Eyelid surgery (blepharoplasty) is cosmetic surgery to remove excess skin or fat from the eyelids.
The aim is to improve hooded or droopy eyelids or eye bags.
Before you go ahead, be sure about your reasons for wanting eyelid surgery. Bear in mind the cost, the risks, and the fact the results can’t be guaranteed.
It’s a good idea to discuss your plans with your GP first. There might be a medical condition affecting your eyelids or a reason why the operation isn’t appropriate for you.
What does it involve?
A blepharoplasty can be done under local anaesthetic with sedation or under general anaesthetic.
The surgeon would need to know about any medicine you may be taking to reduce your risk of blood clots, such as aspirin or warfarin.
Surgery on the upper eyelids generally involves:
Making a cut (incision) along the eyelid crease in the natural skin fold of the eyelid
Removing excess skin, fat or muscle
Closing up the incision – the scar will be hidden in the natural fold of the eyelid
Surgery on the lower eyelids generally involves:
Making an incision either just below the lower lashes or on the inside of the eyelid
Moving or removing fat from the bags under the eyes, and sometimes also a small amount of skin
Supporting the muscles and tendon of the eyelid if necessary
The surgeon will normally apply thin, sticky strips called suture strips to support the eyelids after surgery. These are usually removed up to a week later.
An upper blepharoplasty may take about one hour. Surgery on the lower lid may take up to two hours. Most patients can go home the same day.
It’s advisable to take about a week off work to recover from eyelid surgery.
It may be obvious for a little longer than a week that you’ve just had eyelid surgery.
You won’t be able to drive for a number of days after the operation. Bruises, scars and redness may take several weeks to fade.
You probably need to:
Prop your head up with pillows for a couple of days when resting to reduce the swelling
Gently clean your eyelids using prescribed ointment or eyedrops
Hold a cold pack to your eye for a few days – try a pack of frozen peas wrapped in a tea towel
Wear sunglasses to protect your eyes from the sun and wind
Take paracetamol or another prescribed painkiller to relieve any mild pain
You should avoid:
Strenuous activity and swimming for a few days
Contact lenses and rubbing the eyes
Side effects to expect
It’s common after eyelid surgery to temporarily have:
Puffy, numb eyelids that are difficult to close at night
Irritated, sensitive or watery eyes – this may last a few weeks
Bruising that looks like a black eye
Pink scars – these eventually fade to almost be invisible
What could go wrong
Eyelid surgery can occasionally result in:
Temporary blurred or double vision
Your eyes looking slightly asymmetrical
A pool of blood collecting under the skin (haematoma) – this usually disappears on its own after a few weeks
Rarely, it can result in more serious problems, including:
The lower eyelid drooping away from the eye and turning outwards (ectropion)
The lower eyelid becoming pulled down and showing the white of the eye below the iris (eyelid retraction)
Blindness – this is extremely rare
Also, any type of operation carries a small risk of:
Developing a blood clot in a vein
An allergic reaction to the anaesthetic
The surgeon should explain how likely these risks and complications are, and how they would be treated if they occurred.
Occasionally, patients find the desired effect wasn’t achieved and feel they need another operation.