INTRODUCTION: The aim of this study was to evaluate the incidence of major complications following blepharoplasty and brow lift surgery and to determine if complication rates increase when blepharoplasty and brow lift surgery were performed simultaneously.
METHODS: A prospective cohort of patients who underwent cosmetic blepharoplasty, brow lift, or a combination of the two procedures between 2008 and 2013 was identified from the CosmetAssure Insurance database. The primary outcome was a perioperative major complication requiring emergency room evaluation, hospital admission, or reoperation within 30 days. Groups were compared with univariate analysis (significance p<0.05).
RESULTS: A total of 6,126 patients underwent aesthetic eye surgery, of which 4,879 (79.6%) underwent blepharoplasty, 441 (7.2%) brow lift, and 806 (13.2%) a combination of both. Patients who underwent a combined procedure were older than patients who underwent isolated blepharoplasty or brow lift (55.5 ± 9.4 vs. 54.6 ± 11.1 vs. 53.3 ± 12.0years; p<0.01). Combined procedures were performed less often in males compared to blepharoplasty and more often in males when compared to brow lift (12.9% vs. 17.6% vs. 10.7%;p<0.01); but there were similar rates of smokers (5.7% vs. 8.0% vs. 6.6%;p=0.06) and diabetes (3.0% vs. 3.6% vs. 2.3%;p=0.24) among the three groups. Between combined procedures, blepharoplasty, and brow lift there were similar rates of major complications (0.4% vs. 0.4% vs. 0.7%;p=0.65) and hematoma (0.2% vs. 0.2% vs. 0.5%;p=0.49), which was the most common complication.
CONCLUSION: Aesthetic eye surgery has a very low overall major complication rate (0.4%). When brow lift is combined with blepharoplasty it poses no additional risk of major complications compared to blepharoplasty or brow lift alone.