What Is Upper Blepharoplasty?

Upper blepharoplasty is a type of eyelid surgery designed to remove excess skin and fat from the upper eyelids. Sometimes referred to as an upper eyelid lift or upper eyelid surgery, the goal of the procedure is to create a more alert, rested, and youthful appearance by addressing issues such as drooping eyelids, puffiness, or heaviness above the eyes.

As we age, the eyelid skin naturally loses elasticity, leading to a build-up of excess skin and fat in the upper lids. This can create a hooded look, obscure the natural eyelid crease, or even interfere with your visual field in more severe cases. Upper blepharoplasty surgery works by carefully removing this extra tissue and, in some cases, repositioning excess fat, to restore a more open, natural look.

Although often chosen for cosmetic surgery reasons, upper blepharoplasty can also have a functional benefit for those whose vision is affected by too much skin around the upper eyelids.

The Upper Blepharoplasty Procedure – Step by Step

Understanding the steps of upper blepharoplasty can help reduce uncertainty and prepare you for what to expect. Whether the motivation is cosmetic or functional, the eyelid surgery process is generally straightforward and performed under a calm, controlled environment.

Here’s how a typical upper eyelid lift is carried out:

1. Initial Consultation

Before anything else, you’ll meet with your surgeon for a thorough initial consultation. This is where your medical history is discussed, your eyelids are assessed, and your expectations are explored. You’ll also be advised to stop certain blood thinners or herbal supplements ahead of the procedure.

2. Anaesthesia

Most upper blepharoplasty surgeries are done using a local anaesthetic, which numbs the area around the eyes. In some cases, local anaesthesia with light sedation or general anaesthetic may be used, depending on patient preference and clinical recommendation.

3. Marking the Eyelids

The surgeon carefully marks the natural contours and the planned incisions along the natural eyelid crease. This helps ensure any scars are well hidden within the natural fold of the upper eyelid.

4. Making the Incisions

Using fine, precise instruments, a small incision is made along the natural crease of the upper eyelid. This allows access to the tissue beneath.

5. Removing or Repositioning Tissue

Next, the surgeon will remove excess skin, and in some cases, remove excess fat or reposition excess fat to reduce puffiness and achieve a balanced result.

6. Closing the Incisions

The incisions are closed using fine sutures or suture strips, promoting neat healing with minimal scarring.

7. Immediate Aftercare

Once complete, you’ll rest with cold compresses to reduce swelling. You may also be prescribed antibiotic ointment or eye drops to keep the area clean and aid in recovery.

The entire blepharoplasty procedure usually takes around one to two half hours, depending on whether you are having surgery on one or both upper lids.

Key Considerations Before and After Upper Blepharoplasty

Whether you're considering upper blepharoplasty for cosmetic reasons or to help improve vision affected by excess eyelid skin, it’s important to understand the practicalities of the procedure and how to prepare for a smooth recovery.

Before Surgery: What to Know

• Medical History Matters: During your initial consultation, your surgeon will ask about any existing conditions, medications, or previous eyelid surgery. Be honest and thorough – it helps ensure your safety.
• Stop Certain Medications: You may be asked to pause blood thinners, herbal supplements, or any medication that could affect bleeding and healing. Always follow your surgeon’s advice.
• Expect Realistic Results: Blepharoplasty surgery can achieve a noticeable improvement, but it's not about changing your face, it's about restoring a more rested, youthful appearance while keeping your natural features.
• Other Treatments May Be Suggested: If your concerns are more related to sagging eyebrows or drooping eyelids caused by muscle weakness, a brow lift may be recommended instead or alongside blepharoplasty.

After Surgery: What to Expect

• Mild Discomfort Is Normal: You may experience some tightness, dry eyes, or irritated eyes for a few days. This is common and usually settles quickly.
• Avoid Strenuous Activity: No strenuous activity or heavy lifting for at least 1–2 weeks. Rest helps reduce swelling and bruising and allows the area to heal.
• Sleep Slightly Elevated: Propping your head up at night can help with swelling.
• Protect Your Eyes: Avoid eye makeup, contact lenses, and sun exposure until given the all-clear. You may also notice temporary blurred vision or changes in tear production.
• Stick to the Aftercare Routine: Use cold compresses, eye drops, and any antibiotic ointment as prescribed. Attend your follow up appointment and reach out to your clinic if anything feels unusual, such as severe pain or signs of infection.

Taking time to properly prepare and recover from your upper eyelid surgery helps ensure safe results and a smoother experience overall.

Recovery Timeline

Timeframe

What to Expect

Day 1–2

Mild swelling, bruising, and tightness around the eyes. Use cold compresses and rest. May need eye drops and antibiotic ointment.

Day 3–5

Bruising and swelling may peak, then begin to settle. Avoid strenuous activity and heavy lifting.

Day 5–7

Fine sutures or suture strips are usually removed. Vision may still be slightly blurred.

Week 2

Most swelling has reduced. Bruising fading. You can return to most light daily activities, but avoid eye makeup and contact lenses.

Week 3–4

Results becoming clearer. Minor swelling may persist, but healing continues. Can gradually return to normal routine.

After 4 weeks

Most people see full results with minimal visible scarring, hidden in the natural eyelid crease.

Alternatives to Upper Blepharoplasty

While upper blepharoplasty is a highly effective way to remove excess skin and restore the natural crease of the upper eyelids, it’s not the only approach to improving the appearance or function of the eyelids.

Depending on your facial structure, goals, and symptoms, your surgeon might discuss the following alternatives:

Brow Lift

If your concerns are more related to sagging eyebrows or heaviness across the forehead, a brow lift may be more appropriate. A brow lift raises the position of the brows, which can relieve pressure on the upper eyelid area and restore a more youthful appearance.

Sometimes a brow lift is performed in combination with upper eyelid surgery for a more balanced result.

Lower Eyelid Surgery

If you're also bothered by eye bags, puffiness, or excess fat under the eyes, you may be a candidate for lower blepharoplasty. This procedure focuses on reshaping the lower eyelids and can be done at the same time as upper blepharoplasty.

Who Should Get Upper Blepharoplasty?

Upper blepharoplasty may be suitable for individuals who are experiencing changes in the upper eyelids due to ageing, genetics, or lifestyle factors. It's often chosen by people who are bothered by the appearance of excess skin, puffiness, or a feeling of heaviness above the eyes, but it can also be a functional decision if drooping eyelids begin to interfere with your vision.

You might consider upper eyelid surgery if:

• You have noticeable excess skin and fat in the upper lids, causing a tired or hooded appearance
• Your natural eyelid crease is hidden or sagging
• You feel self-conscious about how your eyelids affect your facial expressions or symmetry
• You have difficulty applying eye makeup due to sagging skin
• Your visual field is affected by the droop of the upper eyelids
• You’re in good general health, with no underlying eye conditions that would make eyelid surgery unsuitable
• You have realistic expectations about results and recovery time

Top Tips for Making a Decision About Upper Blepharoplasty

Choosing to have upper blepharoplasty is a personal decision, and it’s important to take your time and feel fully informed. Whether your concerns are cosmetic or practical, the aim is to choose what’s best for you.

Here are some simple tips to help you make a confident, well-considered choice:

1. Consider Your Motivation

Ask yourself why you’re thinking about upper eyelid surgery. Are you feeling frustrated by the way your eyelids look? Do you find excess skin is affecting your vision or causing discomfort? Clear reasons make for better decisions.

2. Have a Thorough Consultation

Your initial consultation isn’t just a formality, it’s where you’ll get honest, tailored advice about what’s possible and what to expect. Bring any questions you have, and be open about your concerns and goals.

3. Understand the Recovery

Like any surgical procedure, upper blepharoplasty involves downtime. Be prepared for swelling and bruising, temporary dry eyes, and time off work or social events. Understanding the blepharoplasty recovery process makes it easier to plan.

4. Be Open to Alternatives

Sometimes, drooping eyelids are only part of the picture. A brow lift may be more appropriate, or could be combined with blepharoplasty for a more balanced outcome.

5. Choose a Trusted Surgeon

Look for a qualified oculoplastic surgeon or facial plastic surgeon with experience in eyelid surgery blepharoplasty. Ask to see before and after photos, read reviews, and don’t be afraid to get a second opinion if you’re unsure.

6. Don’t Rush

Take time to weigh up your options. The best decisions are made when you feel calm, informed, and supported, not rushed or pressured.

Frequently Asked Questions About Upper Blepharoplasty

How long does upper blepharoplasty last?

For most patients, upper blepharoplasty results can last anywhere from 5 to 10 years, depending on your skin type, ageing process, and lifestyle. While the excess skin and fat that are removed won’t return, natural ageing of the eyelids will still continue over time. However, many people find they only need this type of eyelid surgery once.

How painful is upper blepharoplasty?

Upper eyelid surgery is generally well tolerated. It’s typically performed under local anaesthetic, so you won’t feel any pain during the procedure. Afterwards, some tightness, mild discomfort, or dry eyes are normal, but this usually settles within a few days. You may be prescribed pain relief, antibiotic ointment, or eye drops to help with recovery.

What is the difference between eyelid surgery and blepharoplasty?

In most cases, the terms are used interchangeably. Blepharoplasty refers specifically to the surgical procedure used to remove excess skin and fat from the upper or lower eyelid, whereas "eyelid surgery" is a broader term that could also include ptosis surgery (to lift a drooping lid caused by muscle weakness) or reconstruction following trauma.

What are the disadvantages of blepharoplasty?

While upper blepharoplasty is safe for most patients, like all surgical procedures, it carries some risks. These may include temporary blurred vision, dry eyes, watery eyes, or mild asymmetry during healing. Rarely, complications such as infection, blood clots, or excessive scarring can occur. Choosing an experienced oculoplastic surgeon or facial plastic surgeon, and following aftercare advice carefully, helps reduce these risks.