks of surgical tourism

The eyelids play a vital role in protecting the eye and maintaining a healthy ocular surface and tear film. Blepharoplasty, therefore, requires careful assessment of the eyelid anatomy, eye surface, tear production, eyelid position, vision, general health and any pre-existing eye condition.

Although most blepharoplasty procedures are straightforward, complications can occur. These include infection, bleeding, asymmetry, scarring, dry or gritty eyes, difficulty closing the eyes and changes in the position of the lower eyelid. More serious complications, although very rare, can include bleeding behind the eye and a threat to eyesight from corneal ulceration.

One of the often-overlooked risks of surgical tourism is what happens after the operation.

Swelling and bruising are expected following all blepharoplasty, and the final result can take time to settle. Patients may also need review to assess healing, remove sutures and identify complications at an early stage.

If surgery has been performed hundreds or thousands of miles from home, accessing the original surgeon for an urgent assessment or treatment may be difficult. The responsibility for managing complications may subsequently fall to another healthcare team such as the NHS or other private Oculoplastic surgeons in the U.K.

Revision procedures for blepharoplasty which has gone wrong is undertaken on a case by case basis.

It can often require long periods of waiting for the original surgery to settle, between 6 and 9 months.

Serious complications can be managed more swiftly depending on the associated risks to sight. Often this may include additional incisions and sutures which can lead to more scarring and in some cases skin grafting from other parts of the body. The result is almost never as good as the initial intended outcome.

Psychologically, it is very stressful managing additional surgeries and waiting for the results to settle. There is no one-fix solution and often the revision surgery is more expensive than for a straightforward blepharoplasty in the first place.

The Royal College of Surgeons has previously advised patients considering cosmetic surgery to take time to research their surgeon, understand the risks and avoid feeling pressured into making a quick decision. All cosmetic surgeons in the UK should have certification from the Inter-Collegiate Cosmetic Surgery Board and patients should ask if their surgeon has this.

Blepharoplasty may be a relatively small operation, but it is surgery performed in a highly specialised and delicate area. A safe outcome depends not only on the procedure itself, but on careful patient selection, appropriate surgical expertise and good follow-up care.

Blepharoplasty is unique in that surgeons from different specialties perform these operations, including oculoplastic surgeons, plastic surgeons, general surgeons, ENT surgeons and maxiollo-facial surgeons. Oculoplastic surgeons are unique in that they have trained as eye surgeons and plastic surgeons and focus only around the eye, so they perform blepharoplasty very frequently and keep the safety of the eye as a main focus. At Sapphire Eye Care we only employ oculoplastic surgeons to perform blepharoplasty surgery.

When considering eyelid surgery, look beyond the price and consider the whole patient journey – from your first consultation through to your recovery.

Be extra vigilant of surgery where a cosmetic surgeon is ‘up-selling’ procedures, sometimes not in the patient’s best interest. At Sapphire Eye Care we sometimes see patients for revision surgery who have been offered blepharoplasty at a discount when undertaking other cosmetic procedures on their body, such as breast reduction/ enhancement.

Our consultant ophthalmologist Dan Morris recently spoke to BBC Wales and BBC 5 Live about the risks of blepharoplasty abroad.

Dan Morris has also shared his insights about blepharoplasty abroad with Wales Online.