Upper and lower eyelid surgery to remove sags and bags

Procedure Summary

The eyes are the windows to the soul, but as we get older the curtains can encroach a bit too much! Thankfully, the excess skin that gathers around the eyes can be removed with a blepharoplasty procedure - cosmetic surgery to reduce the sags above the eyes and the bags below the eyes to give a more youthful and alert appearance.

In addition, many people opt for a blepharoplasty to correct functional problems around the eye such as ptosis (drooping eyelid), blepharochalasis (inflammation of the eyelid), herniated orbital fat and visual field obstruction.

Is eyelid surgery right for you?

As our skin loses its elasticity with age, loose skin gathers around the eyelids, collecting in folds. In addition, the muscles around the eyes slacken causing the fat, which cushions the eyeballs in their sockets, to hang forward to create ‘bags’ below the eyes.

By reducing the excess skin around the eyes, a blepharoplasty can enhance your face to give a more youthful and alert appearance. However, as with all plastic surgery, it is designed to deal with very specific problems. So, for example, the procedure will not correct ‘crow’s feet’, dark circles under the eyes or sagging eyebrows.

“My eyes looked 15 years older than the rest of my body,” said one woman in her early forties. “A blepharoplasty simply removed the ageing folds of skin that were hanging around my eyes.”

Eyelid surgery may not be suitable for you if you have glaucoma or dry eyes which don't produce enough tears. Your cosmetic surgeon will be aware of this and arrange for an ophthalmologist to assess your suitability before any surgery takes place.

Undergoing the procedure and the recovery process

Upper eyelid surgery is often carried out separately from lower eyelid surgery. Normally a local anaesthetic is used, although a general anaesthetic may be used, especially if both upper eyelids and lower eyelids are being corrected. Depending on the extent of the work being done, the entire procedure can take between 1 and 3 hours.

In upper eyelid surgery, excess skin, fat and muscle is removed through an incision made along the natural fold of the eyelid. The scar, therefore, is hidden inside the eyelid’s natural crease. Lower eyelid surgery involves removing fat from the eyebags either through an incision made just below the lower lashes or through an incision made on the inside of the eyelid. Occasionally a small amount of skin may also be removed.

Although the scars are hidden, there will be some redness in the skin which may last a couple of months. In addition, there will be some initial bruising, and you will also be advised to keep your head raised for a few days to minimise the swelling (cold compresses can also help).

The swelling in general and the swollen tear ducts in particular will cause your eyes to appear watery after surgery. After a few weeks this will have completely receded. Also, you may experience some tightness when closing the eyes. However, with the help of ointment, this sensation will be resolved as the swelling goes down.

Sutures will normally be applied to support the eyelids. These will be removed after 3 to 7 days. The surgeon may recommend using eye drops or ointment as well as gentle cleansing with water.

Due to these short term discomforts, it is wise to book 1-2 weeks off work to provide the best conditions for the healing process to get well underway. “I was prepared for some tenderness after the operation,” said one blepharoplasty patient. “And when I went outdoors, a pair of large sun glasses were very useful!”

Although a blepharoplasty is a very common procedure, there is a degree of risk, as with all cosmetic surgery. Occasionally, a blepharoplasty can result in haematoma, a pool of blood collecting under the skin. This should disperse naturally over 2 or 3 weeks but it may need to be drained if it is excessive.

There is a possible risk of temporarily blurred vision and bleeding behind the eye, which can lead to blindness. There have also been instances of eyes having an asymmetrical appearance after the operation.

Finding a suitable Blepharoplasty surgeon

The final outcome of a blepharoplasty will depend in part on the skill and experience of the surgeon. Any eyelid surgery procedure should only be performed by fully trained and qualified surgeons registered with the Healthcare Commission (in the UK). Personal recommendation is helpful, however, because plastic surgeons specialise in one particular area, a recommendation from a friend after a successful tummy tuck doesn’t mean the surgeon will be the right choice to perform a blepharoplasty.

Prices for a blepharoplasty procedure can range from £2,500 for a single eyelid to £5,000 for a combined upper and lower lid procedure.

So, if you would like to remove the ‘excess baggage’ that you are carrying around your eyes, a blepharoplasty may be the answer. You can discuss all of the issues mentioned here in greater depth during your initial consultation with the cosmetic surgeon.

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