Reasons to Consider Blepharoplasty

The skin around the eye is the thinnest on the body and the least elastic. It is where age shows first, and it is also where excess tissue can start to interfere with function rather than merely appearance.

What the operation involves

Blepharoplasty removes or repositions excess skin and fatty tissue around the eyelids. It can be performed on the upper lids, the lower lids, or both.

Upper blepharoplasty An incision is made in the natural crease of the upper lid, where it is concealed once healed. Excess skin and fat are removed, and the surrounding muscle may be tightened.

Lower blepharoplasty An incision is made just below the lash line. Excess skin, fat and tissue are removed or repositioned. Support to the lower lid is carefully preserved — over-resection here produces a poor and difficult-to-correct result.

Who is a candidate

• Good general health, with realistic expectations.
• Heavy upper lids that obscure the visual field or produce a persistently tired appearance.
• Puffy lower lids or excess lower lid skin.
• Laxity of both upper and lower lids.
• Under-eye bags that have not responded to topical treatment — which, where the cause is displaced fat rather than fluid, they will not.

The reasons patients have it

Obstructed vision Where the upper lid has descended far enough to encroach on the upper visual field, removing the excess restores it. Some patients also report improvement in headaches attributed to compensatory brow elevation.

Appearance around the eyes Descended upper lids, lower lid bags and compensatory forehead lines all contribute to an appearance that patients most often describe as looking tired regardless of how they feel.

Ptosis True drooping of the upper lid — as distinct from excess skin — can be congenital or acquired, and is corrected surgically. It is a different problem from excess skin and requires a different assessment, so it is worth having the distinction made properly at consultation.

Lower lid fullness Fat that has migrated forward produces the bags that creams do not touch.

The procedure and recovery

Blepharoplasty is a day case and is typically performed under local anaesthesia, with discharge the same day.

Swelling and bruising are usually modest and subside over one to two weeks. Most patients resume normal activity within one to two weeks. The results are durable.

Before you decide

If your concern is that your eyes make you look tired, establish at consultation where the problem actually sits — the upper lid, the lower lid, the brow, or the skin quality. Those have different answers, and only some of them are surgical.