Blepharoplasty: what is the purpose?

Blepharoplasty, often referred to as eyelid surgery, is a cosmetic procedure aimed at improving the look of the eyelids. This surgery can be performed on the upper eyelids, lower eyelids, or both, depending on the needs of the patient. People often seek blepharoplasty to reduce signs of ageing, such as drooping upper eyelids or puffiness below the eyes, which may make them look tired or older than they feel. Additionally, some individuals pursue this surgery to improve their vision, as sagging upper eyelids can sometimes obstruct the field of view.

We speak to a leading consultant ENT surgeon, who explains what happens during the procedure, the recovery process and potential risks.

Who is a good candidate for blepharoplasty?

Good candidates for blepharoplasty are typically adults who have healthy facial tissue and muscles. Ideally, patients are non-smokers without any serious eye conditions or significant medical issues that may impair healing. The procedure is generally best suited for individuals who have realistic expectations and a positive outlook about the surgical outcome. Blepharoplasty is popular among those in their 30s and older, but younger individuals may also consider it if they have inherited conditions causing eyelid drooping or puffiness.

Before undergoing surgery, a consultation with a plastic surgeon will help determine if blepharoplasty is appropriate. During this consultation, the surgeon will assess your medical history, current health, and the specific concerns about your eyelids.

What happens during the blepharoplasty procedure?

Blepharoplasty is usually performed as an outpatient procedure, meaning you won’t need to stay overnight in a hospital. The surgery itself typically takes between one and two hours, depending on whether both upper and lower eyelids are being treated. Local anaesthesia with sedation is commonly used, though general anaesthesia may be recommended in some cases.

For upper eyelid surgery, incisions are made along the natural crease of the eyelid to minimise visible scarring. Excess skin, muscle, and sometimes fat are then removed. For lower eyelid surgery, the incision is often made just below the lash line or inside the lower eyelid. This approach allows the surgeon to reposition or remove excess fat and tighten any sagging skin, helping to eliminate bags or puffiness.

What is the recovery process like?

Recovery from blepharoplasty generally involves some bruising, swelling, and mild discomfort around the eyes. These side effects are normal and should gradually subside within two weeks. Applying cold compresses and keeping your head elevated can help to reduce swelling. Most patients can return to light activities within a week, though it’s advisable to avoid strenuous exercise for a few weeks to ensure proper healing.

Your surgeon may also prescribe ointment or eye drops to keep your eyes lubricated and protect against infection. It's crucial to follow all post-operative instructions and attend follow-up appointments to monitor your recovery.

What are the potential risks and side effects?

As with any surgery, blepharoplasty comes with certain risks. Potential complications include infection, dry eyes, difficulty closing the eyes, and slight asymmetry. In rare cases, individuals may experience a condition called ectropion, where the lower eyelid pulls downwards. Most of these issues can be resolved with further treatment or time, but it’s essential to discuss these risks with your surgeon prior to surgery.

Blepharoplasty is a well-established procedure with a high success rate when performed by an experienced plastic surgeon. For those considering it, a thorough understanding of the process, possible outcomes, and recovery can help in making an informed decision about whether this surgery is the right choice for you.