Blepharoplasty: everything you should know about eyelid aesthetics

The eyes are the most noticed area of the face — and with age or genetics, drooping can appear on the upper eyelid and the puffiness known as "bags" on the lower one. Blepharoplasty is a procedure that targets both of these problems and changes the overall expression of the face considerably.

What is blepharoplasty?

Blepharoplasty is an aesthetic operation carried out by removing or redistributing excess skin, and sometimes fatty tissue, in the eyelid area. The aim is not only a younger look: a drooping upper lid can sometimes restrict the field of vision, and then the procedure carries functional significance as well.

Upper eyelid blepharoplasty

Over time, excess skin and sometimes an accumulation of fat develop on the upper lid. During the operation:

• A small incision is made along the natural crease of the lid
• The excess skin is removed (along with a small fat pad where necessary)
• The suture is fine and stays hidden in the lid crease

The result is an eye that looks more open and more alert.

Lower eyelid blepharoplasty

On the lower lid the main problem is often not loose skin but an accumulation of fat (the look of "bags"). The approach varies with the situation:

• Transconjunctival technique — the incision is made on the inner side of the eyelid and leaves no external mark. Suitable only when the fat is being redistributed.
• External incision technique — an incision below the lashes, used when there is a problem with both skin and fat

Do not confuse dermatochalasis with ptosis

These two conditions are often mixed up, but they call for different solutions:

• Dermatochalasis — the lid skin itself is excessive and has lost its elasticity. It is solved directly by blepharoplasty.
• Ptosis — the lid itself sits low because the muscle that lifts it (the levator) has weakened. This is solved not by removing skin but by repairing the muscle (ptosis correction).

In some patients both conditions are present at once — which is why, at the consultation, the doctor assesses the opening distance of the lid and the muscle function separately.

Who is a suitable candidate?

• People whose upper lid droops enough to restrict the field of vision
• Bags on the lower lid that create a permanently "tired look"
• Patients whose general health suits surgery and who have no active disease of the eye itself
• People with realistic expectations: blepharoplasty does not change the position of the brows and forehead, which is a separate procedure (a brow lift)

About the suture mark

On the upper lid the mark hides in the natural lid crease and becomes almost invisible after a while. With the transconjunctival technique on the lower lid there is generally no external mark at all. With the external incision technique on the lower lid the mark stays beneath the lash line and fades with time.

How does recovery go?

In the first weeks it is advisable to wear sunglasses, avoid direct sun and not spend long periods in front of a screen.

What to ask at the consultation?

1. 1Is my condition dermatochalasis, ptosis, or both?
2. 2Do I need surgery on the upper lid only, the lower lid only, or both?
3. 3Is the transconjunctival technique or the external incision technique right for me?
4. 4When during recovery will I be able to return to work and to social settings?

For an individual assessment regarding blepharoplasty, the soundest step is to have the eyelid and the area around the eye examined by a specialist at a free consultation.

This text is intended for general information and is not a substitute for medical advice; an accurate diagnosis and plan require a doctor's examination.