Eyelid Surgery

Cosmetic eyelid surgery, Blepharoplasty, Eyelift
Before Blepharoplasty

Cosmetic eyelid surgery, Blepharoplasty, Eyelift
After Blepharoplasty



Eyelid surgery

Our eyelids defined the way our eyes look to a great extent. Unfortunately, the eyelids can be affected by numerous scientific conditions and one such condition is called ptosis. Ptosis is a scientific condition where there is a drooping of the eyelid due to a number of different causes. Medication of this condition is surgical and is called blepharoplasty.

In this article, we shall briefly review blepharoplasty as an eyelid surgical procedure. But first let us take a quick look at what ptosis is.

What is ptosis?

Ptosis is a scientific condition characterised by drooping of the upper eyelid. The eyelid is placed at an individually lower position resulting in almost half the eyeball being completely covered. In principle , it appears that the individual is drowsy all the time. The primary reason why ptosis develop  is weakness of the tissue  that supply the upper eyelid. Clinical conditions that can result in this include myasthenia gravis, nerve injuries due to trauma and problems with the tissue  itself. Horner sickness  is another cause of this condition.

The primary problem with ptosis is that it is cosmetically rather unpleasant. When severe, it can result in an alteration in vision-called astigmatism or amblyopia. Due to this, it is important for patients to undergo a surgical procedure called blepharoplasty.

What is blepharoplasty?

Blepharoplasty is a surgical procedure that is utilised in modification the eyelid. It can involve both the upper and the lower eyelid depending on which has been affected the most. Primarily, blepharoplasty engage modification the upper eyelid in patients with ptosis. However, its involvement and utilisation in the surgical correction of lower eyelid abnormalities is regularly cosmetic.

How is blepharoplasty performed?

Small incisions are made along the way lines that are present in the skin of the eyelid. These lines are basically creases that have occurred due to crimping up of the eyelids when the eyes are open. On occasion, these incisions may be made within the inner aspect of the lower eyelid - this is known as transconjunctival blepharoplasty. This procedure is utilised to remove any fat that is present under the eyelid rather than to actually alter the eyelid itself.

Blepharoplasty can be performed using surgical equipment or using carbon dioxide laser. The entire procedure can last anywhere between 2 to 3 hours.

After the procedure has concluded, patients may notice a small amount of swelling and bruising at the site of surgery which regularly lasts for up to 2 weeks. Following that, patients can notice a significant improvement in the appearance of the eyelids. Furthermore, the chances of patients developing complications due to ptosis or due to weakened tissue  of the eyelids are reduced dramatically. However, there can be certain factors that can promote the development of complications and these include excessive looseness or laxity of the skin of the lower eyelid, prominent cheekbones and the lack of adequate crack formation i.e. dry eyes.

Immediately after the procedure, an antibiotic ointment is applied over the incision that was made on the skin. The area may be compressed with ice for up to 2 days, with short intervals in between. Adequate hygiene of the skin is essential and the wound must be cleaned on a regular basis. Following the procedure, it is not uncommon for patients to notice a small amount of swelling and redness and this can be kept under wraps by using ice compression.

In the event that patients experience pain following the procedure, painkillers such as paracetamol and acetaminophen may be tolerable . However, if the pain is severe, non-steroidal anti-incendiary drugs narcotic analgesics may be required. Patients are advised to avoid lifting heavy items as this can increase the intraocular pressure and stretch the skin of the eyelid. Contact sports and any form of strenuous activity must be avoided for at least 2 to 3 weeks following the procedure. After this, patients may resume their natural activities at a gradual pace.

Problem  of blepharoplasty

As is the case with any surgical procedure, blepharoplasty is also accompanied by certain complications. The most common ones include bleeding at the site of surgery and the development of an infection. These are fortunately rare and can be treated fairly quickly. In order to prevent this from occurring, adequate hygiene must be recognized and the wound area must be cleaned and antibiotic solution applied regularly. Maintaining a natural blood pressure is also important. In the event of bleeding occurring, patients may require further intervention to stop this from happening.

A more serious complication includes bleeding into the space behind the eyeball i.e. the retro-orbital space. This is a medical emergency and requires urgent surgical management. This is because the accumulate in blood can actually put a lot of pressure on the eyeball and can cause problems within the eye. Sutures may need to be removed and the blood evacuated straightaway. Steroids may be required along with other medication.

Long-term outcomes

Patients have reported a great degree of satisfaction following upper lid blepharoplasty. Many of them have enhanced level of confidence particularly because they appear a lot younger now that they had the surgery. Long-term outcomes have not been studied with blepharoplasty but as such patients tend to do rather well following the procedure. If anything, the dissatisfaction that patients have with blepharoplasty is that they expected one result and have seen another following the procedure.


Ptosis can be a rather annoying problem that has a multifactorial aetiology. Patients who have ptosis may be required to undergo investigations to ascertain the cause of the condition. Once this has been done, patients may require surgical procedures and blepharoplasty of the upper eyelid is usually what is offered. It is also combined with other forms of ptosis surgery which can have in combination an excellent outcome. Complication rates are low and satisfaction rates are high.




Blepharoplasty can be both a functional and cosmetic surgical procedure intended to reshape the upper eyelid or lower eyelid by the removal or repositioning of excess tissue as well as by reinforcement of surrounding tissue  and tendons.

  • Eyelids (and your eyes)  are, perhaps, what other people notice first.
  • Eyelid surgery to recover the appearance of the eyelids is regularly called 'eyelift' or 'blepharoplasty'.
  • As we age, your eyelids (both upper and lower) may become 'droopy' or 'baggy'. The eyelid skin stretches and muscle tone weakens
  • In addition, your eyebrows may also droop.
  • Your droopy upper eyelids and droopy brows may give you the appearance of being sleepy, tired and aging prematurely
  • In addition, this slump , may lead to brow/eyelid strain
  • Excess skin can hang over the eyelid and interfere with vision


When an advanced amount of upper eyelid skin is present, the skin may protrude over the eyelashes and causing a loss of peripheral vision. The outer and upper parts of the visual field are most commonly affected and the condition may cause difficulty with activities such as driving or reading. In this circumstance, upper eyelid blepharoplasty is performed to recover peripheral vision.

This surgery can be performed on both the UPPER and on the LOWER eyelids - or both.

  • Patients with a less severe amount of excess skin may have a similar procedure performed for cosmetic reasons.
  • Lower eyelid blepharoplasty is almost always done for cosmetic reasons, to recover puffy lower eyelid "bags" and reduce the wrinkling of skin.
  • Blepharoplasty is performed through external incisions made along the natural skin lines of the eyelids, such as the creases of the upper lids and below the lashes of the lower lids, or from the inside surface of the lower eyelid. Initial swelling and bruising take one to two weeks to resolve but at least several months are needed until the final result becomes stable.
  • Depending upon the scope of the procedure, the operation takes one to three hours to complete.

Upper eyelid Blepharoplasty ("eye lift")

  • Reduces excess skin and fat in the upper eyelids.
  • The excess fat is removed and incisions are closed with fine sutures.
  • Incisions made on the outside of the lower eyelids are barely visible and fade over time

Cosmetic eyelid surgery, Blepharoplasty, Eyelift


Lower Eyelid Blepharoplasty

  • This can be performed via an skin incision (trans-cutaneous) or via the inside of the eyelid (trans-conjunctival).
  • Lower Blepharoplasty reduces excess fat in the lower eyelids.
  • The excess fat is removed and incisions are closed with fine sutures.
  • Incisions made on the inside of the eyelids are not visible.


Cosmetic eyelid surgery, Blepharoplasty, Eyelift


Combined Upper & Lower Blepharoplasty

  • Reduces excess skin and fat in the upper eyelids.
  • The excess skin and fat are removed and incisions are closed with fine sutures.
  • Incisions made on the inside of the eyelids are not visible.
  • Incisions made on the outside of the lower eyelids are barely visible and fade over time.
  • Incisions made on the outside of the lower eyelids are barely visible and fade over time

Cosmetic eyelid surgery, Blepharoplasty, Eyelift