The dissection of the intrastromal lenticule created by the femtosecond laser is a surgeon-dependent procedure that may be hindered by the presence of opaque bubble layers, the occurrence of black spots, or the identification of areas with high resistance in regions where the femtosecond lenticule cut has been compromised. Furthermore, the dissection of the lenticule for subsequent extraction must be done carefully. Inadvertent dissection of the lenticule’s posterior plane first, or the iatrogenic creation of false dissection planes, complicates the lenticule extraction. This complication may result in the retention of fragments in the interface, incision tears due to excessive manipulation, or even cap perforation. In this chapter, we will discuss all these complications that are specific to the SMILE technique.