Blepharoplasty (Eyelid Surgery)

Blepharoplasty is surgery to remove or reposition excess skin, muscle and fat from the upper eyelids, the lower eyelids, or both. It is most often done to reduce hooding of the upper lid or puffiness below the eye. Where heavy upper lids obstruct the field of vision, the operation is functional rather than cosmetic.

How it works

On the upper lid the incision is placed in the natural skin crease, so the resulting scar sits within the fold. On the lower lid the incision is made just below the lash line, or on the inside of the lid where it leaves no visible scar. Excess tissue is removed or repositioned and the incision is closed with fine sutures.

What is involved

• Anaesthetic: local anaesthetic, sometimes with sedation, or general anaesthetic.
• Duration: around 45 minutes to 2.5 hours, depending on how many lids are treated.
• Stay: most people go home the same day.

Recovery

Most people take about two weeks off work. Driving is not possible for several days. Bruising and redness can take several weeks to fade, and the eyelids may feel puffy or numb during that time. Irritated, watery or light-sensitive eyes are common for a few weeks.

Risks and limitations

Recognised complications include dry or irritated eyes, visible scarring, and asymmetry between the two sides. Less common but more serious risks include injury to the eye muscles, the lower lid drooping and turning outwards (ectropion), bleeding into the eye socket, and visual impairment. General surgical risks apply: infection, blood clots and reaction to anaesthetic.

Eyelid surgery does not remove crow’s feet, lift the brow, or change dark circles caused by pigmentation or hollowing rather than by excess skin.

Who it may not suit

Dry eye disease, thyroid eye disease, glaucoma, uncontrolled diabetes, bleeding disorders and some retinal conditions all affect whether eyelid surgery is advisable. Anyone considering it should be assessed by a surgeon on the GMC Specialist Register, and an eye examination may be needed first.

Information on this page reflects NHS patient guidance on cosmetic procedures. It is general information, not medical advice, and it is not a substitute for an individual assessment by a qualified clinician.