Can Blepharoplasty Cause Dry Eyes?

Yes, it can, although it does not happen to everyone and it is usually temporary. A 2020 review of cosmetic blepharoplasty and dry eye disease sets out how dry eye can be caused or made worse by eyelid surgery, how often it occurs, why, and how it can be prevented^[1].

Your tears are made by the lacrimal glands and by oil glands along the edges of the eyelids, then spread across the eye by blinking and drained through tiny channels near the inner corner. Surgery adds swelling, stitches, bruising and sometimes a small change in eyelid position, and each of these can disturb the tear film for a while.

The studies show what that looks like in practice. In a 2021 study of 20 people having upper blepharoplasty, dry eye symptom scores and tear instability rose at one month, and by six months the symptom scores in people who already had dry eye were back to where they started^[2]. In a smaller 2024 study of 22 people whose surgery included removing a strip of eyelid muscle, symptom scores and staining of the eye surface were still higher, and tear stability still lower, at six months, although tear production measured by the Schirmer test had not changed^[3]. Dry eye after blepharoplasty is therefore real, but how much, and for how long, differs between techniques and between people.

Typical symptoms include grittiness, burning or stinging, light sensitivity, redness, tired eyes and blurred vision that clears when you blink. Paradoxically, a dry eye can also water, because the irritated surface triggers reflex tearing. The NHS guidance on eyelid surgery ↗ lists irritated, sensitive or watery eyes among the expected side effects, lasting a few weeks.

Can Eyelid Surgery Help Dry Eyes?

It can, and this surprises many patients. Heavy upper eyelid skin (dermatochalasis) can itself make eyes feel tired and irritated, and the research suggests removing it often improves how the eyes feel.

In a 2025 systematic review and meta-analysis of 12 randomised trials in Aesthetic Surgery Journal ↗, covering 450 patients, dry eye symptoms were significantly less likely after upper blepharoplasty than before it^[4]. An older Austrian study found subjective dry eye symptoms in 11 patients (46%) before upper eyelid surgery and five (21%) three months afterwards, although the objective tear tests had not improved^[5]. In a double-blind randomised trial of 54 patients in Acta Ophthalmologica ↗, symptoms of eye irritation were reduced after upper blepharoplasty whichever technique was used, and measured tear dynamics had not changed by 12 months^[6].

These are group averages, not promises. Eyelid surgery is not a treatment for dry eye, and nobody should have it for that reason alone. If heavy lids are part of what is bothering you, our guides to drooping eyelids and saggy eyelids explain when surgery is worth considering.

How Common Are Dry Eyes After Blepharoplasty?

There is no single reliable figure, and the numbers quoted online are rarely sourced. Studies define dry eye differently (symptom questionnaires, tear break-up time, Schirmer testing, surface staining), follow patients for different lengths of time, and are mostly small. What they do show is a pattern: mild, early dryness is common, and troublesome long-term dry eye is much less so.

For lower eyelid surgery, a 2014 prospective study of 30 patients in the American Journal of Ophthalmology ↗ found dry eye in 16.7% of eyes and chemosis (swelling of the clear lining of the eye) in 15% one week after transcutaneous lower blepharoplasty. Schirmer values had dropped at one week and returned to baseline by three months, and the authors concluded the effect was temporary^[7].

For upper eyelid surgery, one prospective study found lower Schirmer results at six months in patients who had upper blepharoplasty, and small spots of staining on the cornea on the first day and first week^[8]. A prospective study comparing upper blepharoplasty alone with the same surgery plus a ptosis repair found no significant change in dry eye tests or symptoms at 90 days in the blepharoplasty-only group, while the ptosis group had more symptoms and more staining^[9]. Our guide to upper vs lower blepharoplasty explains how the two operations differ.

Why Do My Eyes Feel Dry After Eyelid Surgery?

Several things can contribute, and more than one often applies at once.

Swelling, inflammation and a changed tear film

Surgery triggers inflammation, and tears carry the evidence. In the 2021 study above, the inflammatory marker interleukin-6 rose in the tears of everyone after upper blepharoplasty, and other markers rose in those who already had dry eye^[2]. Swelling also changes how the lids sit against the eye.

Incomplete eyelid closure (lagophthalmos)

After blepharoplasty, some gap on gentle closure is a common temporary finding, and a published review notes that it can unmask underlying weaknesses in the tear film or corneal sensation. A lower eyelid that sits slightly low can also shift the pool of tears at its edge and expose more of the cornea^[10]. In the meta-analysis above, removing muscle as well as skin did not change the overall dry eye rate but was linked with more cases of lagophthalmos, although the confidence interval was wide, which is one reason surgeons tailor how much tissue they remove^[4].

Blinking and eyelid position

It is tempting to blame a weaker blink, but the evidence is mixed. A small video study of seven patients found that blink duration and speed were not significantly affected six to eight months after upper blepharoplasty, even though dry eye symptoms had risen in six of the seven, and the authors concluded that changes in blink or lid opening were unlikely to be the whole explanation^[11].

Problems at the outer corner of the eye

Sometimes the outer corner of the eyelids (the lateral canthus) loses support, so the lids close in a concentric, fish-mouth pattern with a small gap. In a retrospective series of 36 people referred for secondary blepharoplasty, all had dry eye symptoms and discomfort after their first operation, and many had signs of this problem, which the authors described as overlooked and easiest to recognise by watching the eyes blink^[12]. This is one of the problems that can follow surgery done without a proper assessment, as we explain in our guide to blepharoplasty abroad.

Stitches and surface irritation

In the meta-analysis, a continuous skin stitch caused more eye irritation than a buried (subcuticular) stitch^[4]. Ointment, which blurs vision, and rubbing a tired eye can also add to the irritation.

Dry Eyes After Upper Blepharoplasty vs Lower Blepharoplasty

Upper blepharoplasty removes skin, and sometimes a little muscle or fat, through a cut in the natural eyelid crease. Dry eye symptoms in the studies above often improve overall, although tear tests can dip for some months in some patients, and the risk is higher if you already had dry eye^[2].

Lower blepharoplasty works closer to the lid margin and the pool of tears. In the 2014 study of lower eyelid surgery, the lower lid margin sat further from the pupil one week after surgery and had still not fully recovered at three months, and the increase in the height of the tear pool was linked with that change in lid position^[7]. A lower lid that drops or tightens is the situation surgeons watch most closely. Watering and chemosis are also well recognised after lower eyelid surgery, and are covered in our guide to watery eyes after blepharoplasty.

The evidence on having upper and lower surgery together is limited. It does mean more swelling and more ways for the lid position to change in the early weeks, so it is worth asking your surgeon how they would plan the operation if you already have symptoms of dry eye.

Upper eyelid blepharoplasty before and after, front view, at Centre for Surgery London — Blepharoplasty before and after at Centre for Surgery. Individual results vary.

How Long Do Dry Eyes Last After Blepharoplasty?

For most people, dryness is worst in the first week or two and fades over the following weeks. The studies give a rough timeline, with the caveat that each followed a small group:

The first week: symptom scores and dry eye signs peaked at one week after lower blepharoplasty in the 2014 study^[7].
The first month: dry eye symptoms and tear instability were raised at one month after upper blepharoplasty^[2], and the NHS describes irritated, sensitive eyes lasting a few weeks.
Three months: tear measurements after lower blepharoplasty had returned to baseline^[7].
Six months: symptom scores were back at pre-surgery levels in people who already had dry eye in one study^[2], although small studies still found raised symptoms or lower tear scores in some patients at this point^{[3], [8]}.
Twelve months: in the randomised trial, objective tear measurements were no different from before surgery and symptoms were better^[6].

Dry eyes that are still bothering you at three months, or that are getting worse rather than better, deserve an assessment rather than more waiting. Can dry eyes go away permanently after blepharoplasty? In most people they do settle, and persistent problems are usually linked to an identifiable cause such as incomplete closure or a pre-existing dry eye condition that can be treated. Our blepharoplasty recovery guide covers the rest of the healing timeline.

Who Is at Risk of Dry Eyes After Blepharoplasty?

Some people are more likely than others to notice dry eyes after eyelid surgery:

Existing dry eye. In the 2021 study, people with dry eye before surgery had shorter tear break-up times for longer after upper blepharoplasty, and the authors identified pre-existing dry eye as a risk factor for worse and more persistent ocular surface damage^[2].
Previous laser eye surgery. Laser vision correction reduces corneal sensation and tear production for a time. A plastic surgery review advises considering dry eye in everyone with that history, and waiting at least six months after laser vision correction before blepharoplasty^[10]. Our guide explains how soon you can have blepharoplasty after laser eye surgery.
Eyelid anatomy. A periocular surgery review lists prominent eyes, lower lid laxity, scleral show (visible white below the iris), lower lid retraction and lagophthalmos among the things to look for before surgery^[13].
Conditions and medicines that reduce tears. Sjögren’s syndrome, other autoimmune and thyroid conditions, menopause, long hours of contact lens wear and some regular medicines, such as certain antihistamines and antidepressants, are recognised causes of dry eye in their own right. Tell your surgeon about them.
Previous eyelid surgery. Revision surgery, or surgery elsewhere that left the lids unable to close fully, carries a higher risk of problems; see our guide to botched eyelid surgery and blepharoplasty complications.
Heavy screen use. Concentrating on a screen reduces how often you blink, which makes any dryness feel worse during recovery.

How Do You Treat Dry Eyes After Blepharoplasty?

Most dry eyes after blepharoplasty need only simple measures, and your surgeon will tell you what to use. Treatment generally steps up as follows:

Lubricating eye drops. Artificial tears used regularly through the day are the usual first step. If you need them many times a day, preservative-free drops are often advised, so ask your pharmacist or surgeon which to choose.
Ointment at night. A thicker lubricating ointment protects the eye while the eyelids are swollen and may not close fully in sleep. It blurs vision, so use it as directed, only when you are not driving.
Comfort measures. Take regular breaks from screens, blink deliberately, avoid fans and air conditioning blowing at your face, wear sunglasses outdoors and keep contact lenses out until your surgeon says they are fine.
Lid care once healed. If the oil glands in the lid margins are involved, your eye specialist may suggest warm compresses and lid hygiene.
Specialist treatment for persistent dry eye. An ophthalmologist can examine the eye surface and may prescribe anti-inflammatory drops such as ciclosporin or place tiny plugs in the tear drainage channels to keep tears on the eye for longer.
Treating the cause. If the eyelids do not close properly, taping at night can protect the eye in the short term. If the lid position or outer corner is the problem, a corrective procedure may be needed once swelling has settled, as in revision blepharoplasty (corrective eyelid surgery)^[12].

Avoid rubbing the eyes, because this can irritate the surface further and disturb healing incisions.

How Can I Reduce the Risk of Dry Eyes Before Blepharoplasty?

Most of the risk can be reduced before the operation, not after it.

Tell your surgeon about your eyes

Mention any gritty, burning or tired eyes, past dry eye diagnoses, contact lens wear, previous laser eye surgery, thyroid or autoimmune conditions, and anything you take regularly. A periocular surgery review stresses a history of dry eye, previous laser vision correction and previous cosmetic injections as things to ask about before any eyelid surgery^[13].

Have your eyelids and tear film examined

A careful assessment looks at how well the lids close, the tone of the lower lids, the outer corner support and the eye surface. Surgeons may use simple tests such as the Schirmer test of tear production and tear break-up time, the same measures the studies above relied on, and may refer you to an ophthalmologist first if there is a concern. Our guide to how to avoid blepharoplasty complications covers the other questions worth asking.

Plan the operation around your eyes

A conservative approach to removing skin and muscle, leaving enough tissue for the lids to close comfortably, is the main protection against lagophthalmos^[4]. Where dry eye risk is high, your surgeon may adjust the plan, delay surgery while your eyes are treated, or talk through non-surgical alternatives to eyelid surgery, such as SmoothEye laser treatment for milder concerns.

Get the timing and aftercare right

If you have had laser eye surgery, wait for the interval your surgeon and eye specialist advise^[10]. Collect your drops and ointment before surgery, use them exactly as directed, and keep to the instructions in our blepharoplasty aftercare guide.

When Should I Worry About Dry Eyes After Eyelid Surgery?

Mild dryness is expected, but some changes need prompt attention. Contact your surgical team if:

your eyes will not close fully, or you wake with the eye open or the white of the eye showing
the eye is painful, increasingly red or very sensitive to light
your vision becomes blurred in a way that does not clear with blinking and lubricant
dryness is getting worse rather than better, or has not improved by around three months

A persistently exposed or painful eye can damage the surface of the cornea, so these symptoms should be examined rather than left. Dryness is also easily confused with other healing changes, such as the firm areas described in our guide to lumps after blepharoplasty. For the first 24 hours, call your surgeon on the direct number on your discharge summary. After that, call the clinic on 020 7993 4849, 9am–6pm Monday to Saturday, and NHS 111 out of hours. Any sudden loss of vision, or severe pain in or behind the eye, is an emergency: go to A&E straight away.

Frequently Asked Questions: Dry Eyes After Blepharoplasty

Does blepharoplasty cause dry eyes?

It can, usually temporarily. Early dryness, grittiness and watering are common in the first weeks, and most studies show tear measurements and symptoms returning towards their starting point over three to six months. Upper eyelid surgery often improves dry eye symptoms overall^[4].

How long do dry eyes last after blepharoplasty?

Most people notice the worst dryness in the first one to two weeks, and it fades over the following weeks to a few months. Persistent dryness beyond about three months, or dryness that is getting worse, should be assessed by your surgeon or an eye specialist.

Is it normal to have dry eyes after lower blepharoplasty?

Yes, in the early weeks. In a 2014 study of lower eyelid surgery, the tear pool and lid position changed in the first weeks and tear measurements had returned to baseline by three months^[7]. Watering and chemosis are also recognised after lower eyelid surgery.

Is it normal to have dry eyes six months after blepharoplasty?

It is not unusual for mild dryness to linger in some people, and small studies have found raised symptoms or reduced tear scores at six months in a minority^[3]. Dryness at six months is worth raising with your surgeon, because treatable causes such as incomplete closure or a pre-existing dry eye condition can be addressed.

Can blepharoplasty make dry eyes worse?

It can, particularly if you already had dry eye before surgery. In one study, people with pre-existing dry eye had longer-lasting changes in tear stability than people without^[2]. Tell your surgeon about any dry eye so that it can be assessed and treated before surgery.

Can eyelid surgery help dry eyes?

Upper eyelid surgery for excess skin often reduces dry eye symptoms. A 2025 meta-analysis of randomised trials found dry eye symptoms were significantly less likely after upper blepharoplasty than before it^[4]. It is not a treatment for dry eye and results vary between individuals.

Which eye drops help with dry eyes after eyelid surgery?

Plain lubricating drops (artificial tears) are the usual first choice, with a thicker ointment at night. If you need drops many times a day, preservative-free drops are often advised. Follow your surgeon’s instructions on what to use and when, and ask a pharmacist if you are unsure.

Can you overuse lubricating eye drops?

Plain lubricating drops are generally gentle and can be used as often as directed, but preserved drops used very frequently can irritate the eye surface, which is why preservative-free drops are often suggested for frequent use. If you find yourself needing drops constantly, see your surgeon or an eye specialist.

What should I do if my dry eye won’t go away?

See your surgeon or an ophthalmologist. They can check how well your eyelids close, examine the surface of the eye, and consider treatments such as anti-inflammatory drops, tear drainage plugs or, where the eyelid position is the cause, a corrective procedure.

Can dry eyes go away permanently after eyelid surgery?

In most cases dry eyes after blepharoplasty settle within weeks to months. Long-term problems are uncommon and usually have an identifiable cause, such as incomplete eyelid closure, that can be treated.

What are the common eye problems after blepharoplasty?

The commonest are dryness, watering, a gritty feeling, light sensitivity, blurred vision from ointment, swelling of the lining of the eye (chemosis) and temporary difficulty closing the eyes fully. Our guide to the risks of eyelid surgery sets out the less common and rare ones.

Does insurance cover eyelid surgery?

Cosmetic blepharoplasty is generally not covered by private medical insurance, and NHS funding is limited to people with significant functional problems. Policies differ, so check with your insurer first.

Blepharoplasty in London

Blepharoplasty at Centre for Surgery is performed by GMC-registered surgeons at our CQC-regulated Baker Street hospital. Your assessment includes a discussion of your eyes, any dry eye symptoms and previous eye surgery, so that the operation can be planned around them, and you have a follow-up review after surgery to check healing. We offer upper and lower blepharoplasty, Asian (double eyelid) blepharoplasty and male eyelid surgery. To see how eyelids look once healed, browse our blepharoplasty before and after photos.

Phone: 020 7993 4849 | Address: 95–97 Baker Street, Marylebone, London W1U 6RN
Contact us to schedule a consultation

References

Zhang SY, Yan Y, Fu Y. Cosmetic blepharoplasty and dry eye disease: a review of the incidence, clinical manifestations, mechanisms and prevention. International Journal of Ophthalmology 2020;13(3):488–492. doi:10.18240/ijo.2020.03.18 ↗
Zhao S, Song N, Gong L. Changes of dry eye related markers and tear inflammatory cytokines after upper blepharoplasty. Frontiers in Medicine 2021;8:763611. doi:10.3389/fmed.2021.763611 ↗
Aygun O, Arat YO, Dikmetas O, Karakaya J, Baytaroglu A, Irkec M. Effect of upper eyelid blepharoplasty on the ocular surface, tear film, and corneal microstructure. Arquivos Brasileiros de Oftalmologia 2024;87(3):e20220220. doi:10.5935/0004-2749.2022-0220 ↗
Todorov D, Mitchell S, Al-Hashimi M, et al. Functional and aesthetic outcomes after upper blepharoplasty: a systematic review and meta-analysis of randomized control trials. Aesthetic Surgery Journal 2025;45(6):554–562. doi:10.1093/asj/sjaf022 ↗
Floegel I, Horwath-Winter J, Muellner K, Haller-Schober EM. A conservative blepharoplasty may be a means of alleviating dry eye symptoms. Acta Ophthalmologica Scandinavica 2003;81(3):230–232. doi:10.1034/j.1600-0420.2003.00064.x ↗
Hollander MHJ, Pott JWR, Delli K, Vissink A, Schepers RH, Jansma J. Impact of upper blepharoplasty, with or without orbicularis oculi muscle removal, on tear film dynamics and dry eye symptoms: a randomized controlled trial. Acta Ophthalmologica 2022;100(5):564–571. doi:10.1111/aos.15036 ↗
Shao C, Fu Y, Lu L, et al. Dynamic changes of tear fluid after cosmetic transcutaneous lower blepharoplasty measured by optical coherence tomography. American Journal of Ophthalmology 2014;158(1):55–63. doi:10.1016/j.ajo.2014.03.016 ↗
Aksu Ceylan N, Yeniad B. Effects of upper eyelid surgery on the ocular surface and corneal topography. Turkish Journal of Ophthalmology 2022;52(1):50–56. doi:10.4274/tjo.galenos.2021.63255 ↗
Zloto O, Matani A, Prat D, Leshno A, Ben Simon G. The effect of a ptosis procedure compared to an upper blepharoplasty on dry eye syndrome. American Journal of Ophthalmology 2020;212:1–6. doi:10.1016/j.ajo.2019.11.021 ↗
Lee WB, McCord CD, Somia N, Hirmand H. Optimizing blepharoplasty outcomes in patients with previous laser vision correction. Plastic and Reconstructive Surgery 2008;122(2):587–594. doi:10.1097/PRS.0b013e31817d61d9 ↗
Mak FHW, Ting M, Edmunds MR, et al. Videographic analysis of blink dynamics following upper eyelid blepharoplasty and its association with dry eye. Plastic and Reconstructive Surgery Global Open 2020;8(7):e2991. doi:10.1097/GOX.0000000000002991 ↗
McCord CD, Miotto GC. Dynamic diagnosis of fishmouthing syndrome, an overlooked complication of blepharoplasty. Aesthetic Surgery Journal 2013;33(4):497–504. doi:10.1177/1090820X13479970 ↗
Mack WP. Complications in periocular rejuvenation. Facial Plastic Surgery Clinics of North America 2010;18(3):435–456. doi:10.1016/j.fsc.2010.05.002 ↗

The Centre for Surgery clinic frontage at 95 to 97 Baker Street, London W1U 6RN — Centre for Surgery, 95–97 Baker Street, Marylebone, London W1U 6RN.

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