What the procedure is
Blepharoplasty treats loose upper-eyelid skin or bulging fat beneath the eye.
In the upper eyelid the operation may be functional where loose skin obscures part of the upper visual field.
In the lower eyelid it addresses bulging fat pads and sometimes excess skin. Distinguishing fat bulges from dark circles caused by other factors matters, because the operation does not treat pigmentation.
Who is a suitable candidate
- People with clear looseness of eyelid skin or fat bulges.
- People without severe dry eye or unstable eye disease; assessment by an ophthalmologist is advised where there is a complaint.
- People in good general health with controlled blood pressure.
How it is performed
Usually performed under local anaesthesia with sedation, sometimes under general anaesthesia, taking one to two hours.
In the upper eyelid the incision lies within the natural eyelid crease.
In the lower eyelid the incision may be immediately below the lash line, or from inside the eyelid with no external scar where only fat is addressed.
Recovery
- Discharge the same day.
- Bruising and swelling around the eye are expected, with most subsiding within one to two weeks.
- Sutures are usually removed at about a week.
- Avoiding exertion, lifting and bending is advised for a period set by the surgeon.
- Return to work is often within one week to ten days.
Scars
In the upper eyelid the scar sits within the natural crease and becomes inconspicuous in most cases.
In the lower eyelid the scar sits immediately below the lash line, or there is no external scar where the internal approach is used.
Risks and complications
Every operation carries risk. This is an educational list, not an exhaustive one; the risks specific to your case are discussed during consultation.
- Risks of anaesthesia.
- Dry or irritated eyes, which may persist for weeks.
- Temporary difficulty closing the eyelid fully.
- Outward turning of the lower lid margin, more associated with lower-lid surgery and which may need correction.
- Asymmetry between the two sides.
- Haematoma.
- Infection.
- Temporary double vision.
- Loss of vision — a very rare complication, stated here because it is serious.
Combining with other procedures
Upper and lower eyelid surgery are often combined in the same sitting, and may be followed by non-surgical facial treatments after recovery.
Common questions
Does the operation treat dark circles?
It addresses the shadow created by fat bulges, but does not treat pigmentation itself where this is due to skin colour or thin skin. Establishing the cause on examination is what clarifies the expected benefit.
Is upper eyelid surgery covered by insurance?
Cases where loose skin obstructs the visual field may be considered differently from aesthetic ones, and a visual field test is usually required. The insurer is the authority on this.