Eyelid Surgery (Blepharoplasty)

It should not. The aim is to reveal the eye you already have by removing what is covering it. Changing the shape — a rounded or pulled-down lower lid, or an over-hollowed upper lid — is a sign that too much was removed, which is why conservative resection matters more than aggressive results.

Sometimes, when the overhanging skin measurably restricts your upper field of vision. That has to be demonstrated with a formal visual-field test and photographs taken before surgery — documentation prepared afterwards is almost never accepted. Raise it with your insurer before you travel, not after.

Often yes, but it must be assessed and treated first, and the surgeon should plan a more conservative skin removal. Blepharoplasty temporarily reduces how completely the eye closes, which worsens dryness. Untreated dry eye is the most common reason for regret after otherwise well-executed eyelid surgery.

Because the assessment is the same consultation and the two are very often performed together. Their techniques, recovery and risks differ, which is why each has its own section above — but deciding between them, or having both, is a single conversation with one surgeon.

Upper eyelid surgery lasts ten to fifteen years and many patients never need it repeated. Lower eyelid surgery is usually permanent, because the fat pockets that are removed or repositioned do not come back. You continue to age normally, so brows may descend and fine lines still form, but the specific problem you had corrected rarely returns to its original state.

Upper surgery treats a heavy fold of skin resting on the lash line, which makes eyes look tired and can narrow your field of vision. Lower surgery treats under-eye bags and the hollow shadow beneath them. They solve different complaints, and many patients only need one. Look in a mirror in daylight and note which bothers you when your face is relaxed — that is what the surgeon should address.

It should not, and a change in shape is the main sign of an over-aggressive operation. Removing too much lower eyelid skin pulls the lid margin downward, exposing white below the iris — a rounded, startled look that is difficult to correct. A good surgeon removes conservatively and supports the outer corner. If preserving your eye shape matters to you, say so explicitly and bring a photograph from ten years ago.

This is the single most important distinction, and it is often missed. Place a finger just above the outer eyebrow and lift gently. If the hooding disappears, your brow has descended and eyelid surgery alone will disappoint you — you need a brow lift, or both. If the fold remains, it is genuine excess eyelid skin. Removing eyelid skin under a fallen brow pulls the brow down further.

Upper eyelid surgery is routinely done under local anaesthesia with light sedation, takes forty-five to sixty minutes and you go home the same day. Lower eyelid work, especially when fat is repositioned from inside the lid, is more often done under general anaesthesia. You will not see anything alarming during the procedure — the eye itself is never touched, only the skin and fat of the lid.

Makeup on the lids after two weeks, once the stitches are out and the incision has closed; concealer on surrounding bruising is fine from day seven. Contact lenses after two to three weeks, because inserting them stretches the healing lid. Wear glasses in the meantime and use the prescribed lubricating drops — dryness and gritty eyes are the most common complaint in the first month and settle on their own.

The upper eyelid scar sits inside the natural crease and becomes essentially invisible once healed, which is why this is one of the best-hidden scars in surgery. Lower eyelid work is often done from inside the lid, leaving no external mark at all; when an external incision is needed it sits just under the lash line. Expect pinkness for six to eight weeks before it fades.

Yes, when excess upper eyelid skin hangs over the lash line and blocks the outer edge of your field of vision. Patients often report a wider view and less brow strain from unconsciously lifting the forehead all day. This is a functional problem measurable by a visual field test, and in some countries that test qualifies the operation for insurance cover — worth checking before you pay privately.

Stitches come out at five to seven days and most people are presentable at ten to fourteen. Bruising is the limiting factor rather than pain, which is usually mild. Sleep with your head raised on two pillows for a week and apply cold compresses for the first forty-eight hours — both measurably shorten the bruising. Fine swelling in the lid takes three months to settle completely.