Eyelid surgery – Blepharoplasty

Eyelid surgery
Eyelid surgery, also known as blepharoplasty, serves to rejuvenate the upper eyelids, lower eyelids or both by removing excess skin/muscle and fat, as well as reshaping the eye.

A youthful eye typically has smooth, wrinkle-free skin on the upper and lower eyelids and absence of puffiness. However, with increasing age eyelid skin can become lax and wrinkled. This combined with puffiness can give the eyes a tired look. The lax and sagging upper eyelid skin can also fold over the eyelashes causing ‘hooding’ and in severe cases compromise vision.

Lower blepharoplasty is suited for patients who develop puffiness of the lower eyelid. If there is significant ageing of the midface aswell, lower blepharoplasty alone may not achieve the rejuvenating effect that is desired. For such patients a combination of lower blepharoplasty and midface lift is more suitable.

Upper blepharoplasty may be combined with brow lift or brow fat grafting to further enhance the upper eyelid rejuvenation.

Am I A Good Candidate For Eyelid Surgery?

The ideal patient for eyelid surgery is one who has healthy eyes with no serious conditions, does not smoke, does not have any medical condition that can hinder healing and has realistic expectations of the outcome of surgery.

What Does An Upper Blepharoplasty Not Do?

Upper blepharoplasty cannot raise the eyebrows or reduce the appearance of deep wrinkles, crow’s feet or dark circles under the eyes. These issues may be addressed with wrinkle-relaxing injections, laser resurfacing or other cosmetic treatments.

What Causes Puffy Lower Eyelids?

In the majority of cases, puffiness of lower eyelids is due to bulging of periorbital fat (as indicated by the black arrow in the photo below). In the lower eyelid there are 3 fat compartments that are held in place by a thin sheet of tissue called the orbital septum. As we age the orbital septum becomes thinner and less supportive, allowing the fat to bulge.

Upper blepharoplasty is performed under local anaesthetic and the incision placed in the natural eyelid crease. Post-operative discomfort is minimal and most patients can expect to return to normal activities after one week. Sutures are removed at one week and most patients can resume wearing makeup and contact lenses at that time.

Lower blepharoplasty is performed under local or general anaesthetic and the incision placed just under the eyelashes. Through this incision bulging fat can be removed or repositioned. If required, a midface lift can also be performed at the same time to address midface ageing. Excess skin of the lower eyelid is then trimmed and the incision closed with fine sutures.

If the lower eyelid does not have excess skin, Mr Karri may perform a transconjunctival blepharoplasty. With this approach the incision is made inside the lower eyelid to remove the bulging fat, leaving no visible scars.

Recovery From Eyelid Surgery

Swelling, bruising and a sense of tightness in the eyelids are common after eyelid surgery. These usually resolve within 2-4 weeks. Sutures are removed after 7 days. In some patients the eyes can be slightly irritated and sensitive to light for a short time. Mr Karri may prescribe lubricating eyedrops and to ease any discomfort. You should see the results of your eyelid surgery usually after two months.

Prior to your surgery, Mr Karri and his team will give you detailed aftercare instructions. This will include how to care for the incisions, pain relief and when you may resume normal activity.

Risks of blepharoplasty include;

Scar / poor scarring


Asymmetry of scars

Dry eyes

Overcorrection (removing too much skin)/ undercorrection (not removing enough of the excess skin)

Numbness of the eyelids

Blurred vision for a few days

Temporary swelling of the eyelids

Ectropion (pulling down of the lower lids)

Vision loss from retrobulbar haemorrhage (very rare)

Related Procedures

Brow Lift

Brow lift surgery reduces loose skin and wrinkles on the forehead giving a smoother, younger appearance.

Midface / Cheek lift

This procedure lifts and rejuvenates the cheeks and lower eyelids, to create a natural refreshed appearance.


Facelift eliminates loose and sagging skin on your face and neck, creating a tighter and more youthful appearance.