So, you had eyelid plastic surgery to treat droopy eyelids or get rid of bags under your eyes. The surgery was a success, and you love what you see in the mirror. However, your eyes are still irritated, and they water constantly. They also feel tired, vision is blurry, and they are red, which makes working on the computer, driving, or reading a book very challenging and somewhat embarrassing to be around your colleagues. You ask yourself, why are my eyes watering if everything went well with the surgery?
It is quite common to have watery eyes after any eyelid surgical procedure, but especially after an upper eyelid lift, ptosis repair, or surgery to remove bags and wrinkles under the eyes. The causes behind this symptom are multiple. First, the blinking mechanism may be affected whenever incisions are made in the delicate eyelid skin. It is especially true when skin is removed, as in a blepharoplasty, for example. If too much skin is excised, the patient’s cornea will be exposed to the air and dry out, causing redness, a foreign-body sensation, and watery eyes.
Another cause may be damage to the muscle responsible for eyelid closure, called the orbicularis oculi muscle. This muscle should be preserved during eyelid plastic surgery, but some surgeons still remove it, at least in part. If the orbicularis muscle is disrupted, the patient will have a slow blink or possibly incomplete eyelid closure, a condition known as lagophthalmos. The consequence, in either case, will be excessive dryness of the cornea, which in turn will cause eye irritation and tearing.
This watering may last from a few months to more than a year, depending on the cause. In some cases, the condition will become permanent. It is more commonly seen in patients who suffered from moderate to severe dry eye syndrome before undergoing eyelid surgery and in patients with postoperative eyelid retraction or lagophthalmos.
Medical treatment for watery eyes after eyelid plastic surgery involves applying artificial tears. Although this may sound counterintuitive, it makes sense if we remember that the main factor in postoperative tearing is excessive dryness of the cornea. Keeping the cornea lubricated with preservative-free eye drops or ophthalmic gels is the most effective way to treat the dryness and improve tearing. In severe or refractory cases, it may be necessary to rely on a surgical procedure to treat the symptom.
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