As we age, the skin around our eyes starts to lose its elasticity causing gradual fine lines and wrinkles.

Over time, under eye bags will start to develop as the muscles relax and lower eyelids sag down. In addition, our upper eyelids can also start to droop with age. Comfort aside, this can also give the eyes an older, tired look and a hooded or bulging appearance that can make patients feel self-conscious.

During a short operation (1-3 hours), loose skin and excess fatty tissue around the eye area is removed, tightening the relaxed muscles and giving the skin a firmer, more youthful appearance and a more attractive aesthetic. 

We use eyelid surgery in conjunction with non-surgical techniques to counteract the effects of ageing around the eyes.

The effects of ageing around the eyes:

The skin of the face and particularly the thin skin around the eyes loses its elasticity initially developing fine lines and wrinkles.

With time the eyebrow becomes lower and the skin of the eyelid becomes looser developing folds, sagging onto the eyelashes.

Crow’s feet appear and become deeper and the lower eyelid becomes longer as the bony rim of the orbit becomes visible.

+ The deeper collagen and muscles slacken, allowing pockets of fat to bulge forward at the inner angle of the upper eye and in three separate sections of the lower eyelid.

Treatment at Cadogan Clinic:

Non-surgical treatments can reduce the wrinkles but not the folds. Injectables can lift the eyebrows. Surgical skin reduction of the upper eyelids leaves a very fine scar in the natural fold and in the lower eyelid is disguised under the eyelashes. Bulging fat can be reduced surgically at the same time the skin can be reduced or re-positioned surgically at the same time as the skin reduction or in the lower eyelid often through the inner conjunctival side of the lid, thus avoiding any possibility of a visible scar.

Finally, fat grafting can be added to restore lost fat of not only of the eyelids but of the brow and the temple. The tired hooded, look with bulging bags should now be a thing of the past. 

A simple upper eyelid reduction takes less than an hour, but other options to restore vitality including fat grafting and tightening of relaxed muscles may take two or three hours. Procedures are carried out either under local or for bigger procedures, general anaesthesia in the form of TIVA (Total Intravenous Anaesthesia).

 

Frequently Asked Questions

Blepharoplasty (also known as eyelid reduction, eye lift or eye bag removal), refers to the surgical rejuvenation of the eyelid which is often used in conjunction with non-surgical procedures. It applies to both the upper and the lower eyelids, but is commonly used to counteract the effects of ageing on the skin muscle and fat around the eyes.

Young people however, can also require eyelid surgery either because patients wish to lessen the oriental features or to remove bulging pockets of fat (eyebags). There are also some children born with drooping upper eyelids called Ptosis, who also require surgical assistance. Blepharoplasty surgery is customised to every patient and no two are the same. It can be performed alone, involving the upper, lower or both eyelids or in conjunction with other surgical procedures of the face, brow or nose. The commonest supplementary procedure would be fat grafting for the ageing face and is now included in most cases to achieve youthful vitality.

 

Blepharoplasty or eyelid reduction is highly effective and is the one lifting procedure which rarely has to be repeated. There may be non-surgical touch-ups in the future but in excision is less likely. The skin of the eyelids makes excellent scars and are hidden in the fold of the upper eyelid and is only potentially visible when there is a hood of skin to be removed which extends beyond the eyelid, however, again for most people this scar becomes invisible. The scar of the lower eyelid is excellent and disguised under the eyelashes and in the crow’s feet.

The folds of skin beyond the lower eyelid overlying the cheekbone are often called Festoons and are more difficult to eliminate.

How effective is Blepharoplasty in treating drooping eyelids?

 

Your surgeon will need to be aware of any medical eye conditions you may suffer from as there are some occasions when surgery is contraindicated. In particular, dry eye can appear worse after surgery. Your experienced surgeon will also need to ascertain whether it is just the eyelids, which are of concern, or whether the surrounding brow, temple, cheekbones and tear trough are also requiring treatment.

All surgery can be carried out as a day case. Usually under Total Intravenous Anaesthesia (TIVA) with the patient only lightly anaesthetised. Smaller procedures can be carried out under local anaesthetic. Your eyes will not be bandaged at the end of the procedure and although vision may be slightly reduced because of the local anaesthesia used, this is only temporary. You should not drive a car for 24 hours. The eyelid skin heals very quickly and in a few days any stitches can be removed. Bruising varies but like all bruises settles, and will become less visible over 10 days. Swelling accompanies all
surgery and on the eyelid, this may give a watery look to the eye (chemosis) which can be annoying and last a few weeks. If patients have festoons or swelling over the cheekbones, then this can remain swollen for a month or two. Patients should be reassured that all this swelling does eventually settle.

Finally, the surgery itself is not painful and the only restrictions are intended to reduce temporary swelling. Wearing a cold compress immediately after surgery and sitting propped up in bed for the first night are useful, but probably do not affect the final result. The eye is also watery because the swelling around the tear ducts which naturally drain tears into the nose, swell up and become blocked, again this is only temporary and usually lasts a day or so. You will probably not wish to go to work the next day because of the appearance of dressings, swelling and bruising, but working from home is reasonable for many.

Blepharoplasty or eyelid surgery is safe in expert hands; however, every surgical procedure involves a certain amount of risk and it is important that you understand the risk before proceeding. You should discuss any existing medical problems with your surgeon, for instance, patients taking blood thinning agents are at risk of bruising which in certain types of lower eyelid surgery could cause bleeding behind the eye and in the exceptionally rare occasion, blindness. It is wise to avoid any aspirin or anti-inflammatory medications for 10 days before surgery as this to can increase the risk of bleeding.

Dry Irritated Eyes - Individuals who normally have dry eyes, may be advised to use special caution in considering Blepharoplasty surgery. If patients do use eye drops before surgery, they are quite likely to be using more afterwards.

Infection – Infection is rare and can be treated with antibiotic eye drops and ointment.

Watery Eye (Epiphora)- the tear ducts normally draining into the nose will temporarily block due to swelling. In addition, the swelling may give a watery appearance to the eye due to fluid under the conjunctiva. This is called Chemosis and may last a week or two.

Ectropion – Swelling after surgery can cause drooping of the lower eyelid and push the eyelid away from the eyeball. This usually settles as the swelling goes down and will be helped by massaging the swelling away from the eye and taping the eyelid upwards onto the eyeball. This can be a problem in the older patient and may be pre-existing to any surgery. There are operative procedures to correct it.

Your surgeon will give you all your pre-operative advice at your consultation. This may include having an eye test, if you have eye health issues, as well as a physical examination and eyelid photography from all angles. 

You will need to stop taking blood thinning medication such as warfarin, aspirin, ibuprofen, naproxen, and any other medication or herbal supplement associated with increased bleeding. Your surgeon will advise how long before surgery you need to stop taking these medicines.

You are advised to stop smoking for at least two weeks before your surgery. Smoking reduces healing and increases the risk of complications. Arrange for someone to drive you to and from surgery on the day.

Blepharoplasty is basically skin deep and there is little pain in the post-operative recovery phase. Any discomfort is minor and can be controlled with simple pain relief and eye ointments provided by your surgeon. Most patients need no analgesia at all. Any feeling of grittiness can be treated with the eye ointment. Although patients may look bruised and have visible dressings, they can often work from home the next day.

Recovery from Blepharoplasty is quick but because surgery is in the middle of the face, the dressings and any bruising will be visible. There are a few patients who disregard this and continue normal life, however, we would suggest that exercise is a bad thing as it will delay recovery from bruising and swelling. Working from home is a good option, but it will take 10 days for bruising of the lower eyelids to settle, the upper eyelids generally settle rather quicker. Bruising can be disguised with make-up and we can advise you about cosmetic camouflage. If you are at all sensitive, you should take two weeks before appearing at work. Stitches are removed in the first week. You should also remember that vision can be a little blurred the first day. This is partly due to the surgery and local anaesthesia used, even when you have a general anaesthetic, but also the ointment applied inside the eyelid morning and night does to some extend obscure vision.

On occasion surgery to the lower rather than the upper eyelid can cause swelling which is a nuisance for longer. There is always swelling of tissues after surgery and if this extends under the conjunctiva and on to the eyeball, this is called chemosis. It makes the eye look watery and this can take several weeks to completely settle. In addition, any bruising under the conjunctiva gives bright red ‘haemorrhages’. Chemosis and haemorrhages are of no significance other that the appearance, it does eventually settle.

Swelling can also push the lower eyelid away from the eyeball causing a ectropion, which is annoying but in most cases settles spontaneously within a few days or weeks.

This really depends on your tolerance to your appearance. All the surgery is in the middle of the face and therefore rather obvious. There will be some small dressings for about a week and a little bruising of the cheeks below the eyelids. We would advise you to rest so that any swelling or bruising settles quicker, but we do have patients who disregard this, without long-term issues and go back to full work or off on holiday the following day. We do however, like to see the patients to remove stitches a few days later. We will advise on make-up or in the form of cosmetic camouflage which does allow you to get out and about with confidence.

Blepharoplasty surgery can give life-changing results and an experienced expert surgeon will not change the shape of the eyes. Surgery has evolved in recent years and less muscle fat and skin is being removed. Fat may be repositioned rather than removed and the tell-tale short lower eyelid of the television presenter is avoided by a more careful conservative approach. In addition, the extra youthful vitality is achieved by fat grafting of the brow, temple, cheekbones, lower eyelids and tear trough that surround the eye. This is a very specialised technique which makes all the difference.

Minor Blepharoplasty procedures start from £2,500 however, every individual is different and an accurate price will be quoted depending on your individual needs on consultation with your surgeon.

Eyelid Reduction (Blepharoplasty) Results

Click here to view our gallery of before and after and Eyelid Reduction (Blepharoplasty)

What to expect

Free Consultation with a Patient Advisor

We offer a free, no-obligation 30-60 minute consultation with one of our Patient Advisors. They will work with you to understand your objectives and the results you want to achieve, talk you through the procedure and answer any questions you may have. If you decide that you would like to proceed to the next step and see a surgeon, your Patient Advisor will be happy to arrange this for you. At this point, you will be required to pay a consultation fee. 

Surgical Consultation

Once you’ve booked your consultation, the next step will be for you to meet your chosen surgeon at the Cadogan Clinic. Your surgeon will use this time to make a comprehensive medical assessment of you, your condition, and your expectations before making a recommendation and personalised treatment plan for you. You will then discuss the outcomes you can expect to see and ask any questions

The Procedure

On the day of your procedure you will be welcomed at the Cadogan Clinic by your Patient Advisor and dedicated nursing staff. Following a brief medical check, you will meet with both your surgeon and anaesthetist to run through the details of your procedure one final time and answer any last questions you may have.  

Recovery

After the procedure, you will recover in the capable hands of our aftercare team. As we are a day-case facility you can expect your recovery to be complete within 2 to 3 hours. If your surgeon is happy with your results, you will be able to be discharged from the Clinic the very same day. In some cases patients may wish to stay locally in our exclusive partner hotel the day before or after your procedure in order to be close to their surgeon. Talk to us about these options if this is for you. 

After Care & Support

Our care and support continues in the days and weeks following your procedure with our complimentary aftercare programme. This comprised of a series of appointments made with your surgeon and nursing team to monitor your progress and recovery. They will also introduce you to several scar minimization techniques and bespoke products to aid your progress. Our team are also on call to answer any questions you have around your surgery at any time you are concerned.

Why Cadogan Clinic?

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