Some of the factors that can lead to a bad outcome include:
- poor quality or condition of the tissues (disease, smoking, sun, etc.)
- individual anatomical variation (eyeball, socket, cheek, etc.)
- selecting an inappropriate procedure
- attempting to maximize results with aggressive or unproven surgery
- failure to follow pre- or post-operative instructions
- unexpected, unexplained, or uncommon reactions to well-performed surgery
- choosing a surgeon with minimal relevant training and experience
- choosing a surgeon whose sense of aesthetics differs from yours
- bad luck (that is, the unpredictability inherent in all operations)
On the lower eyelid, internal tissue disruption, muscle injury, scarring, and/or shortage of skin may contribute to produce an eyelid that is turned out, pulled down, or rounded at the corners. Substantial preexisting midface descent may leave a hollow beneath the operated lid.
On the upper eyelid, excessive skin excision may limit the ability of the eyes to close fully, while stress on the elevating muscle or tendon may produce a droopy lid.
On the eyebrow and forehead, an aggressive forehead lift may leave a patient with a look of surprise, hair loss, or a "movie-star" face from the 1950s.
Should you elect to undergo cosmetic eyelid surgery, the good news is that the eyelids are located in a very convenient and accessible location. The bad news is that any flaws in the surgery or your healing are likely to show.
Other well-recognized risks from eye plastic surgery include infection, bleeding, and injury to the eye or eye muscles, all of which may decrease vision and/or require additional medical or surgical treatment.