Eyelid surgery, also known as blepharoplasty, is a surgical procedure performed to remove or reposition excess skin, muscle, or fat from the upper eyelids and aims to reduce under-eye bags, perceived puffiness, and skin laxity from the lower eyelids. Both procedures are often performed together as part of periorbital (or peri-orbital) rejuvenation. This procedure is commonly undertaken to address concerns such as lowered eyelid position, hooded upper lids, or a heavy appearance that can affect vision. It may be performed for functional or cosmetic reasons, depending on the patient's symptoms and goals, and aims to achieve a refreshed appearance around the eyes while preserving natural contours.
What the Procedure Involves
Blepharoplasty is typically conducted under local anaesthesia with sedation or general anaesthesia, depending on the complexity of the procedure and patient preference. The steps involved usually include:
- An incision made within the natural crease of the upper eyelid to minimise visible scarring.
- Incisions made just below the lower lash line or inside the lower eyelid (transconjunctival)
- Precise removal of redundant skin that contributes to hooding or droopiness.
- Repositioning or removal of muscle and fat, especially when puffiness is present.
- Tightening of skin or muscle if needed.
- Meticulous closure of the incision to ensure a natural eyelid contour.
The procedure(s) usually take 45 minutes to 2.5 hours, depending on whether it is performed on one or both eyelids and whether any additional procedures are combined.
Periorbital rejuvenation may include surgical and non-surgical treatments, depending on your goals. These include:
- Topical Therapies and Skincare: Creams and serums targeting fine lines, wrinkles, and pigmentation.
- Injectables: Botulinum toxin (Botox) to smooth crow’s feet and glabella lines, and dermal fillers to restore volume in hollows or tear troughs.
- Chemical Peels and Microneedling: Improve skin texture and tone, reduce pigmentation, and stimulate collagen production.
- Micro fat grafting: May be combined with lower eyelid surgery to address these changes.
- Laser and Light Therapies: Ablative and non-ablative lasers, LED, and intense pulsed light (IPL) for skin resurfacing, tightening, and reducing hyperpigmentation.
What to Expect During the Procedure
- Typically performed under local anaesthesia with minimal sedation, or sometimes under general anaesthesia, depending on the complexity and patient preference.
- The eyelid area will be cleaned and marked before the incision is made.
- A precise incision is created along the natural upper eyelid crease to minimise visible scarring.
- The surgeon makes incisions either just below the lashes or within the lower eyelid (transconjunctival approach), depending on whether excess skin or fat needs to be removed.
- Excess fat is removed or repositioned, and if needed, excess skin is trimmed, and the area is sutured closed.
- After closure, ointment and cold compresses may be applied, and most patients return home the same day.
Potential Benefits of Eyelid Surgery & Periorbital Rejuvenation
This procedure may assist in:
- A more open and rested appearance of the eyes.
- Reduced hooding of the upper eyelid increases the visibility of the upper eyelid crease.
- Smoothing puffiness or under-eye bags
- Reducing excess lower eyelid skin
- Greater peripheral vision in cases where excess skin obstructs the field of view.
- Enhancing the overall periorbital area appearance.
Individual results vary depending on the extent of correction required, skin quality, and individual healing response.
Risks and Considerations
Modern surgery is generally safe, but, as with any surgical procedure, blepharoplasty and periorbital rejuvenation carry risks. These include dry or irritated eyes, changes in eyelid contour, and asymmetry. Rare complications may include infection or scarring. Working with a certified and experienced plastic surgeon significantly minimises these risks. For a list of general and specific risks and complications associated with plastic surgery and eyelid surgery, please click here to download.
During your consultation, your plastic surgeon will talk about possible risks and complications. It is essential to grasp these factors before deciding to proceed with a lower eyelid procedure. Any concerns should be communicated to the team at Advanced Plastic & Cosmetic Surgery.
Recovery and Aftercare
Recovery timelines and experiences can differ among individuals, but general expectations include:
- First Week: Swelling, bruising, and mild discomfort are common. Cold compresses and head elevation are recommended to reduce inflammation. Stitches are usually removed within 5–7 days.
- 2–4 Weeks: Most patients feel comfortable returning to normal activities. Makeup and contact lenses can usually be resumed after your surgeon advises it is safe to do so.
- 3–6 Months: Scars begin to mature and fade. The eyelid contour continues to refine as swelling resolves.
Your Advanced Plastic & Cosmetic Surgery plastic surgeon will provide detailed aftercare instructions, including how to clean the incision site, avoid strenuous activities, and manage temporary changes in eyelid sensation.
For non-surgical periorbital rejuvenation treatments (fillers, Botox, lasers), downtime is minimal, with possible minor swelling or bruising that typically resolves quickly. Your plastic surgeon will provide detailed instructions for care and activity. These instructions may include:
- How to care for your surgical site(s) following surgery
- Medications to apply or take orally to aid healing and reduce the risk of infection
- Specific concerns to look for at the surgical site(s) or in your general health
- When to schedule follow-up appointments with your Advanced Plastic & Cosmetic Surgery plastic surgeon
Who Might Be Suitable for Eyelid Surgery & Periorbital Rejuvenation?
Those who may benefit from eyelid surgery and periorbital rejuvenation include individuals who:
- Have concerns about the natural ageing process beneath the eyes.
- Experience elasticity loss or excess upper eyelid skin.
- Have puffiness or bulging due to fat pads.
- Find that drooping upper eyelids affect your vision or comfort.
- Are in good health.
- Have realistic expectations about the outcomes of surgery.
Consultation with a qualified plastic surgeon is required to assess individual suitability. The decision to undergo lower eyelid surgery and periorbital rejuvenation should be based on a thorough consultation with a registered specialist plastic surgeon who can assess your individual needs and explain potential outcomes and risks.
Q: Will scaring be visible?
A: Incisions are placed within the natural eyelid crease, making scars typically well-concealed. Scarring usually fades over time and becomes barely noticeable in most cases.
Q: Can this improve vision?
A: If excess upper eyelid skin impairs your peripheral vision, upper blepharoplasty may help to restore a clearer visual field. Your surgeon may perform a visual field test to assess this.
Q: How long do the results last?
A: Results are long-lasting, although the ageing process will continue. Many patients enjoy improvements for 10 years or more before considering further treatment.
Q: Is upper eyelid surgery only for older individuals?
A: No. Some younger individuals seek surgery for hereditary heavy eyelids or puffiness. Suitability is based on anatomy and goals rather than age alone.
Q: Can upper and lower eyelid surgery be performed together?
A: Yes, upper and lower eyelid surgery can be performed together. Patients can opt to do this for a more comprehensive approach.
Important Note
Surgical outcomes can vary significantly between individuals. Any before-and-after images or descriptions of outcomes (not included here) are not indicative of what every patient may achieve. Only a consultation with a RACS Certified plastic surgeon can determine whether blepharoplasty (eyelid surgery) is suitable for you.
Deciding on blepharoplasty (eyelid surgery) and periorbital rejuvenation is a personal choice that’s best made with a full understanding of the potential benefits, limitations, and risks. Our surgeons at Advanced Plastic & Cosmetic Surgery provide evidence-based guidance and a transparent consultation process to help you make an informed decision. If you would like to explore whether blepharoplasty (eyelid surgery) and periorbital rejuvenation are suitable for you, we encourage you to arrange a consultation with our team.