Eyelid Surgery (Lower)

Procedure time

60 to 90 mins

Overnight stay

0 – 1 night


General or local with sedation

Final results

3 – 6 weeks

Eyelid surgery, also known as an eyelid reduction or blepharoplasty, is a procedure that aims to remove excess skin, fat, and muscle from the eyelid. The ultimate goal is to improve droopy eyelids or eye bags. This eyelid surgery overview will inform you about the procedure and what it involves.

What can eyelid surgery achieve?

The area around our eyes is one of the first places on your face to show the signs of aging. As a result of this, you may find that the skin here becomes loose, wrinkled and puffy. Consequently, over time this may leave you with a permanent tired appearance. For some, you may find that there is an inherited tendency to develop changes around the eyes, such as eye bags, earlier on in your adult life. If this is something that affects you, then eyelid surgery can help reverse these changes around your eyes. The procedure aims to:

  • Reduce the excess skin and fat on your upper or lower eyelids
  • Improve your vision if excess skin on your upper eyelid is impeding it
  • Give your eyes a more youthful and awake appearance
  • Make you less conscious of age-related changes around your eyes
  • Boost your self-esteem.

However, eyelid surgery is unable to resolve all problems. It cannot resolve:

  • Wrinkles around the eyes
  • Dark shadows under the eyes
  • Folds of skin extending into the cheek (called festoons).

If you find that you are struggling with any of the above, then a brow lift or a facelift may be a more appropriate option for you.

Who are the best candidates for a eyelid surgery?

Blepharoplasty, commonly known as eyelid surgery, is a popular cosmetic procedure for men and women. The eyes are one of the first places on the face to show the signs of aging. As we age, the skin around the eyes can start to lose its elasticity and the muscles begin to slacken. This slackening of the muscles causes the fat around the eyes to become more prominent, therefore, making the eyes look puffy. This can, therefore, create the appearance of eye bags. Some people find that this bagginess of the eyelids affects their self-esteem and makes them feel unhappy. The purpose of eyelid surgery is to remove this excess skin and fat making the eyes appear more youthful. Individuals suffering from these problems may be suitable eyelid surgery candidates.
As the purpose of eyelid surgery is to remove excess skin and fat from the upper and lower eyelids, suitable eyelid surgery candidates include those who are unhappy with:

  • Any loose or baggy skin around the eyelids.
  • Their vision due to excess skin drooping over your eyes.
  • Eyebags or puffiness around the eyes.

Before going ahead with the procedure, it is important to make sure that you:

  • Feel mentally and emotionally ready for surgery.
  • Are a healthy individual.
  • Do not smoke or use nicotine for at least 6 weeks before surgery.
  • Have no serious eye conditions.

Your surgeon will fully assess and examine your face during your consultation. This will allow them to decide which procedure will best meet your desired outcome.

Why have eyelid surgery?

The earliest signs of aging occur around the eyes. These can leave the upper and lower eyelids looking puffy, loose and may create a permanent tired appearance. Hence, eyelid surgery can resolve these issues and can:

  • Tighten the skin on the eyelids
  • Create a more awake and youthful appearance
  • Improve your self-esteem
  • Improve the symmetry of your eyes.
What eyelid surgery will not resolve

Although eyelid surgery can improve the appearance of the eyes, there are some problems that it cannot resolve. It is important to remember that this procedure focuses only on the upper and lower eyelids. It is, therefore, unable to correct the following:

  • Folds of skin that extend onto the cheeks (which are known as festoons)
  • Wrinkles in the corners of the eyes which are known as ‘crow’s feet’
  • Dark shadows under the eyes
  • Forehead wrinkles
  • Low set eyebrows that are drooping over the eyes
  • Loose skin anywhere else in the face.

However, although eyelid surgery does not address the above issues, there are surgical procedures that can! Many people combine their eyelid surgery with other procedures. For example, a brow lift can address low set or drooping eyebrows. You can also have a face or neck lift if you are unhappy with wrinkles on your mid to lower part of your face. These can be done at the same time as your eyelid surgery. It is therefore vital that you make it clear to your surgeon what issues you would like to address so they can recommend the most suitable procedure for you.

How is eyelid surgery performed?

An eyelid surgery procedure usually takes between 60 and 120 minutes to complete. It is usually done as a day case, which means you will be able to go home the same day. Your surgeon may perform the surgery using either a general anaesthetic or a local anaesthetic with the use of sedation. Once you have chosen your surgeon, you will have a consultation with them. During this consultation, your surgeon will give you details about the procedure. They will also discuss your expectations from the surgery. Finally, they will give you instructions on what to eat, drink and what medications to take on the day of your surgery.

1. Consent

Either in your pre-operative assessment or on the day of surgery you will need to sign a consent form. In order for you to sign this, you will need to be fully informed about all aspects of the eyelid surgery procedure. Therefore, your surgeon and anaesthetist will discuss the surgery with you and it’s potential risks and complications. It is important that you ask any questions that you may have. Next, your surgeon will examine and draw some lines on the treatment area. You will also discuss your goals for surgery.

2. Anaesthesia

On the day of your surgery, you will meet your anaesthetist and be taken to the operating theatre. Your anaesthetist will then deliver your anaesthetic. This may be a general anaesthetic where you go to sleep and wake after the surgery. This may leave you feeling groggy for a couple of hours post-op but will wear off. Alternatively, a local anesthetic which numbs the treatment area with some sedation so you feel relaxed may be used.

3. Incisions

Once you are asleep, your surgeon will clean and drape the treatment area. This is to ensure the treatment area is sterile and to reduce the risk of infection.
According to what your desires are, your surgeon will correct the upper or lower eyelids or both. The location of the incision will depend on which part of the eyelid you are unhappy with. Therefore, your surgeon may use two different incisions in this procedure.

This involves making an incision along the natural crease of the upper eyelid. The scar from this technique will be very discreet and lie in the fold of your eyelid.

This technique involves making an incision below the line of the lower eyelashes. This is called a transcutaneous blepharoplasty. Alternatively, your surgeon can also make a small incision on the inside of your lower eyelid. This technique removes fatty deposits only from the lower eyelid and is known as transconjunctival blepharoplasty.

From either of these two incisions, your surgeon is able to:

  • Remove or re-position excess fat
  • Remove excess skin
  • Tighten or remove loose and slacking muscle

The incision site may vary according to your own personal desires and what you wish to achieve from your eyelid surgery procedure.

4. Closing of incisions

Following the procedure, your surgeon will apply steri-strips or sutures to support the eyelid. They may give you eye pads to put on after to help reduce swelling. These will only be kept on for a short amount of time, typically an hour.

5. Return to the ward

Once your surgery is complete, you will return to the ward. You will need to stay there for a few hours or overnight. This is to allow the effects of the anaesthetic to wear off, ensuring you are safe to return home.

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