Blepharoplasty (Eyelid Reduction and

Eyebag Removal)

Blepharoplasty or eyelid reduction is a cosmetic surgery procedure to remove excess skin from the upper eyelid, and excess skin and / or eye bags from the lower eyelid. It can produce a more youthful appearance by opening up the eyes. You can either have the procedure performed on your upper eyelids, lower eyelids or both together.

The aging process causes the skin around our eyes to lose its elasticity, causing folds of excess skin to appear on the upper and lower eyelids. In addition, muscles may lose their tone so that fat bulges out causing eyebags. Some people have a genetic predisposition to developing eye bags and get them as early as their twenties, prior to any changes in the skin.

The surgery will remove excess skin, muscle and eyebags from the eye area. However, it will not remove "crows feet" and will not change the colour of dark circles under the eyes.

The Operation

Eyelid surgery can be carried out under either a general or a local anaesthetic. If you are having a local anaesthetic you may not need to stay in hospital at all, but be treated as a day case.

The incisions around your eyes may be made either conventionally or with a laser. The incision is made close to the line of your eyelashes on the lower lid, or in the crease of your eye on the upper lid to hide the scars as much as possible. If you are just having the eye bags removed and not excess skin, the incision can be made on the inside of the lower eyelid so that there will be no external scar. This version of the operation is called "transconjunctival blepharoplasty".

After the excess fat, muscle and skin are removed, the site is closed with little stitches which are generally removed after a few days.

After surgery your eyes may be covered with gauze and the surgeon will apply some suture strips to support the eyelids. You will be advised to keep your head raised for a few days to reduce swelling. You will be advised on how to clean your eyes with water and you may need to apply ointment or eye drops. Avoid wearing eye makeup for a few days and contact lenses for at least two weeks.

Your eyes may not shut properly at first due to the swelling and they may be watery. These symptoms should settle down within a few weeks. The scars will fade to barely visible fine lines in a few months.

blepharoplasty - before
eyelid reduction and eyebag removal - after
Before eyebag removal and eyelid reduction

What are the risks?

The vast majority of patients do not suffer from the following problems. However, risks include:

  • Haematoma
  • Infection
  • Reaction to the anaesthetic
  • The eyelid not closing properly. This is usually temporary but occasionally a further operation is necessary.
  • Tiny whiteheads can appear along the suture line but they can be pricked out.
  • There have been reported cases of blindness but these are exceptionally rare.
  • Other possible complications include glaucoma, a sunken appearance if too much fat is removed, an asymmetrical result and keloid scarring.
  • Damage to the surface of the eye or surrounding muscles.