​What is an upper surgical blepharoplasty?

Upper blepharoplasty is a surgical procedure to remove excess skin and sometimes muscle or fat from the upper eyelids. It can improve drooping eyelids, reduce heaviness, and in some cases restore vision where loose skin is blocking the upper visual field. The surgery gives a fresher and more youthful appearance while keeping a natural look.

 

Why do people have a blepharoplasty?

You may benefit if you have:

• Loose or sagging skin folding over the eyelids

• Puffiness from fat pockets

• Heavy eyelids that strain the forehead muscle and cause discomfort

• A tired or aged appearance

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It is important to note that blepharoplasty will not remove crow’s feet, dark circles under the eyes or lift the eyebrows. If droopy brows are contributing to the problem, additional surgery such as a brow lift may be required.

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How is the procedure done?

• Performed under local anaesthetic, similar to dental anaesthesia

• The eyelid is marked to show the tissue to be removed

• Small injections numb the eyelid within seconds

• An incision is made in the natural crease of the eyelid

• Excess skin, and if necessary fat or muscle, is removed

• Bleeding is controlled with cautery

• The incision is closed with fine stitches hidden in the natural crease

The procedure usually takes 30–45 minutes.

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Is the procedure painful?

The injections may sting briefly, but once numb you should not feel pain. Afterwards, most patients only need simple pain relief such as paracetamol.

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How long does recovery take?

• Bruising and swelling are expected for 1–2 weeks

• Stitches are usually removed after 5–7 days

• Swelling gradually improves but can take up to 3 months to fully settle

• Most people return to work and social activities within 1–2 weeks

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How long do results last?

Results typically last 10–15 years, but ageing will continue. Some people may need further treatment in the future.

 

What are the alternatives?

There are no non-surgical alternatives for removing significant excess skin. Minor wrinkling may be improved with skin treatments such as peels or laser, but these do not address skin heaviness. Choosing not to have surgery is always an option, as excess skin does not damage the eyes.

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What are the risks?

Complications are uncommon but can include:

• Bruising and swelling

• Temporary irritation, dryness or blurred vision

• Infection (rare, treated with antibiotics)

• Visible scars (usually well hidden in the crease)

• Asymmetry or under/over correction

• Skin discolouration or delayed healing (higher risk in smokers)

• Eyelid retraction or granuloma (very rare)

• Double vision or vision loss from bleeding behind the eye (extremely rare, <0.1%)

Your surgeon will discuss these with you in detail.

 

Who is not suitable?

Surgery may not be suitable if you:

• Have uncontrolled medical conditions

• Have severe dry eyes

• Are pregnant or breastfeeding

• Have unrealistic expectations

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Aftercare instructions

• Apply cold compresses for the first 24–48 hours

• Sleep with your head elevated for 2 nights

• Use antibiotic ointment on the wound for 2 weeks

• Clean the area with cooled boiled water and cotton wool for 10 days

• Avoid bending, heavy lifting and strenuous exercise for 2 weeks

• Avoid eye make-up for 3 weeks

• Avoid contact lenses for 2 weeks

• Protect scars from sunlight with sunglasses and SPF for several months

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When to contact us after surgery?

You should get in touch with us if you experience:

• Severe pain not controlled by painkillers

• Sudden drop in vision

• Increasing redness, swelling or discharge from the wound

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