Blepharoplasty Risks and Complications in Pune: What to Know Before Surgery?

Blepharoplasty is one of the more commonly performed facial surgical procedures, and for most patients in Pune it is straightforward with a manageable recovery and a satisfying result. Like all surgery, however, it carries risks. Some are temporary effects that resolve without intervention. Others are complications that require treatment. A small number are serious and require prompt action. Understanding the full range before surgery allows patients to make an informed decision and to recognise the difference between normal post-operative experience and a sign that something needs clinical attention.

Blepharoplasty risks include dry eye, lagophthalmos (incomplete eye closure), asymmetry, haematoma, infection, ectropion (lower lid turning outward), scleral show, and in rare cases vision-threatening complications. Most complications are manageable when identified early. Patients with pre-existing dry eye, thyroid eye disease, or previous eyelid surgery are assessed more carefully at consultation. Dr. Dhruv Chavan at Dr. DC Plastic Surgery, Pune, is an MCh Plastic Surgery qualified plastic surgeon and APSI member performing blepharoplasty at six Pune clinic locations.

Categories of Blepharoplasty Risks

The risks associated with blepharoplasty fall into three broad categories. Understanding the difference helps patients distinguish between what is normal and what requires a call to the clinic.

• Expected temporary effects: Swelling, bruising around the eyes and upper cheeks, tearing, sensitivity to light, and mild eye discomfort in the first 1 to 2 weeks after surgery. These are part of normal healing and do not indicate a complication. They resolve progressively without treatment.
• Manageable complications: Dry eye symptoms, lagophthalmos (incomplete lid closure), temporary asymmetry, chemosis (conjunctival swelling), and hypertrophic or widened scarring. These may require treatment or additional time but are not sight-threatening and typically resolve with appropriate management.
• Serious complications: Haematoma (blood pooling), infection, ectropion (lower lid turning outward), scleral show, corneal injury, and very rarely retrobulbar haematoma (bleeding behind the eye that can affect vision). These require prompt clinical attention.
  

Dry Eye After Blepharoplasty

Dry eye is the most frequently encountered functional issue after blepharoplasty, particularly upper blepharoplasty. The eyelid plays a critical role in distributing the tear film over the eye with each blink. Changes to lid tension, lid position, or the completeness of lid closure after surgery can temporarily reduce the efficiency of this tear distribution.

In patients who already have mild dry eye before surgery, blepharoplasty can make symptoms worse in the post-operative period. Pre-existing dry eye is assessed specifically at the blepharoplasty consultation: a patient with significant dry eye may require optimisation of their tear film management before surgery is scheduled, or may be advised that the risk of worsening dry eye post-operatively affects whether the procedure is appropriate for them at this time.

For most patients without significant pre-existing dry eye, mild post-operative dryness and grittiness resolve within weeks as swelling settles and lid function normalises. Lubricating eye drops are used regularly during the recovery period. For a full overview of what blepharoplasty recovery involves, see the blepharoplasty recovery guide.

Lagophthalmos: Incomplete Eye Closure After Blepharoplasty

Lagophthalmos is the inability to fully close the eye. After upper blepharoplasty, a small gap between the upper and lower lid when the eye is gently closed is common in the early post-operative weeks, as swelling affects lid movement. This temporary lagophthalmos typically resolves as swelling settles, usually within 4 to 8 weeks.

Persistent lagophthalmos, where the lid genuinely cannot close fully after swelling has resolved, is a complication. It occurs when too much skin has been removed from the upper lid, leaving insufficient skin to achieve full closure. The consequence is corneal exposure: the eye surface is not protected during sleep or blinking, which causes dryness, irritation, and in persistent cases, corneal damage.

Prevention is through careful pre-operative planning: measuring the available skin and pinch-testing to confirm that the planned excision does not compromise closure. Treatment of persistent lagophthalmos depends on severity: lubricating drops and ointment, taping the lid closed at night, or in significant cases, a revisional procedure to add skin back to the upper lid.

“The most important technical decision in upper blepharoplasty is how much skin to remove,” says Dr. Dhruv Chavan, plastic surgeon at Dr. DC Plastic Surgery, Pune. “Taking too little leaves the patient with residual hooding and an incomplete correction. Taking too much creates lagophthalmos, which in a persistent form is a serious problem that can damage the cornea and require a revisional procedure to correct. I measure the available skin carefully before every upper blepharoplasty and I pinch-test to confirm that the planned excision still allows complete closure.”

Scleral Show and Lower Lid Malposition

Scleral show is the visible exposure of the white of the eye (sclera) below the lower edge of the iris when looking straight ahead. A small amount of scleral show is normal in some individuals; prominent scleral show after lower blepharoplasty indicates that the lower lid has dropped slightly below its natural position, often from mild lid laxity or from skin tension pulling the lid down. It is related to ectropion but distinct: in scleral show the lid edge is still against the eye but positioned lower than it should be. Management ranges from observation and massage to canthoplasty in cases where the lid does not recover to its natural position.

Haematoma After Blepharoplasty

A hematoma is a collection of blood that pools in the surgical wound. Around the eye, haematomas present as increasing swelling, tension, and pain that is disproportionate to the normal post-operative experience, typically in the first 24 to 48 hours. Small haematomas may resolve without intervention. Larger haematomas require drainage to relieve pressure, prevent wound healing problems, and in the rare case of a retrobulbar haematoma (bleeding behind the globe), to protect vision.

A retrobulbar haematoma is a rare but serious complication of blepharoplasty. Blood accumulating behind the eye increases intraorbital pressure, which can compress the optic nerve and restrict blood supply to the retina. It presents as sudden severe eye pain, rapidly increasing pressure, proptosis (the eye appearing to bulge forward), and visual changes. This is a surgical emergency: if suspected, the wound should be opened immediately to relieve pressure and the patient transported to emergency care without delay.

“Every blepharoplasty patient receives a specific instruction at discharge: if you have sudden severe eye pain or increasing pressure in the eye, or any change in vision in the hours after surgery, this is not normal and you call us or go to emergency immediately,” says Dr. Dhruv Chavan, eyelid surgery specialist at Dr. DC Plastic Surgery. “A retrobulbar haematoma is rare but time is critical if it occurs. I want every patient to know what to do and to act on it without waiting to see whether it passes.”

Asymmetry After Blepharoplasty

Some degree of asymmetry between the two eyelids is common in the early weeks after blepharoplasty as swelling resolves at different rates on each side. Most asymmetry that is present at two weeks has resolved significantly by six weeks and largely by three months.

Pre-existing facial asymmetry, which is normal and present in everyone to varying degrees, continues after surgery: blepharoplasty improves the eyelids but does not equalise underlying facial asymmetry. Patients who have significant asymmetry before surgery should be aware that this persists after surgery; the blepharoplasty is planned to improve each eyelid individually rather than to make asymmetrical underlying structures appear identical.

Persistent significant asymmetry after full healing is assessed at a follow-up consultation. Minor asymmetry is managed with observation; significant asymmetry affecting the result may be suitable for a minor revisional procedure once the result has fully matured.

Infection After Blepharoplasty

Infection after blepharoplasty is uncommon given the excellent blood supply of the periorbital area. Signs of infection include increasing redness at the wound site, warmth, tenderness, swelling that is worsening rather than improving after the first few days, and discharge that is yellow, green, or foul-smelling. Infection requires prompt treatment with antibiotics and, if there is an abscess, drainage. Infection that is identified and treated early does not typically affect the long-term result significantly.

Scarring After Blepharoplasty

The upper blepharoplasty incision is placed within the natural lid crease and heals to a fine line that is typically not visible when the eye is open. The scar matures over 3 to 6 months and continues to fade through 12 months. Hypertrophic or thickened scarring in the lid crease can occur but is uncommon given the thin, mobile nature of eyelid skin and its good blood supply. If it occurs, it responds well to silicone gel application and, where needed, steroid injection.

Lower blepharoplasty via a subciliary incision (just below the lower lash line) produces a fine scar that is typically imperceptible at conversational distance by 3 to 6 months. Transconjunctival lower blepharoplasty (incision inside the lid, no external scar) leaves no visible scar at all.

Who Is Higher Risk for Blepharoplasty Complications?

Certain factors identified at the consultation are associated with a higher risk of specific complications:

Pre-existing dry eye syndrome increases the risk of worsening dry eye post-operatively. Thyroid eye disease causes its own lid position abnormalities and requires careful assessment before any eyelid surgery. Prior eyelid surgery affects tissue planes and scar tissue, increasing technical complexity. Naturally lax lower lids (assessed by the snap-back test at consultation) increase the risk of ectropion after lower blepharoplasty. Patients on anticoagulant medication have a higher haematoma risk. These factors do not necessarily mean surgery cannot be performed, but they affect the pre-operative preparation, the surgical technique, and the counselling about risks. For more on ptosis and its relationship to blepharoplasty candidacy, see the ptosis vs blepharoplasty guide.

Urgent-Care Guidance After Blepharoplasty

Contact the clinic or an emergency service immediately if you experience any of the following after blepharoplasty: sudden severe pain in or around the eye, rapidly increasing swelling or pressure that is worsening rather than stable, any change in vision, blurring, or loss of vision in either eye, the eye appearing to protrude or bulge forward, spreading redness with warmth and fever, heavy bleeding that does not settle with gentle pressure, or complete inability to open the eye due to increasing swelling. These symptoms require immediate clinical assessment and should not be managed at home.

Discuss Blepharoplasty Risks at a Consultation in Pune

Dr. Dhruv Chavan, MCh Plastic Surgery, APSI member, discusses the full risk profile for each patient at consultation, assesses individual risk factors including dry eye and lid laxity, and explains what is planned to minimise each risk. Every patient receives specific post-operative instructions before leaving the clinic.

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Cost Considerations for Blepharoplasty and Potential Revision

All surgical fees at Dr. DC Plastic Surgery are all-inclusive: surgeon fee, surgical facility, anaesthesia, and standard post-operative care are included. Minor revisions that fall within a reasonable post-operative adjustment period may be discussed at follow-up. Significant revision surgery is a separate procedure priced at consultation based on what is required. See the blepharoplasty cost guide and treatment pricing page for more detail.

Prices last reviewed: 2026.

Blepharoplasty Consultations at Six Pune Clinic Locations

Dr. DC Plastic Surgery has six clinic locations: Kharadi, Baner, NIBM, Pimple Saudagar, Prabhat Road, and Pune Station. Patients from Koregaon Park, Wakad, Hadapsar, Aundh, Viman Nagar, and across Pune attend blepharoplasty consultations at the clinic most convenient to them. International patients can see the international patients page.

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Frequently Asked Questions

What is the most common complication after blepharoplasty?

Dry eye is the most frequently encountered functional issue after blepharoplasty, particularly upper blepharoplasty. Temporary dryness, grittiness, and tearing are common in the first 4 to 8 weeks as swelling affects lid function. For patients with pre-existing dry eye, there is a risk of more significant and longer-lasting worsening of symptoms. Pre-existing dry eye is assessed at consultation and, where significant, managed before surgery is scheduled. Most patients with mild post-operative dry eye find it resolves fully within 6 to 8 weeks with lubricating drops. For an overview of all aspects of the recovery experience, see the blepharoplasty recovery guide.

Can blepharoplasty cause blindness?

Vision loss after blepharoplasty is rare. The principal mechanism is retrobulbar haematoma: blood accumulating behind the eye that increases intraorbital pressure and can compress the optic nerve or restrict blood supply to the retina. The incidence of retrobulbar haematoma is very low, estimated at less than 0.04 percent in published literature, but it is a surgical emergency where rapid treatment is critical to protecting vision. Patients are given specific instructions at discharge to call the clinic or go to emergency immediately if they experience sudden severe eye pain, increasing pressure, or any vision change in the hours after surgery. Prompt action is what protects the outcome in this rare event.

Will I have scars after blepharoplasty?

Upper blepharoplasty incisions are placed within the natural lid crease. In the first weeks the scar is visible as a pink line when the eye is open but this typically fades to an imperceptible fine line by 3 to 6 months and continues improving through 12 months. Lower blepharoplasty performed via a subciliary incision (below the lash line) leaves a scar that is generally not visible at conversational distance by 6 months. Lower blepharoplasty performed through the conjunctiva (inside the lid) leaves no external scar. The appropriate approach for lower blepharoplasty depends on the anatomy and what needs to be corrected, and is discussed at consultation. For patients interested in blepharoplasty for cultural or specific aesthetic reasons, see the Asian blepharoplasty guide.

What happens if too much skin is removed during upper blepharoplasty?

Removing too much skin from the upper lid creates lagophthalmos: the inability to fully close the eye. This causes corneal exposure, dryness, and irritation, and in significant or prolonged cases can affect corneal health. Management of significant persistent lagophthalmos requires a revisional procedure to restore adequate skin to the upper lid, typically using a skin graft. Prevention is through careful pre-operative planning: measuring available skin and pinch-testing to ensure that the planned excision still permits full lid closure. This measurement is performed at the surgical planning stage and is part of why choosing a qualified surgeon with specific eyelid surgery training is important.

How do I know if my blepharoplasty recovery is normal?

Normal blepharoplasty recovery involves swelling and bruising that peaks in the first 2 to 3 days and progressively improves over 2 weeks, temporary tearing and light sensitivity, mild eye discomfort or grittiness, and asymmetry between the two sides as swelling resolves. Signs that require contacting the clinic include: pain that is increasing rather than improving, any change in vision, swelling that is rapidly worsening rather than stable, spreading redness with warmth, discharge from the wound that is not clear serous fluid, and any pressure in the eye that is worsening. The distinction between normal recovery and a complication is explained specifically at discharge. For a full guide on what to expect week by week, see the blepharoplasty recovery guide.

Blepharoplasty Consultation in Pune

At Dr. DC Plastic Surgery, Dr. Dhruv Chavan, MCh Plastic Surgery, APSI member, plastic surgeon in Pune, assesses each patient’s eyelid anatomy and individual risk factors, discusses all relevant risks with specific information for each patient’s situation, and provides a complete cost estimate before any decision is made. For more on the approach to patient care, see the process and approach and about us .

Call +91 99604 341 11 to book at any of six Pune clinic locations.