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Medically Reviewed April 2023, by Mr. Bryan Mayou (GMC: 1414396) - founder of the Cadogan Clinic and one of the world's leading plastic surgeons
Blepharoplasty, also known as eyelid reduction, eye lift or eyelid surgery, is a surgical procedure to reshape the eyelids by removing excess fat and skin. Blepharoplasty is a highly effective treatment for the signs of aging around the eye area and can improve common complaints of eye bags and hooded or droopy eyelids. The surgery can also help to improve vision.
As we age, the skin loses elasticity, causing it to wrinkle and sag. Our muscles also slacken as we grow older. This combination of lax skin and relaxed muscles causes the upper and lower eyelids to sag. Loose skin accumulates as folds in the upper eyelids and forms deepening creases in the lower eyelids. The relaxation of the muscle causes the fat which cushions the eyes in their sockets to push forward, causing eyebags to appear.Get in touch
Stress, a lack of sleep, excessive sun exposure, smoking and genetics can make eye folds, creases and bags look worse.
The ageing process can also cause eyelids to droop and folds of skin to accumulate in the upper lids. Sometimes this gathered skin can hang over the eyelashes and interfere with vision. An upper blepharoplasty can improve vision and make you look younger. A lower blepharoplasty reduces wrinkles and puffiness, rejuvenating the eye area. The procedure is suitable for men and women looking for a quick and effective way to eliminate the tell-tale signs of aging around the eyes.
Blepharoplasty is increasing in popularity and was the third most popular surgical procedure carried out on men and women in the UK in 2020, beaten only by breast augmentation and breast reduction.
1 - 2 hours
Time off work
After 1 week
After 1 day
After 6 weeks
After 4 weeks
Sleeping on back
2 - 4 weeks
Blepharoplasty is a very common procedure for both men and women looking to achieve a fresher, more youthful and rejuvenated facial appearance.
Blepharoplasty is a short and highly effective procedure that can achieve immediate changes with very little downtime, and the treatment can deliver both an improved physical and psychological sense of wellbeing.
Cadogan Clinic considers individuals fit for the procedure, if all of the following are true of them:
Words from our clients:
"I was extremely satisfied with the care and treatment I received at the Cadogan Clinic. My surgeon was friendly and informative and explained the procedure fully. My procedure went very well and with the excellent care of the nursing staff, I made a speedy and full recovery. Would recommend to anyone."Eva Berry
"At the beginning before the operation the nurse taking care of me made me feel so comfortable. The surgeon and anesthetist helped me feel so calm. Fantastic before and after treatment"Scarlett Elliott
"The girls on the reception at the clinic were very pleasant and professional. The nurse who took out my stitches after my surgery was just lovely and took me through step by step what she was doing and she also recommended a great cream to use to help with healing."Georgina Nolan
“I was treated with care and provided with thorough knowledge about the procedure I was undertaking. My surgeon was very methodical (a perfectionist) and I felt I received A class treatment."Courtney O'Sullivan
"Outstanding experience from the first appointment to being discharged. Very professional, friendly and a fantastic outcome."Gemma Stevenson
"Reception staff very welcoming and efficient. Both nurses who I dealt with were fantastic, and the whole team (anaesthetist, surgeon etc) were friendly but professional, and really put my mind at ease. That I was able to stay later than I perhaps needed after my surgery to fit in with my husbands schedule was greatly appreciated."Emma Davies
At Cadogan Clinic we use eyelid surgery in conjunction with non-surgical techniques to counteract the effects of ageing around the eyes, such as anti-ageing injectables. These are best for targeting wrinkles and fine lines, however, with Blepharoplasty more suited in cases where major intervention is required.
The eye area is one of the first places on the face to display the signs of aging.
The skin around the eyes is very thin, so, combined with skin laxity caused by an age-related drop in collagen levels, this means the skin around the eyes is more prone to wrinkles, including crow’s feet, or laughter lines, at the corners of the eyes. This sagging also causes the brow to ‘drop’, meaning we lose our youthful wide-eyed appearance. The natural age-related descent in the midface area can cause tear troughs or hollows to develop underneath the eyes.
As we age, fat from the eyelids settles into the eye sockets, giving the eyes a ‘sunken’ appearance. The skin on the lower eyelids sags, resulting in under eye bags.
Although we are all affected by aging, there are certain lifestyle factors which can accelerate this natural process.
One of the biggest things you can do for your skin, not to mention your overall health, is to quit smoking. There are more than 4,000 chemicals in tobacco smoke, with many of these helping to destroy the skin’s natural collagen and elastin, which give the skin its elasticity. Loose excess skin under the eyes is a common trait which can be seen in smokers.
Excessive sun exposure also plays a huge role in premature aging. The sun’s UV rays penetrate the skin and affect collagen and elastin production, leading to wrinkles.
A lack of sleep, stress and a poor diet can contribute to the appearance of eye bags.
Sometimes the signs of aging around the eye area are down to genetics. For example, droopy eyelids (ptosis) can be hereditary while some people are also genetically predisposed toward dark circles under the eyes, and the early formation of under eye bags.
We have invited a selection of the country's very best consultants to join us at the Cadogan Clinic so that you can be sure that whatever the nature of your treatment, you will be seeing one of the top practitioners in the country.
Miss Sujatha Tadiparthi
Mr Jonathan Britto
Ms Monica Fawzy
Mr. David Gateley
Mr. Garrick Georgeu
Miss. Elizabeth Hawkes
Mr. Manaf Khatib
Mr. Hazim Sadideen
Mr. Hagen Schumacher
Mr Mark Solomos
Mr. Tunc Tiryaki
Below you will find some key information to help you prepare for surgery and make necessary arrangements to ensure you have the support you need and that everything runs smoothly on the day.
The first step for all of our patients is to meet with the surgeon we feel is best placed to perform your procedure for a consultation.
At the consultation, you will be able to discuss with your surgeon what your hope to achieve from the procedure, as well as discuss in detail what may or may not be possible given your existing ageing profile.
Having established what will be done, several key measurements will be made and standard clinical photography will be taken.
Finally, a comprehensive discussion regarding risks and complications will take place, alongside a discussion regarding the post-procedure and recovery phase. Your previous medical history will also be recorded (including previous surgery, medications, allergies etc.) and an assessment of your fitness for surgery.
If your surgeon feels you are a good candidate for surgery, you are then invited to consider whether you would like to proceed for surgery or otherwise following a two-week 'cooling-off' period.
Within this period you are welcome to come in and discuss your potential surgery with your surgeon as many times as you like.
02.Leading up to procedure
If you choose to proceed with surgery, the next time you come into the Clinic after your final consultation will be the day of your procedure.
Before admission the following behavioural changes are recommended/required:
03.On the day
On the day of your procedure, we ask that you arrive for your admission an hour before the agreed start time of surgery. At this point a nurse will come and record blood pressure and other relevant vitals, you will meet with your anaesthetist and your surgeon who will make the final mark-ups.
The procedure itself is straightforward and takes place under general anaesthetic over the course of between thirty minutes and one hour. The surgery involves your surgeon making tiny incisions along the natural crease of the eye carefully separating the skin from underlying structures and removing or repositioning the fatty tissue before stretching the skin and stitching it back together ensuring any wrinkles are smoothed out.
Following the procedure, you will recover in our ambulatory recovery rooms for between one to two hours, dependent on the scale of the procedure. Once our specialist nursing team are happy that your initial recovery is complete and you are safe to return home, you will be allowed to leave the Clinic accompanied by a friend or member of your family.
Once home you will have access to our dedicated oncall nursing team 24 hours a day, 7 days a week. This team of specialists are dedicated to your comfort and pain control, and are there to field any questions you may have in the immediate post operative phase.
Blepharoplasty recovery is relatively quick and any residual swelling should subside in a matter of days. We advise total rest for several days after treatment. We recommend at least 1 week off work to allow adequately for this process. We also recommend avoiding UV light for 2 -4 weeks to aid the scarring process.
We ask that you come in and see our nursing team 1 week after surgery to ensure your incision sites have been properly reviewed. At this juncture we also recommend you meet with one of our on site aestheticians to discuss ongoing treatment to support the healing and scarring process.
We ask that you come in to see your surgeon after 6 - 8 weeks for a final check up.
The Patient Journey. A breakdown of what you can expect on your journey with us
We are deeply invested in ensuring that every step of your surgical journey with us is as informative and reassuring to you as it can be. This article outlines what you can expect at each stage of the journeyThe Patient Journey
What is eyelid reduction?
Eyelid reduction is another term for blepharoplasty, but is specifically used to refer to techniques designed to tighten the eyelids and reduce, reshape or lift the eyelid skin around the eye to achieve a refreshed, rejuvenated appearance.
It is possible to tighten the eyelids and reduce, reshape and lift the eyelid skin in just 45 minutes, and this treatment is appropriate for both men and women.
What side effects does blepharoplasty surgery have?
It is very common after surgery to have puffy eyelids for a while, but significant complications are rare. You might have more trouble in the evening when trying to shut your eyes to sleep the first few nights. Your eyes may be irritated or watery for several weeks following the surgery, but this will return rapidly to normal. You may also have bruising resembling a black eye, and some light pink scarring that will fade over time.
Blurred vision immediately after surgery due to persisting local anaesthetic and ointment applied to the eye at the end of the procedure.
Our surgeons will explain all the risks, the likeliness of them occurring and any possibilities of complications upon consultation.
What does blepharoplasty surgery involve?
Blepharoplasty is a straightforward surgery which is carried out as a day case. It is usually done under Total Intravenous Anaesthesia (TIVA), a light anaesthetic, but smaller procedures may only require local anaesthetic. The surgery takes between 30 minutes and one hour, depending on the particular type of blepharoplasty which is being carried out.
There are three different types of procedure that our blepharoplasty surgeons carry out at the Cadogan Clinic:
Double eyelid blepharoplasty is particularly popular in East Asia.
What risks are associated with blepharoplasty surgery?
Blepharoplasty is a safe surgical procedure, and you will be in the hands of a world-class, highly experienced, blepharoplasty surgeon here at the Cadogan Clinic.
However, like any other surgery, blepharoplasty is not entirely without risk.
Common side effects include:
If you already suffer from irritated or dry eyes which require regular eye drops, it is quite likely that you will need to use even more eye drops, post-surgery. Watery eyes are temporary and should clear up in a couple of weeks.
An eye lift can very occasionally result in:
Very rarely, a blepharoplasty may result in more serious problems, such as:
Ectropion is caused by post-operative swelling and usually settles as the swelling subsides.
Visual impairment is an extremely rare side effect of blepharoplasty and many people find that their vision improves in the long term.
How should I prepare for the blepharoplasty treatment?
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 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.
Is blepharoplasty surgery painful?
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 after this surgery. Any feeling of grittiness after surgery can be treated with the eye ointment given to you at the time of surgery. Although patients may look bruised and have visible dressings, they can often work from home the next day, and be back to their daily activities after a few days. The pain is minimal.
How long does it take to recover from blepharoplasty?
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 extent 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 than the appearance, it does eventually settle.
Swelling can also push the lower eyelid away from the eyeball causing an ectropion, which is annoying but in most cases settles spontaneously within a few days or weeks.
Do I need downtime after the blepharoplasty treatment?
This really depends on your tolerance to of 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. There may be some minor pain and swelling around the incision areas, and your eyes will tend to water.
Alternatively, there may be some dryness that occurs, which is easily relieved with some ointment that your surgeon will provide. Occasionally the ointment will cause the patient to have slightly blurred vision, so you may want to rest and take some extra time off work to just relax at home where you’ll be comfortable. Some patients may have added sensitivity to light temporarily following eyelid surgery, so bare that in mind if your work involves bright lights.
Longer term you may develop chemosis, which is oedema (swelling) of the conjunctiva covering the white of the eye. It settles, but it may take a week or two. Those people who have malar pads or festoons of the upper cheek will find that these swell and persists for a month or two.
We would advise you to rest, avoid putting your head down and ad an extra pillow at night, so that any swelling or bruising settles quicker. We do have patients, who completely disregard this advice, 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.
Will my eyes look natural after blepharoplasty?
Blepharoplasty surgery can give life-changing results and an experienced expert surgeon will not change the shape of the eyes, unless this is the aim. Surgery has evolved in recent years and less muscle fat and skin are being removed.
Fat may be repositioned rather than removed. There will be no tell-tale signs that it has been removed, you will have a natural, face new look to your face. In addition, we aim for an extra youthful vitality which is achieved by fat grafting of the brow, temple, cheekbones, lower eyelids that surround the eye. Fat grafts include stem cells, which improve skin quality as well as contours This is a very specialised technique which makes all the difference in achieving incredible results you’ll be happy with.
What scarring can I expect following blepharoplasty?
Blepharoplasty leaves minimal scarring. Any upper blepharoplasty scars will be well hidden in the fold of the eyelid, while lower blepharoplasty scars heal very well, disguised by the eyelashes and in the crow’s feet.
However blepharoplasty scars may potentially be visible when there is a hood of skin extending into the eyelashes to be removed. However this scar fades to be virtually invisible on most people.
It is vital that you follow all the aftercare instructions issued by your surgeon to help aid the scarring process.
We advise total rest for several days after treatment, including taking at least one week off work.
You should avoid UV light for between two and four weeks and quit smoking, as this irritates the eyes, delays healing and can cause scars to be more noticeable.
What are some of the genetic reasons for having eyelid surgery?
Typical genetic causes for eyelid surgery include an array of cosmetic issues such as lumps on the eyelid, sunken eyes, droopy eyelids (ptosis).
Some individuals are also genetically predisposed toward dark circles under the eyes, and the early formation of bags under the eyes.
All of these genetic conditions can be addressed by eyelid surgery and blepharoplasty.
Should I choose an oculoplastic surgeon for my blepharoplasty surgery?
Blepharoplasty, eyelid surgery, is a highly specialised area. So it is important that you choose an expert in this field to carry out any surgery on this most delicate of areas.
An oculoplastic surgeon is an ophthalmologist, otherwise known as an eye doctor, who has undergone many years of specialised training in eyelid and facial plastic surgery. Although plastic surgeons are highly trained and are able to carry out aesthetic eyelid surgery, they do not possess the depth of knowledge or expertise of the eye as an oculoplastic surgeon does.
As a trained ophthalmologist, an oculoplastic surgeon is able to examine the eye, identify any pre-existing eye disease and deal with any functional eyelid disease such as eyelid cancer, lid malpositions and entropion, a condition which turns the eyelid inward. These specialists are also able to examine the eye after blepharoplasty to ensure there are no eye complications and expertly manage any complications should they arise after surgery. A plastic surgeon will not be able to carry out these examinations as they have not undergone the same level of training in the eyes and have no training in the basic equipment used to carry out eye examinations. As a result, a plastic surgeon cannot provide the same level of expert care as a trained ophthalmologist.
These specially trained oculoplastic surgeons are responsible for eyelid surgery in hospitals across the UK.
As well as blepharoplasty, oculoplastic surgeons can carry out other eyelid surgery including repairing an eyelid which is turning in or out, correcting drooping eyelids (ptosis) and removing eyelid cysts (also known as chalazion or meibomian cyst).
Here at the Cadogan Clinic, we would highly recommend that an oculoplastic surgeon carries out any eye-related surgery, be it for functional or purely aesthetic reasons.
How to choose the best eyelid reduction surgeon
Eyelid reduction surgery, also known as blepharoplasty, is a highly specialised area, so it is important that you choose a surgeon who is an expert in their field to carry out this type of surgery.
The best surgeon to carry out eyelid reduction is an oculoplastic surgeon, an ophthalmologist who has undergone many years of specialised training in eyelid and facial plastic surgery. Although highly qualified, a plastic surgeon does not possess the same expert knowledge about the eye and has not undergone the same level of training as an oculoplastic surgeon.
A good surgeon should be able to explain the procedure in great depth, as well as the recovery period and any potential risks or complications. They will also be honest about potential outcomes and help you to manage your expectations.
When you have your initial consultation, make sure the surgeon has an extensive portfolio of before and after photographs that they can share with you so you can get a good idea of how the results of your surgery will look. Be sure to check out testimonials from previous patients.
If you are not physically and psychologically fit and healthy, an ethical surgeon will not attempt to perform the procedure.
You can check if a surgeon is a registered doctor or surgeon on the General Medical Council (GMC) online register.
Some surgeons may be members of professional associations, such as the British Oculoplastic Surgery Society (BOPSS). However there are some qualified surgeons who are experts in their field but choose not to sign up to a trade body for their own reasons.
Founded in 2004 by world renowned plastic surgeon Mr Bryan Mayou, we now work with over 100 leading consultants and successfully treat over 20,000 patients each year. We have been winning industry awards since inception.About Us
Best in Class Facilities
All of our treatments take place at our beautiful boutique premises in Chelsea. We have six consulting rooms and five operating rooms, as well as a dedicated pre and post-operative suite, and a full team of specialist nursing staff.Our Clinic
A Strong Tradition of Innovation
We were founded in 2004 by world renown plastic surgeon Mr Bryan Mayou, best known for his pioneering work in the area of liposuction, lasers and microvascular surgery. We continue to collaborate with pioneers in our field.Our History
At Home in Sloane Street, London
We are proud that our state of the art award-winning clinic is located in one of the best neighbourhoods in the countryWelcome to Sloane Street
We offer surgical consultations in London, Birmingham, Chelmsford and Bristol, and attract international patients from all corners of the globe such as as the USA, the Middle East and Europe.Get in Touch
Complications are rare although, as with all surgery, possible. Your surgeon will discuss each of these risks comprehensively at your consultation. Read our FAQ section for more information.
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