Blepharoplasty & Eyelid Reduction London
Blepharoplasty, also known as ‘eyelid reduction’ or ‘eyebag removal’, which is a surgical procedure of the upper or lower eyelids to rejuvenate the periocular region or the area around the eyes. Ageing of the periorbital region often creates that undesirable tired look which often makes us look much older. An eyelid lift or blepharoplasty (eyelid surgery) is a cosmetic surgery procedure to address tired, sagging to puffy looking eyes. By removing excess skin, fat or muscle, the procedure provides restoration of the periorbital region. An eyelid lift can be performed on the upper eyelids, the lower eyelids or both upper and lower eyelids at the same time. Blepharoplasty can also be combined with facial fat grafting and/or laser resurfacing for even more enhanced results.
View our eyelid surgery patient education videos
Blepharoplasty Expected Results
- Upper and lower eyelid rejuvenation
- Reversal of the “tired” eyes look with removal of lower eyelid bags and saggy and droopy upper eyelids
- Some patients may develop impaired vision as a result of excess loose skin and a blepharoplasty is able to medically correct this
Our surgeons can help revitalise the periorbital region including the eyelids and support tissues, improving the appearance of the upper eyelids, lower eyelids or both. This provides patients with a more youthful, rested and more alert look. Centre for Surgery even offers male blepharoplasty and Asian blepharoplasty. Eyelid surgery is often performed alongside a brow lift.
Non-surgical options for eyelid reduction & blepharoplasty
Centre for Surgery specialise in the full range of both surgical and non-surgical treatment options for eyelid rejuvenation. In many cases, your surgeon will deploy both eyelid surgery and non-surgical treatments to address the effects of the ageing process in the eye region. Anti-ageing injectables are very commonly used and are ideal for treating fine lines and wrinkles with blepharoplasty being more suitable when more significant ageing changes are present. If you would prefer a non-surgical option for periorbital tightening – read about SmoothEye with the Fotona laser which we offer.
All our surgeons are on the GMC specialist register. Our London clinic at 106 Crawford Street was recently inspected and rated as good across all 5 domains.
10 REASONS TO CHOOSE US – CLICK HERE TO LEARN MORE
What is included in my treatment package?
- As many preoperative consultations with your surgeon as you like to make sure the procedure is right for you
- Treatment at a specialist day surgery facility recently rated ‘Good’ by the CQC
- Enhanced same-day discharge with the added benefits of recovering in your own home
- 24/7 clinical support from your surgeon for the first 48 hours and our expert postoperative support team
- Your very own dedicated patient coordinator
- In-depth preoperative medical assessment to make sure you are fully fit for the rhinoplasty procedure
- Exceptionally high standards of postoperative care described as ‘outstanding’ by the CQC with regular telephone and face to face checks by our expert postoperative support team
RealSelf Top Doctors
RealSelf top doctor status is awarded to less than 10% of the RealSelf doctor community. This status is earned by achieving consistently high patient satisfaction (from RealSelf reviews), getting excellent feedback on expert answers to patient questions, and investing significant time in Q&A and other doctor activities. RealSelf top doctors are rated among the very best surgeons in the United Kingdom and the USA.
Eyelid surgery | Fast facts |
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Procedure time ⏳ | 1-2 hours |
Anaesthetic type 💉 | LA or GA |
Length of stay 🛏 | Day case |
Up and mobile 🚶🏻♂️ | Same day |
Washing 🛁 | 1 week |
Sexual activity ❤️ | 4 weeks |
Back to work 📅 | 3 days |
Driving 🚗 | 1 week |
Postoperative garment 👕 | Ice pack for first 2 days |
Sleeping 😴 | On back 5 days |
Exercise 🏃🏽♀️ | 2 weeks |
Full recovery 🕺🏻 | 6 weeks |
Final results 😃 | 3 months |
Why choose Centre for Surgery for your eye bag removal procedure ?
- Over 15 years experience with all types of blepharoplasty surgery – upper eyelid, lower eyelid and combined procedures
- We regularly receive patients from overseas at our facial plastic surgery specialist centre.
- Our surgeons are UK trained NHS consultant plastic surgeons who live and work in the UK. We don’t work with ‘fly-in, fly-out’ surgeons from other countries. This is very important because whilst your surgeon takes all precautions to minimise complications, complications can and do occur and our surgeons are readily available to manage any issues if and when they arise.
- We own and manage our own surgical facilities. Properly performed eyelid surgery takes time and should never be rushed. Our surgeons perform a maximum of three blepharoplasty procedures per day. We do not cram 5-6 procedures into one day like some providers do. You want your surgeon to be well-rested, mentally and physically sharp to perform eyelid surgery, which is a very intensive procedure to get the very best results.
Trust a facial plastic surgeon
A facial plastic surgeon is trained to undertake aesthetic surgical procedures in the facial region. They are dedicated sub-specialists. Compared with general plastic surgeons, facial plastic surgeons are inherently better trained to perform delicate procedures in the eye region. The extra years of surgical training by facial specialists focused on the facial region results in an exceptionally high degree of skill. Blepharoplasty surgery is highly intricate and our surgeons are highly experienced to undertake surgery on the delicate eyelid region.
Our surgeons are full members of:
Really wonderful experience, Jasmin the receptionist was very helpful and sweet she assisted me throughout my appointments, bookings and payment. The day of my surgery I was extremely nervous and very anxious, I was booked in for upper eyelid surgery (Blepharoplasty).
First I was met with the lovely Gregory who I could not have asked for such a lovely kind person to be the Surgeons right hand man, he made me feel at ease straight away and as comfortable as possible. I then met my Surgeon Dr Ertan Erel who was also wonderful ( I had previously met him 2 weeks before for my consultation) I had an instant liking to him and felt comfortable with him performing the procedure on me. I had the treatment with Local anaesthetic so I was fully awake and aware of what was going on, again I was extremely nervous and felt like I was having a small mini panic attack when we started but both Dr Ertan Erel and his assistant Gregory both made me feel at ease and as relaxed as they possibly could, we even had some 80s music on that helped to calm me down, Gregory was holding my hand the majority of the time and was having a chat with me that made me feel so relaxed, I could not have asked for 2 lovely men to have worked on me. Both the Surgeon and his assistant are as important as each other when you have a very nervous patient like myself. I have not had any complications since leaving the clinic and so far I am really so happy I can already see the amazing results. Dr Ertan returned my call back two days later to make sure everything was ok and how I was getting on (that was very reassuring). Very excited to get my stitches out in a few days. I could not give less than 5 stars so thank you very much. I will definitely be recommending.
Eyelid Surgery London
The eye is a key important component of facial aesthetics, and an eyelid lift can play a beneficial role in facial harmony and reducing the effects of ageing of the periorbital region. Eyelid surgery is one of the most commonly performed facial aesthetic procedures at Centre for Surgery in London. If you suffer from features such as permanently tired-looking eyes, eyelid laxity, eyelid drooping, or dark circles around the eyes, a blepharoplasty may be ideal for you. Eyelid surgery is often combined with other facial aesthetic procedures including brow lift, facelift or laser resurfacing.
The most common indications for blepharoplasty are:
Loose skin: Laxity of the skin and tissue under the eyes gives an aged appearance, and blepharoplasty is used to smoothen out the fine lines.
Droopy eyelids: Having excess upper eyelid skin can lead to droopy lids, which give the appearance of tiredness and fatigue. Severely droopy eyelids can even impair vision.
Eye bags: During the ageing process, people can develop bags underneath the eyes. Excessive stretching of the lower eyelid layers is often the most common reason for the formation of eye bags and is a problem that is efficiently corrected with a blepharoplasty procedure.
Heavy, droopy eyes: Eyelids that have excessive amounts of fat can make you look tired all the time. This fat can be extracted during the surgery, leaving you with a more alert appearance. The key, however, is to extract the right amount of fat to avoid a sunken appearance. Choosing a plastic surgeon at Centre for Surgery means you get specialised expertise delivered within excellent day surgery facilities.
Upper Blepharoplasty
An upper blepharoplasty is also known as upper eyelid surgery. It allows upper eyelid rejuvenation without undergoing significant facial changes as with a facelift. It is normal to have eyelid skin but with the ageing process, the reduction of collagen and elastin leads to eyelid laxity and this can make a person look more tired and patients will often remark their work colleagues think they look tired all the time. With women, the application of make-up can become more difficult due to the extra loose skin and applying cosmetics like eyeshadow becomes more difficult to apply. With younger women in their thirties, one of the most common reasons for seeking upper blepharoplasty is the difficulty with applying make-up. Patients often notice their upper eyelid feels heavier and patients may actively elevate their brows without thinking to open up their eyes more. Constant activation of the frontalis muscle which is the main elevator of the brow may increase the incidence of horizontal forehead wrinkles. Treating these forehead wrinkles with neurotoxin is not effective until the extra skin of the upper eyelid is removed. Many practitioners will incorrectly treat the frontalis muscle with neurotoxin when the patient actually needs an upper blepharoplasty. This is because the neurotoxin will prevent the brows from being able to be raised and this will amplify the impression of the upper eyelids looking even more saggy and droopy. In these cases, the priority is always to treat the upper eyelids before the horizontal forehead lines.
Lower Blepharoplasty
Patients often seek a lower blepharoplasty to address the presence of under-eye bags. Patients both feel as if they look constantly tired as well as being remarked upon by work colleagues. The skin of the lower eyelid is the thinnest skin on the entire face. It is therefore very prone to undergoing premature ageing changes with the appearance of wrinkly skin. Patients will often have targeting injections of HA filler to this area and these are referred to as ‘tear trough’ injections. Injection of the tear trough is one of the most challenging areas to treat and sometimes the area is inappropriately treated with HA filler when the more suitable treatment is a lower blepharoplasty. The treatment of dark circles, hollowness of the lower eyelids and loose skin is optimally addressed with a combination of lower blepharoplasty, fat grafting and laser resurfacing. It is important to consult with a specialist facial plastic surgeon to ensure you get optimal outcomes.
Types of Blepharoplasty
Aesthetic Blepharoplasty
An aesthetic blepharoplasty is performed on the upper and lower eyelids. Aesthetic eyelid surgery is indicated for rejuvenation of the upper and lower eyelid region.
Reconstructive Blepharoplasty
A reconstructive blepharoplasty is used when the extra upper eyelid interferes with the patients vision or due to some other medical issue such as excessive tearing, thyroid eye disease, removal of eyelid lumps and bumps or revision blepharoplasty.
Prior to any surgical procedure, you will need to have a consultation with one of our blepharoplasty surgeons.
During the eyelid reduction consultation, you will be able to state your ideas, concerns and expectations about a proposed blepharoplasty procedure and what it can achieve.
The blepharoplasty surgeon will:
- Take a full history and perform a thorough examination
- Explain the procedure of blepharoplasty
- Provide an opinion on your suitability based on your needs and preferences
The specific technique of which blepharoplasty procedure to employ will depend on your underlying condition and the degree of skin laxity. A blepharoplasty surgeon can be either from a plastic surgery, ENT surgery, maxillofacial surgery or ophthalmology background. All four surgical specialities are fully trained to perform blepharoplasty of the upper and lower eyelids.
Things to consider before having eyelid reduction & eyebag removal
Why does the eyelid begin to sag?
During the ageing process, the skin will gradually lose collagen which results in a reduction in skin elasticity. A combination of a loss of skin elasticity combined with the effects of gravity will cause the skin to descend and lead to sagging.
With the eyelids, the edges of the upper eyelids will descend first. The small tendon of the eyelid muscle which normally functions to lift the upper eyelid will also undergo stretching. The upper eyelid muscle will therefore struggle to properly lift the upper eyelid.
With continued ageing, the loss of elasticity and muscle atrophy act in concert to create the appearance of a droopy upper eyelid. Those who habitually rub their eyes or have a degree of eyelid retraction will also lead to laxity of the upper eyelids. Ophthalmic surgery such as surgery for cataracts is also a common cause of droopy eyelids. The reason for this lies in the stretching of the eyelid to keep the eye open during surgery leading to muscle atrophy or weakening. Droopy eyelids or eyelid ptosis can also be present from birth where it is then referred to as congenital ptosis.
On top of the development of eyelid laxity, the ageing process also affects the entire face. The most noticeable feature of facial ageing is often a loss of facial volume. This may make bony structures on the face appear more prominent. When the cheeks begin to descend, the aged appearance of the lower eyelids can be more evident due to the development of hollowness.
Read our latest testimonials from our amazing patients
Drooping heavy eye lids were making me look older and more tired than I felt. (Nothing more deflating when feeling sparkling and vibrant at a party, to be told you’re looking tired!)
Time for action. Blepharoplasty.
Did my research, found Centre for Surgery, booked a consultation and met Mr Erel, a highly qualified surgeon. Any nervousness was dispelled immediately by his calm, friendly and professional guidance. The supporting team were great, special mention for Lidia, and the whole process was straightforward.
Two weeks in from the operation and I am thrilled with the results.(Should have done it sooner!) I thoroughly recommend them.
Ideal candidates for eyelid rejuvenation
Blepharoplasty or eyelid surgery will enhance the periorbital region. It is commonly performed for older people as well as those of Asian origin. During the ageing process, skin elasticity diminishes which often causes drooping eyelids because of the added effect of gravity over the decades. Lower blepharoplasty is used for skin laxity and loose muscle which often needs to be tightened up.
Ideal Candidate for Blepharoplasty
Good Candidates for Upper Blepharoplasty
- Good health
- No history of immunosupression
- Non-smokers
- Excess upper eyelid laxity
- Loss of the normal upper eyelid skin
- Impairment of vision due to excess upper eyelid skin
- Realistic expectations
Good Candidates for Lower Blepharoplasty
- Good health
- No history of immunosupression
- Non-smokers
- Lower eyelid bags
- Eyelid puffiness
- Wrinkly skin of the lower eyelid
- Presence of dark circles
- Realistic expectations
Assessment of the eyebrow
Eyelid lift preparation
Patients who smoke will be advised to stop for at least 2 weeks before the date of their blepharoplasty procedure. Smoking has detrimental effects on microcirculation and is well known to significantly delay the healing process. All medications, prescribed and over the counter will be reviewed by your doctor. Aspirin and any medicines containing aspirin should be stopped both before and after the eyelid lift procedure Aspirin and NSAIDS impair the body’s natural clotting process and may increase the risk of bleeding after surgery. If you require pain relief after surgery, paracetamol is advised.
What tests may I need before surgery?
At Centre for Surgery, we believe the success of any cosmetic procedure including blepharoplasty can be improved with optimal patient preparation. Our surgeons strive to go above and beyond to ensure all patients are fully prepared – mentally, physically and emotionally.
Blepharoplasty techniques
Centre for Surgery perform both upper and lower blepharoplasty in London :
Upper and lower blepharoplasty can be performed together or separately. An upper blepharoplasty can be performed under a local anaesthetic with or without oral sedation. Combined upper and lower eyelid blepharoplasty need to be performed under TIVA general anaesthesia for optimal patient comfort. The option is always yours on the type of anaesthetic you would prefer for your procedure – LA or GA.
Types of eyelid surgery:
Upper Blepharoplasty overview
Upper blepharoplasty involves the removal of loose skin that can cause multiple wrinkles or hooding onto the eyelash line. A repair of the eyelid muscle must also occur if there is droopiness in this structure. An upper blepharoplasty can be performed under a local anaesthetic but you have a choice on your preferred method of anaesthetic – local or general anaesthetic. Under correction or overcorrection is the most common pitfall in upper blepharoplasty surgery. It is better to under correct rather than overcorrect in upper blepharoplasty.
Lower Blepharoplasty overview
Surgery on the lower eyelid is known as a lower blepharoplasty. Lower blepharoplasty surgery is more complex to perform than upper eyelid surgery. A lower blepharoplasty often requires a general anaesthetic. The procedure involves making a small incision either below the lashes (trancutaneous approach) or inside the eyelid (transconjunctival approach). Prolapsed fat in the lower eyelid/cheek area will either be removed or repositioned, in order to improve the eyebag appearance. In some instances, excess skin may also be removed. Sutures and paper strips will then be applied to the eyelid for extra support. Eyebag removal can be performed as part of a lower blepharoplasty / combined blepharoplasty. This will help to reduce puffiness without causing an unsightly ‘hollowed-out’ look.
Combined upper and lower blepharoplasty
For patients who present with significant degrees of skin laxity, a combined procedure may be required for comprehensive periocular rejuvenation.
Male eyelid surgery or male blepharoplasty
Male eyelid surgery is available for men who wish to tighten their eyelids, remove excess fat or appear more youthful. This is also an appropriate procedure for men whose eyesight is impacted by sagging eyelid skin.
Asian Blepharoplasty
An Asian blepharoplasty differs from traditional blepharoplasty surgery because the eyelid is changed to a double eyelid. Eyelids that do not have a crease can then have a crease. The Asian blepharoplasty is not meant to alter a patients appearance, but the change achieved will often be subtle in nature. Asian blepharoplasty is performed in a very similar manner to an upper eyelid blepharoplasty. The difference lies in the fact that a small strip of eyelid muscle is precisely reconstructed to form a new eyelid crease. The incisions are closed with very fine sutures and the appearance is one without a ‘heavy’ appearance to the eyelid – a more natural-looking appearance.
A simply fabulous experience with Dr Misra. Centre for Surgery was recommended to me by a close friend who had received excellent treatment. From the first call to the day of my procedure and beyond, the level of care has been exceptional. The aftercare phone calls really gave me peace of mind and I look forward to my follow up appointment with Dr Misra.
Blepharoplasty types compared
Upper eyelid surgery
Procedure duration: 1 – 1.5 hours
Type of incision: Eyelid crease incision
Anaesthetic: Local anaesthetic or general anaesthetic
Recovery period: Day case and minimal downtime
Lower eyelid surgery
Procedure duration: 1.5 – 2 hours
Type of incision: Transcutaneous (below the eyelashes) or transconjunctival (inside the lower eyelid)
Anaesthetic: General anaesthetic recommended
Recovery period: Longer than an upper blepharoplasty. Depends on the individual.
Combined eyelid surgery (upper and lower eyelids)
Procedure duration: Approximately 3 hours
Type of incision: As above
Anaesthetic: General anaesthetic compulsory
Recovery period: As for a lower blepharoplasty with 2-3 days extra.
Recovery after blepharoplasty surgery
As blepharoplasty is a minimally invasive surgical procedure and there is a very short recovery period.
The surgeon uses very fine sutures which are removed about 4-5 days after your procedure.
You may notice some bruising or swelling, which will subside after five days.
We recommend avoiding putting any pressure on the nose for at least five days. You will also have to avoid wearing any glasses for two weeks, as this may impact the filter and change the appearance of the nose.
You will have to avoid sleeping on your side or front; make sure you sleep on your back for at least five days.
Risks and potential complications of blepharoplasty
Complications can potentially occur with any surgical procedure, a blepharoplasty is no different. At the consultation, your surgeon will always take time to fully discuss the risks and complications associated with blepharoplasty surgery. All risks need to be outlined regardless of how rare they are. By choosing Centre for Surgery for your blepharoplasty procedure, you can be confident in having highly experienced and expert surgeons to perform your procedure.
Potential complications associated with blepharoplasty
- Anaesthetic risks
- Visual impairment
- Double vision
- Visible surgical scarring
- Eyelid malposition
- Over resection of eyelid skin
- Eyelid sensory changes
Blepharoplasty cost
There are a number of factors that will determine the overall cost of your blepharoplasty procedure and the final quotation will be given after your face to face consultation with your specialist plastic surgeon.
- Upper eyelid, lower eyelid or combined upper and lower blepharoplasty
- Local anaesthetic or general anaesthetic
- Primary or revision blepharoplasty
- Blepharoplasty as a standalone procedure or combined with other procedures such as facelift surgery
Why not call 0207 993 4849 and speak to one of our expert patient coordinators who may be able to give you a rough costing prior to your blepharoplasty procedure.
Always remember that price should never be the determining factor when it comes to choosing your provider. We feel that safety and quality of service should be your number one priority and instilling in you the confidence that our team will look after you before, during and after your procedure to the best of their ability.
Spread the cost of your treatment
Centre for Surgery are fully approved to offer finance for eyelid surgery via our specialist finance partner, Chrysalis Finance. You no longer need to use your savings to pay for your treatment – you can apply to spread the cost of your procedure with Chrysalis Finance using their simple 1,2,3 application to pay for your procedure. Don’t wait until you have enough money for your treatment, apply today and (subject to status) pay for your procedure easily in monthly instalments, using one of their payment options. Chrysalis Finance is the only ethical provider that focuses solely on the provision of specialist financing for medical and cosmetic surgery procedures.
The Centre for Surgery approach to aftercare
Our aftercare programme was recently described as ‘outstanding’ by our regulator, the Care Quality Commission.
Our postoperative support team phones all our patients the day after their eyebag removal procedure and then every other day thereafter for the first two weeks. The proactive nature of our postoperative support gives every patient the best opportunity for a smooth postoperative recovery free of complications. In many cases, if complications were to occur, their impact is markedly lessened by early detection, prompt clinical assessment and correct treatment. Where a patient expresses concern to our team over the phone, then we often call patients on the same day for assessment with one of our expert nursing team. Even if there is no significant issue, the careful explanation and calm reassurance provided by our team can help to alleviate any worries you may have experienced.
FAQs
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Why should I choose a facial plastic surgeon for my blepharoplasty surgery?Blepharoplasty also known as eyelid surgery or eyelid reduction is a highly specialised surgical procedure which must be carried out with pinpoint accuracy and precision to get the very best results. It is therefore extremely important that patients select a surgeon who is an accredited specialist in facial plastic surgery to enable accurate assessment and treatment of patients considering blepharoplasty surgery.
Facial plastic surgeons can come from one of three backgrounds, ENT surgery maxillofacial surgery or ophthalmic surgery. After completing their specialist training in one of the three disciplines above, they then proceed to complete a one to 2 year long specialist fellowship in facial plastic surgery. During their training they acquire the expertise in both aesthetic and reconstructive surgery of the face. This training is above and beyond what most general plastic surgeons receive. Facial plastic surgeons therefore have the appropriate knowledge and expertise to perform all types of upper and lower eyelid surgery.
Facial plastic surgeons are fully trained to examine the eye and diagnose any pre-existing conditions of the eye as well as to treat many common functional eyelid conditions such as ectropion and entropion. Facial plastic surgeons are also trained to treat skin cancer of the eyelid region including highly complex eyelid reconstruction. They also possess the skills to accurately assess the eye after blepharoplasty surgery and to identify and manage any complications that may result after eyelid surgery. General plastic surgeons are not trained to this level of skill and can therefore not provide the same level of gold standard care as that of a facial plastic surgeon.
At Centre for Surgery, we would always recommend that patients be seen and assessed by a fully qualified facial plastic surgeon for both aesthetic and functional surgery of the eyelids. -
How to choose the best eyelid reduction surgeonEyelid reduction surgery is also known as blepharoplasty and is a highly specialised area of facial plastic surgery. It is therefore vital that you select the right type of surgeon to carry out this highly intricate type of cosmetic surgery procedure.
In our view, facial plastic surgeons are the most qualified type of surgeon to carry out all types of eyelid surgery both aesthetic and reconstructive. Facial plastic surgeons have carried out extra years of training under instruction of some of the worlds leading experts in facial plastic surgery. General plastic surgeons do not have the same level of expertise and skill compared with specialist facial plastic surgeons.
The facial plastic surgeon is best placed to explain all aspects of the eyelid reduction procedure in detail as well as giving information on what to expect in the recovery period after surgery and the potential risks and complications of eyelid reduction surgery. They will be able to determine if your expectations for Surgery are realistic and if you are in the best health, both physical and mental, for cosmetic eyelid surgery.
You should make sure to ask your surgeon to see their portfolio of before and after blepharoplasty images especially of patients that are similar to yourself to give you an accurate idea of how you could look after eyelid reduction surgery. You should also view verified patient reviews on trusted review platforms such as Trustpilot.
As part of your research, be sure to check the surgeons accreditations on the GMC website. Your surgeon should be on the specialist register and belong to a specialist organisation such as the European Academy of Facial Plastic Surgery or its equivalent. -
What are sagging eyelids?Sagging eyelids are one of the most obvious signs of the ageing process in both men and women. The presence of sagging eyelids can be a source of psychological distress especially when the perception exists that you feel you look older than one's actual age. Droopy eyelids can also lead to a sad or angry-looking appearance which may be remarked upon by others. In more severe cases of eyelid sagging, functional disturbance can result from impairment to vision from eyelids that droop too low.
Sagging eyelids can be caused by a number of factors but the most significant factor is the ageing process which exerts its effects through a loss of tissue firmness. In the eyelid region, the levator muscle acts to elevate the eyelid but with ageing, the levator muscle begins to thin out which leads to stretching of the overlying skin and deeper fat pockets begin to herniate outwards.
Droopy eyelids are more likely to happen in some individuals as they may have a hereditary link to forming droopy eyelids and this can affect both eyelids equally or one eyelid may be affected more than the other. Other extrinsic factors which can contribute to eyelid sagging or drooping include chronic sunlight exposure. -
What is blepharoplasty?Blepharoplasty is also known as eyelid reduction, eye lift and eye bag removal. Eyelid surgery targets the upper and lower eyelids for enhanced peri-ocular rejuvenation. An upper blepharoplasty and lower blepharoplasty target the eyelids to address ageing changes of the skin, underlying muscle and eye region. Eyelid surgery is ideally suited for older patients aged 50 and older but is often necessary for younger patients particularly when there are underlying structural issues such as drooping of the eyelids, eyelid lumps or puffy eyelids. Excess fat deposits which bulge outwards can also be addressed. These are known as eye bags and can develop earlier in life. Eyelid surgery can also be commonly performed with other facial cosmetic procedures such as a brow lift, facelift or facial fat transfer.
Facial fat transfer or fat grafting is very commonly combined with eyelid surgery particularly when there is volume loss in the upper or lower eyelids. -
What is eyelid reduction?Eyelid reduction describes the same procedure as a surgical blepharoplasty and eyelid surgery but differs in that eyelid reduction is specifically used to tighten the skin of the eyelids and reshape redundant eyelid skin to achieve a healthy youthful and rejuvenated appearance. Eyelid reduction can achieve dramatic eyelid tightening and lifting of the eyelid skin in both women and men in a procedure that can take an hour or less under a local anaesthetic.
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What side effects are associated with blepharoplasty?After the blepharoplasty procedure, it is common to experience puffy eyelids due to postoperative swelling but fortunately, the serious risks of blepharoplasty are rare. It can be difficult to fully close the eyes at night when sleeping and this can last up to 3 days. Watery and irritated eyes are commonly experienced for a number of weeks but this will subside without any long term impairment. Bruising of the eyelids can develop which can resemble a black eye and the incision scars may be raised and red for the first week. The surgeon will inject local anaesthetic and may apply topical local anaesthetic eye drops before starting the procedure and this may result in blurred vision due to residual effects of the local anaesthetic. At your consultation for eyelid surgery, your plastic surgeon will explain the potential risks and complications associated with the procedure and the potential chances of them occurring.
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What is the best way to prepare for eyelid surgery?At your face-to-face consultation with your blepharoplasty surgeon, the surgeon will explain in detail the important preoperative instructions to enable an excellent outcome following blepharoplasty surgery. In some cases you may be asked to have an eye examination if you have a history of conditions affecting your eye. Your eyes will also be physically examined and standardised photography will be taken off the eyes from a number of angles.
It is recommended to stop smoking two weeks before the procedure. Smoking has a negative effect on wound healing and leads to an increase in the risk of post-operative complications occurring.
You may also be advised to stop taking aspirin or any medicines containing aspirin and herbal supplements should also be stopped. These medicines are associated with an increased risk of bleeding after eyelid surgery. This is particularly important after a lower blepharoplasty with fat repositioning where it is vital that the risk of post-operative haematoma is minimised as much as possible. -
Am I a good candidate for blepharoplasty?You must have realistic expectations because although eyelid surgery can improve your appearance, other people may not always notice it. The procedure is suitable for both men and women with most patients being over 35. However, droopy eyelids can also be hereditary so those may consider eyelid surgery at a younger age.
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How long does eyelid surgery take to perform?From 1 hour for an upper blepharoplasty to 3 hours for a combined blepharoplasty.
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Where are the incisions placed?Upper blepharoplasty - eyelid crease
Lower blepharoplasty - inside the lower eyelid or below the lower eyelash -
Is blepharoplasty surgery a painful procedure?Blepharoplasty or eyelid surgery is a superficial procedure in that it involves removal only of excess skin and does not involve any deeper work. There is therefore very little in the way of post-operative discomfort in the recovery period. Any pain can be controlled with simple over-the-counter painkillers and the application of antibiotic eye ointment prescribed by your surgeon.
In most cases, patients require no pain relief whatsoever after eyelid surgery. It is common to have a feeling of grittiness in the eyes and this is affectively treated with the eye ointment prescribed to you to take after the surgery. It is common to have a bruised and swollen appearance after surgery although this rapidly settles down after a few days. Most patients often work from home for a day or two after surgery and are back to their normal activities of daily living after 3 to 4 days. Any post-operative discomfort is very insignificant in nature. -
Can eyebags be treated with a blepharoplasty?Eyebags are often due to excess skin and these can be treated effectively with a lower blepharoplasty procedure.
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Can fine lines and wrinkles around the eyes be treated with a blepharoplasty?Peri-ocular wrinkles around the eye region are most effectively treated with ablative laser skin resurfacing using erbium laser or CO2 laser, not a surgical blepharoplasty.
Centre for Surgery specialise in both fractional and full-field laser resurfacing using the state of the art Erbium YAG laser and fractional CO2 laser. -
Can brow ptosis (droopy brow) be treated by blepharoplasty?Brow ptosis requires a browlift and if blepharoplasty surgery is contemplated for eyelid laxity then it is recommended that the browlift is performed first.
Browlifts can reduce the forehead creasing and also the frown lines. It can also reposition the brow up to 1cm higher to provide excellent correction of low lying dropping brows. -
Can eyelid surgery be combined with other procedures?Blepharoplasty surgery is very often combined with other facial procedures such as a facelift, laser resurfacing or facial fat transfer.
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What does the blepharoplasty procedure involve?At Centre for Surgery in London, blepharoplasty or eyelid surgery is a very commonly performed procedures and is always carried out as a day case procedure which means you will be admitted and discharged on the same day. Most eyelid surgery is carried out under our form of general anaesthetic known as TIVA. However if you are having only a upper blepharoplasty then it may be possible to carry this out under a local anaesthetic. Eyelid surgery takes on average between 45 minutes and two hours to carry out depending on the extent of work performed.
- Upper blepharoplasty
Upper eyelid blepharoplasty is primarily carried out to reduce or eliminate visual impairment caused by droopiness of the upper eyelids caused by aging. The upper eyelid blepharoplasty procedure aims to restore a healthy youthful and vibrant appearance to the upper eyelids. The incision for upper blepharoplasty is located along the natural eyelid crease followed by the removal of extra redundant skin and herniated fat pockets or the removal of excess muscle laxity. Before closing the skin with sutures, the skin is stretched out to remove any overlying lines and wrinkles. The resulting scar after upper blepharoplasty is very well concealed in the natural fold of the eyelid which makes it barely perceptible to others after a few weeks.
Procedure duration: 1 - 1.5 hours
Type of incision: Eyelid crease incision
Anaesthetic: Local anaesthetic or general anaesthetic
Recovery period: Day case and minimal downtime
- Lower blepharoplasty
Lower eyelid blepharoplasty is most commonly carried out to reduce or eliminate localised eyelid wrinkles and eyelid puffiness in the area beneath the eye. The incision for lower eyelid blepharoplasty is positioned just below the eyelash margin and extends outwards into the lateral canthal lines also known as the crow's feet. In some cases in patients with minimal skin excess, your surgeon may carry out a trans-conjunctival approach using CO2 laser dissection to expertly reposition the herniated fat pads giving rise to visible bags under the eyes. The advantage of this approach is that it does not involve any visible scar as the incision is well concealed in the conjunctiva.
Procedure duration: 1.5 - 2 hours
Type of incision: Transcutaneous (below the eyelashes) or transconjunctival (inside the lower eyelid)
Anaesthetic: General anaesthetic recommended
Recovery period: Longer than an upper blepharoplasty. Depends on the individual.
Combined blepharoplasty (upper and lower eyelids)
Procedure duration: Approximately 3 hours
Type of incision: As above
Anaesthetic: General anaesthetic compulsory
Recovery period: As for a lower blepharoplasty with 2-3 days extra. -
What is the recovery process like?There will be some bruising and swelling after the surgery, which is managed with elevation and cold packs. Patients can return to work one week after the surgery.
It can take a few months for the swelling to resolve. -
When can I return to work after eyelid reduction?We would advise 7-14 days off work.
A responsible adult escort should take you home after surgery and look after you for the first 24 hours. -
When can I resume driving after blepharoplasty surgery?We would recommend one week off as the painkiller medications may impair your ability to drive.
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When can I resume going to the gym after eyelid surgery?Light exercise can be resumed after 2-3 weeks.
Strenuous exercise and contact sports may be restarted after 6 weeks. -
Can I wear glasses or contact lenses after blepharoplasty?You can wear glasses as normal following your procedure. Contact lenses will require a period of at least 2-3 weeks before they can be used again.
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Can make-up be applied straight after eyelid surgery?You should wait at least 8-10 days before wearing eyeshadow, mascara, eyeliner and fake lashes.
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What is the scarring like after blepharoplasty?Scarring is minimal, and the scars will become almost invisible when the eyes are open.
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What is an Asian blepharoplasty?Asian blepharoplasty is a type of blepharoplasty surgery that creates a crease in the upper eyelid when the crease is absent. Many Asian men and women choose to have this procedure to increase the definition of the eyes.
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How long do the results last after eyelid surgery?Blepharoplasty surgery creates long-term results. However, the results could be affected by the ageing process.
What To Expect
The blepharoplasty consultation
We always recommend a face to face consultation with one of our expert plastic surgeons as the first step in your journey towards rejuvenated eyelids. When you meet with one of our surgeons, your surgeon will take time to listen carefully to what you hope to achieve and give you an expert opinion on what can and cannot be achieved after performing a thorough physical examination. Your surgeon may use computerised digital imaging to map the structure of the eyelid region in detail to give you an idea of what your eyelids could look like after your procedure.
Your surgeon will also take a number of measurements as part of a detailed facial analysis. Finally, high-resolution photographs are taken in a number of views. Your surgeon will also discuss with you the potential risks and complications of eyelid surgery and what to expect in the postoperative phase during your healing and recovery. It is important to know what medicines you taking as some medicines can interfere with blood clotting and may need to be stopped. Any history of medical conditions or previous surgery will also be recorded and all the compiled information is used to make a decision on your medical fitness for the blepharoplasty procedure. After a recommended two week "cool off" period and provided you are appropriate for the procedure, you can then make an informed decision on whether you would like to proceed with the eyelid reduction procedure. If you are unsure of any aspect of the eyelid surgery procedure and what it entails then we would invite you to return for as many follow-up consultations with your surgeon as you like to make sure that eyelid reduction surgery is right for you. The consultation lasts about 45 minutes on average. It may take longer if your procedure is going to be more complex. We would actively recommend coming in for a follow-up consultation to ensure all your questions are answered.
Before your procedure
Once you have decided to move forward with eyelid surgery. Our preoperative assessment team will be in touch to assess medical fitness prior to coming in on the day of surgery. There are a number of instructions to follow before your procedure including stopping any aspirin-containing medicines as these can increase bleeding and ideally stopping smoking. Smokers have a higher risk of slower wound healing as well as more chance of wound complications. On the day of your procedure, you must follow the preoperative fasting guidance which includes no food for 6 hours prior. Only clear fluids (water) is allowed up to 2 hours before your procedure. If you have eyelid surgery under local anaesthetic only, there is no need to fast beforehand.
On the day of your procedure
When you arrive for your blepharoplasty procedure, you should aim to arrive on time to allow the admission process to proceed smoothly. One of our nurses will formally admit you and will check a number of items including making sure you have your postoperative medications. You will have your vital signs measured including blood pressure and heart rate. The anaesthetist will then meet you to perform a preoperative airway assessment. Finally, your surgeon will consent you for the planned procedure followed by a detailed preoperative marking of the areas to be treated. Eyelid surgery takes about 1-2 hours to perform and if you choose GA, our anaesthetists use TIVA general anaesthesia to keep you comfortable throughout the procedure. Depending on the type of eyelid surgery whether upper blepharoplasty or lower blepharoplasty, the surgeon makes small incisions within the natural folds of the eyelid skin and will then carefully dissect the redundant eyelid tissue followed by repositioning of any underlying fat. The skin will then be carefully closed using fine sutures resulting in any wrinkles being smoothened out. After the procedure is complete, you will spend time in our recovery suite where you will be prepared for nurse-led discharge once you have met all the discharge criteria. It is important to have a responsible adult such as a friend or family member to accompany you home and to look after you for the first 24 hours.
After your procedure
Once you are safely at home, you can be assured of having access to our specialist postoperative team round the clock. You will be given a contact number to contact your surgeon in the first 24 hours after surgery if there is any concern. Eyelid surgery is associated with very little in the way of postoperative discomfort although a bruised and swollen appearance is common for the first week after surgery. Bruising should start to subside after 7-10 days. You should avoid intense sunlight after the procedure to reduce the risk of pigmentary changes.
Our postoperative team will look to call every day for the first 2 weeks after your procedure. This is so we can monitor your levels of comfort and can alert your surgeon if there is any concern. Our proactive approach allows the detection of any potential issues early which results in more effective treatment. You are advised to rest for at least a few days after your eyelid reduction procedure which will also help with pain control. Heavy exercise should be avoided for at least the first 4 weeks. Our postoperative clinical team will assess you face to face at your 1-week post-operative appointment to ensure healing is progressing normally and the site of the wound is healthy. Your sutures will be removed if your surgeon used non-absorbable sutures. You will be booked for your surgeon follow-up appointment for 6 weeks after your procedure.