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Suitability

When blepharoplasty is not recommended

There are real reasons to decline performing blepharoplasty even on patients who request it. Knowing these in advance saves you a wasted consultation — and protects you from a surgeon who would accept a case they shouldn't.

Doç. Dr. Ayhan Işık Erdal
Doç. Dr. Ayhan Işık Erdal Associate Professor of Plastic Surgery
MD · FACS · FEBOPRAS · Associate Professor
✓ Medically reviewed · Last updated: May 18, 2026

Absolute contraindications

Cases where surgery should not be performed:

  • Active eye infection — conjunctivitis, blepharitis, herpes simplex keratitis flares — must be treated and resolved first
  • Uncontrolled hypertension — risk of intraoperative bleeding and retrobulbar hematoma
  • Bleeding disorders not adequately controlled
  • Active thyroid eye disease (Graves' orbitopathy) in a non-stable phase
  • Severe dry eye with corneal compromise
  • Recent eye surgery (cataract, LASIK) — wait minimum 6 months
  • Body dysmorphic disorder — cosmetic surgery worsens, doesn't improve, the underlying dissatisfaction

Relative contraindications (caution, not refusal)

  • Diabetes — wound healing slower; needs good glycaemic control
  • Long-term steroid use — affects healing and skin quality
  • Smoking — significantly affects healing; ideally stopped 6 weeks pre-op
  • Negative vector anatomy — not a contraindication but changes the surgical plan (canthopexy added)
  • Pre-existing dry eye (mild) — modify technique; conservative skin resection
  • History of facial nerve dysfunction — affects lid closure dynamics

The 'I just want to feel better' case

Cosmetic surgery is a poor treatment for unhappiness, depression, or loneliness. Patients whose primary motivation is to feel different about themselves rather than to address a specific anatomical concern are at very high risk of post-operative dissatisfaction — they get exactly what they asked for surgically, and find themselves still feeling the way they did before.

A surgeon who notices this pattern should decline, or at minimum require a psychiatric consultation before proceeding. It's not condescension — it's protection for both surgeon and patient.

Frequently asked questions

If I smoke, will you refuse to operate?

We'll ask you to stop 6 weeks pre-operatively and 4 weeks post-operatively. We accept that you may resume after. Smoking during the healing window dramatically increases scar issues and wound complications — non-negotiable.

Can I have surgery if I have dry eye?

Mild dry eye: yes, with conservative technique. Moderate-severe with corneal involvement: needs ophthalmology clearance and possibly treatment before surgery. We'd rather defer than risk symptomatic worsening.

Medical disclaimer: This page provides general information about blepharoplasty and reflects the clinical opinions of Doç. Dr. Erdal. It does not constitute medical advice for any individual patient. Results vary; all surgery carries risk. Blepharoplasty in some cases produces irreversible changes to eyelid anatomy. Suitability is determined only through personal consultation with full medical history disclosure.

Not sure if you're a candidate?

Blepharoplasty is most successful when patient anatomy, age, and goals align with what surgery can realistically deliver. Send three facial photos (front, profile, eyes-closed) and Doç. Dr. Erdal will give you an honest, no-pressure suitability assessment before you commit to anything.

Ready to discuss your case?

Doç. Dr. Erdal personally reviews every enquiry. Honest assessment of whether blepharoplasty is right for you, with no pressure to book.

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