Blepharoplasty

A blepharoplasty is an operation to remove excess skin and fat from your eyelids and to tighten your skin and soft tissues around your eyes.

If an upper eyelid is interfering with your vision, your vision should improve.

Your surgeon may be able to assess you for laser skin resurfacing, where a laser is used to gently burn the surface of your skin in a controlled way.

Injecting Botox can smooth out fine wrinkles.

Your surgeon may be able to suggest an alternative. If an upper eyelid is interfering with your vision, the problem may get worse over time.

An upper-eyelid blepharoplasty is usually performed under a local anaesthetic that is injected in your eyelids. A lower-eyelid blepharoplasty is performed under a general anaesthetic or sedation.

The operation usually takes an hour to 90 minutes.

• Upper-eyelid blepharoplasty – Your surgeon will make a cut on the natural skin crease just above your eyelid. They will remove any excess skin and fat that is pushing through the muscle.
• Lower-eyelid blepharoplasty – Your surgeon will make a cut along the rim of your eyelid below your eyelashes to just beyond the outside edge of your eye. They will remove any excess skin, and remove or redistribute any fat that is pushing through the muscle. Your surgeon may tighten your eyelid to help to prevent it from sagging (canthopexy).

Keeping in the same position

If the operation is performed under a local anaesthetic, you will need to lie still and flat during the operation. If you cannot lie still and flat, let your surgeon know.

Lifestyle changes

If you smoke, stopping smoking now may reduce your risk of developing complications and will improve your long-term health. Try to maintain a healthy weight. You have a higher risk of developing complications if you are overweight.

Regular exercise should help to prepare you for the operation, help you to recover and improve your long-term health. Before you start exercising, ask the healthcare team or your GP for advice.

Speak to the healthcare team about any vaccinations you might need to reduce your risk of serious illness while you recover. When you come into hospital, practise hand washing and wear a face covering when asked.

The healthcare team will try to reduce the risk of complications.

Any numbers which relate to risk are from studies of people who have had this operation. Your doctor may be able to tell you if the risk of a complication is higher or lower for you. Some risks are higher if you are older, obese, have other health problems or you smoke. Health problems include diabetes, heart disease or lung disease.

Some complications can be serious and may even cause death.

General complications of any operation

• Bleeding during or after the operation.
• Infection of the surgical site (wound).
• Allergic reaction to the equipment, materials or medication.
• Chest infection. Your risk will be lower if you have stopped smoking and you are free of COVID-19 (coronavirus) symptoms for at least 7 weeks before the operation.

Specific complications of this operation

• Too much skin being removed, which can cause a tight eyelid that you cannot close properly.
• Swelling of the conjunctiva.
• Bleeding into your eye socket. This can increase the pressure in your eye socket and, if not relieved quickly, can lead to permanent loss of vision.
• Corneal abrasion, where the surface of your eye gets scratched during the operation or by a stitch.
• Double vision. Double vision can be permanent so you may need another operation.
• Unsatisfactory result. You may need another operation to redo (revise) the blepharoplasty.
• Cosmetic problems.

Consequences of this procedure

• Pain.

If you have only an upper-eyelid blepharoplasty, you should be able to go home after a few hours.

Do not do strenuous exercise or bend down for the first week.

Do not wear eye make-up or drink alcohol for a few weeks, and keep your face out of the sun.

Regular exercise should help you to return to normal activities as soon as possible. Before you start exercising, ask the healthcare team or your GP for advice.

The results of a blepharoplasty can last for 5 to 10 years and sometimes can be permanent.

A blepharoplasty is an operation to remove excess skin and fat from your eyelids and to tighten your skin and soft tissues around your eyes.