What are the material risks of blepharoplasty I must disclose?

Bruising, swelling, asymmetry, dry eye, incomplete eyelid closure (lagophthalmos), ectropion, over- or under-correction, scarring, altered sensation, the need for revision, and the rare but serious risk of vision loss. Montgomery requires the material ones to be disclosed and recorded, tailored to the patient.

Is dry eye a risk I need to consent for in eyelid surgery?

Yes. Dry eye and irritation are recognised and can persist, and for many patients they are material to the decision. They should be discussed specifically and the discussion documented, not left to a generic risk sheet.

What alternatives should I record for blepharoplasty?

Non-surgical options where appropriate, and no treatment. McCulloch requires you to discuss the reasonable alternatives and record which were considered and why surgery was chosen. In an elective, appearance-driven procedure this is central to a defensible record.

Blepharoplasty & Oculoplastic Consent

Blepharoplasty and oculoplastic consent

Eyelid and periocular surgery is high-satisfaction and high-expectation, which is exactly why its consent has to be watertight. This guide, informed by an oculoplastic surgeon and CPR 35 expert witness, sets out what Montgomery requires you to disclose and record.

Why oculoplastic consent is scrutinised

Blepharoplasty sits at the meeting point of function and appearance, on some of the most delicate anatomy in the body. Patients arrive with a clear picture of the result they want. That combination, high expectation and fine margins, is why consent here is examined so closely when a complaint arises, and why Montgomery's patient-centred test matters.

The material risks to disclose and document

Bruising, swelling and asymmetry, and the possibility of revision.
Dry eye and irritation, which can persist.
Lagophthalmos (incomplete eyelid closure) and ectropion (lid turning outward).
Over-correction or under-correction and a result that differs from expectation.
Scarring and altered sensation.
Rare vision loss, including from retrobulbar haemorrhage, the most serious recognised risk.

Expectations and alternatives (McCulloch)

Because so many oculoplastic complaints are about a mismatch between expectation and outcome, the record should capture what the patient wanted, what was realistic, and the reasonable alternatives, from non-surgical options to no treatment at all. Documenting that the alternatives were weighed, and why surgery was chosen, is a McCulloch requirement and a strong defence.

Why the record is the case

The value of a consent record is decided long before a complaint. An oculoplastic surgeon who also reports on these cases for the courts reads notes the way a claimant expert will: looking for the tailored discussion of dry eye, of asymmetry, of the rare but serious risks, and for evidence the patient had time to reflect. If it is there, the claim struggles. If it is not, the negotiation begins at your expense.

Where this sits

Every material risk below is a Montgomery disclosure and, where an alternative exists, a McCulloch one too. If it was discussed, it needs to be on the record. See how the standard rose in the interactive timeline, and how a claim actually unfolds in Anatomy of a Claim.