Eyelid or Blepharoplasty Surgery

Your eyes have tremendous impact on your appearance, as they are often the first thing that people notice about you.

Are your eyes looking tired? Are you experiencing the signs of ageing around your eyes, with the tell-tale bags under your eyes? Then cosmetic eyelid surgery, known as Blepharoplasty could be the solution.

The skin surrounding the eyes is much finer than the rest of your face and therefore can be the first place that ageing can appear.

Eyelid Surgery, or Blepharoplasty, is used to remove the fat deposits and loose skin that forms on the upper or lower eyelids with age.

From the mid-30’s onwards is when you may notice changes around the eyes, such as the development of “hoods” on the upper eyelids due to excess skin and muscle, sometimes in association with a variable degree of excess fat. This “hooding” along with the loss of the youthful crease above the upper eyelid is what produces the commonly observed “heavy” or “tired look”.  Also the development of “bags” on the lower eyelids can occur over time.

These symptoms can sometimes appear much earlier, even in the twenties.  They also tend to run in families with the same appearances often being found in other family members. Sun damage, as well as these hereditary factors, can accelerate these changes.

It is not uncommon for patients who undergo Blepharoplasty to have other facial rejuvenation procedures at the same time to enhance their appearance. Some patients have Face lifts; Anti-Wrinkle Muscle Relaxant therapy; Dermal Skin Fillers; Ultherapy®; Laser treatments; or Fractora™ Fractional Resurfacing to give them an overall more youthful appearance.

As with any surgery it is important that you have all the relevant information available to make an informed decision. All of our surgeons have had many years of experience performing this surgery and can assist you in determining the most appropriate course of action.

So contact our clinical aesthetics team at Cosmetic Image Clinics within Aquarius Health and Medispa for advice on how we can help you with your cosmetic surgery query.

Frequently Asked Questions

More information on Eyelid or Blepharoplasty Surgery

Why choose Cosmetic Image Clinics for Eyelid or Blepharoplasty surgery?

At Cosmetic Image Clinics, we pride ourselves on delivering the highest levels of personal care while providing both surgical and non-surgical options for people seeking cosmetic rejuvenation and cosmetic plastic surgery.

Our selected team of doctors, plastic and cosmetic surgeons, clinical nurses and administrative team, have a wealth of experience caring for men and women undergoing cosmetic treatments.

By selecting our multi-award winning Cosmetic Image Clinics in Aquarius Health and Medispa, you can be assured that your comfort and satisfaction is our highest priority.

Your consultation will be conducted in the strictest of confidence and you will receive professional care and expert advice from our highly trained team.

What is involved in Eyelid or Blepharoplasty surgery?

Upper (upper eyelid ‘lift’ or upper blepharoplasty) or lower eyelid surgery (lower blepharoplasty) can dramatically rejuvenate the appearance of the eyes.

With the upper eyelids the excess skin is removed along with any excess muscle and fat thus restoring the youthful eyelid crease.  The skin is then sutured.  In some younger patients only the excess skin needs to be removed.  The skin on the upper eyelid usually heals with a very fine, inconspicuous scar.  This scar is made even less noticeable by placing the incision within the new eyelid crease.

In the case of the lower eyelids, the traditional scalpel technique involves cutting the skin all the way across the lid just under the eyelashes in order to gain access to the fat producing the “bag”.  Sometimes a trans-conjunctival lower eyelid surgery approach is used with an incision made on the inside of the lower eyelid.

Blepharoplasty or eyelid surgery can be performed in a day surgery centre using twilight sedation or in a hospital under general anaesthesia. The surgery usually takes one to three hours if you are having all four eyelids done, or half that time if you are only having upper or lower eyelid surgery alone.

Usually, the surgeon makes incisions following the natural lines of your eyelids, that is, in the creases of your upper lids, and just below the lashes in the lower lids. The incisions may extend into the crow’s feet or laugh lines at the outer corners of your eyes. Working through these incisions, the surgeon separates the skin from underlying fatty tissue and muscle, removes excess fat and trims sagging skin. The muscle may be trimmed or tightened with sutures. The incisions are then closed with very fine sutures.

Surgical scars will be situated in the upper eyelid crease or just under the lower lashes, and therefore be inconspicuous.

If you have a pocket of fat beneath your lower eyelids but you do not need to have any skin removed, your surgeon may perform a ‘transconjunctival’ blepharoplasty. With this procedure the incision is made inside your lower eyelid, leaving no visible scar. Sutures are not usually required. This approach is more suitable for younger patients with thicker, more elastic skin and has a more rapid recovery period.

What is involved in planning your Eyelid or Blepharoplasty surgery?

In your initial consultation, the doctor will evaluate your health, check your vision and take a complete medical history. If it can be demonstrated that drooping upper lids interfere with your vision, Medicare and/or private health insurance may contribute to the cost of your procedure.

You and your doctor should carefully discuss your goals and expectations for this surgery. You will need to discuss whether to do all four eyelids or just the upper or lower ones, whether skin as well as fat will be removed, and whether any additional or alternative procedures are indicated to achieve the best results.

What is involved in your Eyelid or Blepharoplasty surgery post-operative care?

After surgery, the surgeon will probably lubricate your eyes with ointment and may apply a bandage. Your eyelids may feel tight and sore, but we will ensure that you have adequate pain medication to control any discomfort.

You should keep your head elevated for several days, and use cold compresses to reduce swelling and bruising in the first 24 hours. Swelling is generally minimal to moderate. It should peak on the morning after surgery and mostly resolves over the next 7 to 10 days. A tiny amount of puffiness, however, may persist for longer. Bruising varies from person to person: most people experience moderate bruising that begins to fade several days after surgery and is gone by 7 to 10 days.

You will need to clean your eyes, which may be gummy for a week or so. The doctor may recommend eye drops, since your eyelids may feel dry at first and may burn or itch. You will need to use medicated eye ointment as well post-operatively. For the first few weeks you may also experience excessive tearing, sensitivity to light, and possibly blurred vision. You won’t be able to wear contact lenses for about two weeks, after which they may feel uncomfortable for a while.

You will be reassessed in our clinic 5 to 7 days after surgery. The swelling and discoloration around your eyes will gradually subside, and you’ll start to look and feel much better. You will subsequently be seen at our clinic 6 weeks and 3 months after surgery.

Normal day-to-day activities, including a return to work, can be resumed within 2 to 5 days of surgery, however most people feel ready to go out in public after 7 to 10 days. You will be able to wear makeup to hide the bruising that remains. Your scars may remain slightly pink for six months or more after surgery however they will be hidden in the eye crease or below the lashes. Eventually they’ll fade to a thin, nearly invisible white line.

Strenuous activity should be avoided for about three weeks. It’s especially important to avoid activities that raise your blood pressure, including bending, lifting, and rigorous sports.

There is a very large amount of information available on blepharoplasty surgery. Much of this information will be explained to you during your consultation appointment.

At Cosmetic Image Clinics within Aquarius Health and Medispa we understand the issues involved in making such an important decision and we are happy to discuss your concerns at any time.

What is Eyelid or Blepharoplasty surgery?

Eyelid Surgery, or blepharoplasty, is used to remove the fat deposits and loose skin that forms on the upper or lower eyelids with age.

As we age the eyes can develop an aged and perpetually “tired look” due to the development of “hoods” on the upper eyelids. This is caused by the excess skin and muscle, sometimes in association with a variable degree of excess fat. This “hooding” along with the loss of the youthful crease above the upper eyelid is what produces the commonly observed “heavy” or “tired look”.  Also the development of “bags” on the lower eyelids occurs over time.

These are due to protrusion of some of the normal fat from around the eyeball into the lower eyelids. These fatty protrusions also contribute to the “tired look”.

These changes most commonly appear from the mid-30’s onwards but they can appear much earlier, even in the twenties.  They also tend to run in families with the same appearances often being found in other family members. Sun damage, as well as these hereditary factors, accelerates these changes.

Younger people with congenital excess fatty tissue also elect to have this procedure done to eliminate puffy bags under the eyes, or sagging upper eyelids. Muscles may also be tightened to eliminate that hollowed out look or droopy upper eyelids. These conditions can make you look older and more tired than you feel and may even interfere with your vision.
Blepharoplasty or eyelid surgery can be performed as an isolated upper eyelid lift or lower eyelid procedure or in combination. It is a good first option to create a more youthful, fresher appearance, and the results are permanent although you still continue to age at your normal rate.

Eyelid surgery will not eliminate dark circles, fine lines or “crows feet” wrinkles around the eyes, or alter sagging eyebrows. To enhance the results of your eyelid procedure, your doctor may also recommend a brow lift to correct a drooping brow and smooth the forehead, or skin resurfacing to eliminate fine lines. Sometimes wrinkle smoothing injections in the brow and crow’s feet areas will be suggested to complete your new look. Blepharoplasty is often performed in conjunction with face lift surgery.

A procedure known as “double eyelid surgery” can be performed to add an upper eyelid crease to Asian eyes. Whilst the majority of Asians are born with this crease, upper blepharoplasty surgery is popular amongst those who don’t have this additional skin fold, as they seek to achieve a more ‘wider eyed’ look.

What are the risk factors involved in Eyelid or Blepharoplasty surgery?

A few medical conditions make blepharoplasty more risky. They include thyroid problems such as hypothyroidism and Graves’ disease, dry eye or lack of sufficient tears, high blood pressure or other circulatory disorders, cardiovascular disease, and diabetes. A detached retina or glaucoma is also reason for caution.

Post-operatively, all patients will have some swelling and some bruising. The minor complications that occasionally follow blepharoplasty include double or blurred vision for a few days and a slight asymmetry in healing or scarring. Tiny whiteheads may appear after your stitches are taken out, which the surgeon can easily remove with a very fine needle. Initially following surgery, some patients may have difficulty closing their eyes when they sleep. A very rare complication is a pulling down of the lower lids. In this case, further surgery may be required.

Outlined below are the possible complications:

  • Bruising and swelling – post-operatively, all patients will have some swelling and bruising.
  • Brown staining of the skin – occasionally, bruising of the skin under or around the eyes can leave brown staining of the skin as the bruising clears. This is due to hemosiderin and represents the iron that was present in the red blood cells of the bruise. It tends to gradually disappear with time but in some people it can take years to disappear. There is no specific treatment to make it resolve more quickly. However, until it does, it can be camouflaged with makeup. Rarely, the staining can be permanent.
  •  Infection can occur after any surgery and the risk is small (approximately 3%).
  • ‘Dry Eye’ Syndrome refers to a feeling of grittiness or dryness of the eyes and it sometimes occurs after eyelid surgery.  If you already have ‘Dry Eyes’ before the surgery it could become temporarily worse after the surgery.  For most patients it is usually a temporary condition only and in the meantime lubricating drops can be used to relieve the symptoms.At Cosmetic Image Clinics we also offer Intense Pulsed Light (IPL) treatment for ‘Dry Eyes’. Click here to read more about Dry Eye IPL treatment.
  • Ectropion, a ‘turning outwards’ of the lid margin, is unlikely.  If it were to occur, it could be temporary otherwise additional surgery would be required to correct it.
  • Scleral ‘Show’ or excess visibility of the ‘white’ of the eye.
  • Excessive or insufficient removal of fat from the lower eyelids: this is unlikely in experienced hands but still possible due to the swelling of the tissues from the local anaesthetic solution and the supine position. Excess removal produces a ‘hollow’ look under the eyes; insufficient removal leaves a residual bulge of fat under the eyes. In both cases additional surgery may be required.
  •  Blindness, although rare, is possible after eyelid surgery. One of its principal causes is unchecked post-operative bleeding. This is more of a risk after lower eyelid surgery than upper eyelid surgery. The incidence of this complication after traditional scalpel surgery has been reported as between 1:40,000 and 1:100,000 cases.
  • Lagopthalmos refers to an inability to completely close the eye after upper eyelid surgery thereby leaving a narrow gap between the upper and lower eyelids in the ‘sleep’ position. Careful pre-operative measurements and marking minimise the chances of permanent lagopthalmos from removal of too much skin. Minor, temporary lagopthalmos due to post-operative swelling of the lids is occasionally seen but disappears once the eyelid swelling resolves.
  • Secondary malar bags – this is not really an outcome of the surgery but instead is something that was present prior to the surgery but only noticed afterwards on scrutinising the eyes. The term refers to small swellings near both cheekbones but well away from the surgically operated areas. Their cause is not completely understood. They may appear more prominent after the surgery.
  • Visibility of the scars – in most people the upper and lower eyelid incision heals with a very fine, inconspicuous scar which for most of its length is hidden in the crease of the upper lid. However, some people have a general tendency to form thicker surgical scars. Please notify the doctor of any such tendency before booking your surgery.


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