Blepharoplasty

Our consultant ophthalmic surgeon Mr Tristan Reuser explains what blepharoplasty is and answers some frequently asked questions.

Blepharoplasty is a surgical procedure to remove some of the excess skin or fat from the upper or lower eyelids. The aim is to improve hooded, droopy or sagging eyelids or eye bags and reduce wrinkles and puffiness. Excess skin is often due to ageing, sun damage, trauma or other medical conditions such as thyroid problems. There may be also be an inherited tendency for eye bags to develop earlier in some people than others. In some cases vision can be affected due to the excess skin obscuring vision.

Blepharoplasty surgery is usually performed under a local anaesthetic.  During surgery, incisions are made in the natural folds of the eyelid in the crease of the upper eyelid and just beneath the lashes or behind the lower eyelid,  so that they are virtually unnoticeable after the tissues have healed.

The excess skin is cut away and the skin wounds are then closed with sutures (stitches), which may also involve strengthening the natural eyelid crease in the eye. If dissolvable sutures are used, they will fall out in a few weeks, otherwise they have to be removed 7-14 days later. At the end of the surgery, ointment is put on the wounds and eye pads applied to the lids.

The whole treatment may last 90 minutes and, usually, both eyes are treated at the same time.

In cases where the eyebrows are also droopy, a procedure to elevate the eyebrows may be appropriate. This procedure is known as an eyebrow lift.

An upper eyelid blepharoplasty can be an effective treatment to make you look younger and improve your vision if it is impaired by excess skin.  A lower eyelid blepharoplasty can help to reduce wrinkles and puffiness.

Your surgeon will carry out a detailed assessment before deciding if surgery is suitable for you.

Blepharoplasty can enhance your appearance and self-confidence, but it will not necessarily change your looks to match your ideal. Think carefully about your expectations and discuss them with us. The better you can tell us what you expect, the better we can tell before any procedure whether this can be done.

Once the anaesthetic has started to work, the eyelid will be numb and the surgery will not hurt.

Following the operation the eyelids may be slightly painful for about 24 – 48 hours after the surgery during this time rest is recommended, normal painkillers such as paracetamol should be enough to ease any pain.

Antibiotic and anti-inflammatory eye drops may be prescribed to minimise the risk of infection and reduce the redness and inflammation in the eye. It is important to wash your hands before using these to prevent infection. It is not uncommon for your vision to be blurred for few days and it may not be possible to wear contact lenses.

Most people who have a successful blepharoplasty are more comfortable with their appearance.  Your face should look younger and brighter.  If an upper eyelid is interfering with your vision, your vision should improve.

It is advisable to a week off work to recover following the operation and you will not be able to drive for a number of days following surgery. Bruises, scars and redness may take several weeks to fade. Strenuous activity, including swimming, should be avoided for at least two weeks.