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Eyelid Surgery on Harley Street

What is blepharoplasty?

Blepharoplasty, also known as eyelid reduction, eyelid lift or eye bag removal, is a cosmetic or functional surgical procedure whereby excess skin and muscle is removed from around the eye area.

As we age, our skin begins to lose its elasticity, resulting in droopiness and the development of eye bags beneath or above the eyes. This can leave us with an undesirable, tired, worn-out appearance. This sagginess is often more noticeable in smokers or those who have been exposed to UV/sunlight a great deal throughout their lives.

An effective anti-ageing treatment, the blepharoplasty treatment can be a life-changing procedure for people with perpetually tired-looking eyes, helping to dramatically improve appearance by rejuvenating the eye area and giving a firmer, fresher, more youthful appearance.

If excess tissue is interfering with a patient’s vision or making the eyelids feel particularly heavy, the blepharoplasty procedure becomes a functional one, rather than cosmetic.

The overall purpose of the procedure is to correct the excess skin folds (dermatochalasis) and eye bags or to reduce lower lid festoons. Festoons are the folds of muscle and skin that drape and hang from one corner of the eye to the other in the lower lids.

Blepharoplasty is a popular procedure with both women and men, and for both cosmetic and functional reasons.

How is blepharoplasty surgery performed?

A blepharoplasty procedure will be different for each patient, as no two people are the same. It can be performed on the upper or lower eyelid areas, with the method and time taken varying depending on which is performed.
Blepharoplasties are carried out as a day case and can be performed as a singular procedure, or in conjunction with other surgical or non-surgical treatments of the brow, face, eyes or nose.

Upper eyelid blepharoplasty

The upper eyelid blepharoplasty is an eyelid lifting surgery to remove the excess upper eyelid skin, which is causing droopy eyelids. We will typically make incisions in the upper eyelid skin crease, where they heal best and will remain well hidden.
We make the incision along the skin crease of the natural eyelid, a few millimetres above the eyelashes. The height of this will vary between six and eight millimetres and is commonly lower in patients for Asian blepharoplasty, who have a low skin crease naturally unless they are comfortable with a result that changes slightly the appearance of the eye to one that is more western.
We then remove an elliptical piece of skin and muscle using a blade and a colorado needle (ultra-sharp microdissection needle designed for precision cutting and coagulation), which greatly minimises bleeding and helps ensure the surgery is kept very neat. We then close the skin incision using delicate sutures (stitch) and /or Tisseel fibrin adhesive.
We are also able to remove the underlying fatty material when carrying out the procedure, in order to get rid of upper bulges (called the medial fat bags), predominantly at the inner corner of the upper eyelid.
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Lower eyelid blepharoplasty

Patients with slight eye bags, mild lower lid skin laxity, discolouration or fine lines may not need to undergo blepharoplasty.

For instance, those with deep tear trough hollows (orbito-malar groove), or those who have hollowing at the orbital rim and upper cheek (orbital rim and zygomatic hollow) may be more suitable for different types of treatment, such as an injection of hyaluronic acid filler, which helps increase the volume of soft tissue. After several months, re-injection may be necessary as the hyaluronic acid is absorbed. Afterwards, patients might wish to proceed with an autologous fat transfer (referred to as a Coleman fat transfer). If we think that a lower eyelid blepharoplasty would be beneficial, we can arrange for the procedure to take place.

This procedure is carried out by making an incision from the inside of the lower eyelid, which leaves no visible outside scar and does not result in excessive swelling. This approach is referred to as a transconjunctival blepharoplasty and is used when a small quantity of fat is removed from the area and is repositioned at the tear trough.

If skin needs to be removed from the lower eyelids, a small incision, close to the eyelashes, will be made (referred to as infra-lash incisions). Simultaneously, the eyelid can be tightened and fixed with an orbicularis muscle flap. A lateral canthal canthopexy is also frequently carried out at the lateral corner of the eye, in order to strengthen and improve the lateral angle of the eyelids.

Subtle, dissolvable sutures are used to close up the incisions in the skin, which helps the patient heal quickly and generally leaves no visible scars.

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How do I prepare for the procedure?

During a consultation, the surgeon will ask you about your medical history, any medication you are taking and examine your eyes, skin and face, as well as taking other measurements, such as weight and height. If you are pregnant or overweight, you may be asked to delay surgery until it is safe for you to undergo. The surgeon will likely take some pre-operative photographs too.

If, after the in-depth consultation, the surgeon has determined that you are a suitable candidate for blepharoplasty, you will be invited to book your procedure. Once scheduled in, you will be asked to prepare beforehand.

Smokers will be asked to stop smoking for at least six weeks prior to the surgery, as there is a higher risk of complications otherwise and the healing process takes longer. For two weeks before your procedure takes place, you must stop taking Aspirin-containing medication or other NSAIDs, like Ibuprofen.

You should not eat or drink anything for 6 hours before surgery if general anaesthetic or local anaesthetic with sedation is being used. Water is fine, but only up until two hours before surgery. You should not wear make-up or apply facial/eye creams on the day of the procedure.

Before operating, a nurse will carry out any vital checks, such as your blood pressure. You will then meet with your surgeon, who will mark you up, and the anaesthetist.

How long does the surgery take?

Blepharoplasty procedures usually take between 1-2 hours to perform, however, if other treatments are being carried out at the same time, this may be longer.

You may be required to stay in the ward for a couple of hours after the surgery until our team can ensure you are safe to go home. Be sure to arrange for a family member or friend to pick you up and accompany you home as it is not safe for you to drive.

Does blepharoplasty surgery hurt?

The surgery is not painful as patients will be under anaesthetic. Some slight irritation, bruising and swelling will occur during the post-operative period, but painkillers, eye ointments and ice packs can be used to help minimise the discomfort. Sleeping propped up in bed using an extra pillow and with the head elevated can help for the first few days.

How long does it take to recover from the surgery?

The recovery period will differ from patient to patient and will vary depending on whether an upper or lower eyelid blepharoplasty is performed. In general, there is a recovery period of up to two weeks, but your surgeon will provide a more accurate picture during a consultation.

As the surgery is carried out on the face, swelling and bruising will be visible, but this should subside within a week or two, depending on the type of procedure that was performed.

Patients should rest following the surgery, absolutely avoiding strenuous exercise or heavy lifting, as this can increase blood flow and delay the healing process. Rubbing the eyes or wearing contact lenses should also be avoided.

Will I need time off work?

Most patients need between 7-14 days downtime before they return to work as the bruising and swelling settle down. After this time, it is unlikely that people would notice you have had surgery. It is wise to factor in your responsibilities when deciding when to return to work. For instance, if your job is particularly manual or strenuous, you may wish to have a longer downtime than someone who works sitting at a desk.

Working from home using a laptop is the preferred option for many, but, before doing so, it is advisable to have at least 48 hours of rest post-surgery.

Aftercare

Administration of eyedrops:

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Are there any side effects of a blepharoplasty procedure?

Though highly unlikely to occur, any surgical procedure comes with its risks. At Clinica, you are in safe hands, but any possible risks, side effects or complications will be discussed with patients during the consultation period. Patients will also be given detail information in written form, which summarises the risks and ensures the patient consents.

Following the surgery, swelling and bruising are to be expected due to the delicate tissue which surrounds the eye area, but this will subside in due course. Gently placing an ice pack over the area can help with the healing process.

The eyes may also feel dry or watery for the first few weeks. Many patients experience temporary blurred vision immediately after the surgery, but this is due to the thick antibiotic ointment applied during surgery, which helps to stop the ocular surface from drying out. This ointment should be applied daily, four times, to the eyes and surrounding wounds.

Will there be scarring?

Scarring following blepharoplasty is minimal, as the incisions made are intended to hide scars within the folds of the upper eyelid skin, which means they will be almost invisible to others. For lower eyelid surgeries, the scar will be hidden under the eyelashes and therefore hardly noticeable.

How long do the results last?

A blepharoplasty treatment provides long-lasting, natural results that vastly improves the look of the eye area. Ageing and gravity will still take place, but the majority of patients are happy with the results and do not need to undergo a repeat procedure.

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How much does blepharoplasty cost?

Prices will depend upon the type of procedure carried out and individual patient needs. For a blepharoplasty in London at Clinica, costs range from £3400-£7900. This includes surgeon and clinic fees. Initial consultation fees are not included.

Miss Jane Olver

Consultant Ophthalmic Surgeon
Oculoplastic Eyelid & Lacrimal Specialist
Medical Director

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Ms Tessa Fayers

Consultant Ophthalmic Surgeon
Oculoplastic, Lacrimal & Cataract Specialist

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