	home

	products & services

	health information

	facilities finder

	about BUPA

	jobs at BUPA

	contact BUPA

Products and services

	Health insurance
	Financial protection
	Care homes
	Health assessments
	Childcare
	Travel insurance
	International cover
	Cash plans
	Shop

Visitor interest areas

	Individuals
	Business
	Intermediaries
	Health professionals
	BUPA members

Facilities finder

Find local health and fitness facilities

World of BUPA

BUPA services around the world at bupa.com

| health information | health factsheets

Cosmetic eyelid surgery (blepharoplasty)

Published by BUPA's health information team, healthinfo@bupa.com, December 2007.

This factsheet is for people who are considering having cosmetic eyelid surgery. This involves removing excess skin, fat and muscle from around the eyes to give a more alert and youthful appearance. The procedure can be done on the upper and lower lids, at the same time or separately.

Your care will be adapted to meet your individual needs and may differ from what is described here. So it's important that you follow your surgeon's advice.

About cosmetic eyelid surgery
Getting advice
What are the alternatives?
Preparing for your operation
About the operation
What to expect afterwards
Recovering from cosmetic eyelid surgery
What are the risks?
Further information
Sources
Related topics

About cosmetic eyelid surgery

As you age, the skin around your eyes loses its elasticity. You may develop loose folds of skin on your upper eyelids and deep creases under your lower lids. Your muscles in this area may also slacken so that any fat bulges forward and looks baggy. Cosmetic eyelid surgery can remove the excess skin, fat, or both, from around your eyes.

Getting advice

It's important not to rush into the decision to have cosmetic surgery. Discuss your options with your GP, who may be able to recommend a reputable surgeon or give advice about how to choose which hospital to be treated in.

Before opting for cosmetic eyelid surgery, discuss with your surgeon what you are hoping to gain from the operation and the result you can realistically expect. For example the surgery won't remove wrinkles at the corners of your eyes (crow's feet) or the dark shadows under your eyes.

What are the alternatives?

Wrinkles around your eyes may be reduced using chemical or laser treatments, or by a forehead or brow lift.

Preparing for your operation

Your surgeon will examine your eyelids, vision, tear film (a layer of tears covering the surface of your eye), front of your eye and your retina.

Your surgeon will examine the condition of your skin, and measure the position of your eyebrows and eyelids.

Your surgeon will explain how to prepare for your operation. For example if you smoke you may be asked to quit, as smoking increases your risk of getting a chest or wound infection and slows your recovery.

Cosmetic eyelid surgery is usually done as a day case under general anaesthesia. This means you will be asleep during the operation. Alternatively you may prefer to have the surgery under local anaesthesia, in which case the area around your eyes is numb but you stay awake. A sedative may be given with a local anaesthetic to help you relax.

Your surgeon will advise which type of anaesthesia is most suitable for you.

If you are having a general anaesthetic, you will be asked to follow fasting instructions. Typically you must not eat or drink for about six hours before a general anaesthetic. However some anaesthetists allow occasional sips of water until two hours beforehand.

At the hospital your nurse will explain how you will be cared for during your stay. Your nurse may do some tests such as checking your heart rate and blood pressure, and testing your urine.

Your surgeon will usually visit you to discuss the operation and ask you to sign a consent form. This confirms that you understand the risks, benefits and possible alternatives to the procedure and have given your permission for it to go ahead.

Your surgeon will examine your eyes and may take photographs, so that the results of surgery can be compared with your original appearance.

Your nurse will prepare you for theatre. You may be asked to wear compression stockings to help prevent blood clots forming in the veins in your legs.

About the operation

The operation takes one to two hours, or less if just the upper or lower lids are being done. Your surgeon may use either conventional or laser techniques.

For surgery on the upper eyelids, cuts are made into the natural lines and creases in your eyelids, and in the wrinkles at the corners of your eyes.

For surgery on the lower eyelids, cuts are made just below your eyelashes. This means your scars will run along the natural folds of your eyes.

Excess fat, muscle and loose skin are then removed, and the cut is closed using fine stitches.

If only fat is removed and there is no excess skin, the cut may be made inside the lower eyelids, leaving no visible scar.

Your surgeon will apply ointment to your eye area to stop it from drying out and use sterile paper tape to support your eyelids.

What to expect afterwards

You will need to rest until the effects of the general anaesthetic have passed. You may need pain relief to help with any discomfort as the anaesthetic wears off.

You will be able to go home when you feel ready.

You will need to arrange for someone to drive you home. You should try to have a friend or relative stay with you for the first 24 hours.

Your nurse will give you some advice about caring for your eyes before you go home. You may be given eye ointment to use at home and a date for a follow-up appointment.

Dissolvable stitches will disappear on their own in seven to ten days. Non-dissolvable stitches are usually removed three to five days after surgery.

Recovering from cosmetic eyelid surgery

If you need them, you can take over-the-counter painkillers such as paracetamol or ibuprofen. Follow the instructions in the patient information leaflet that comes with the medicine and ask your pharmacist for advice.

The tape supporting your eyelids is usually removed after three to five days. Lower eyelid support may be worn for one week.

You will have some swelling around your eyes. Applying a cold compress, such as ice or a bag of frozen peas (both wrapped in a towel) can help to reduce the swelling and bruising. You should not put ice directly on your skin as it can give you an ice "burn".

There are some important things to remember while recovering from cosmetic eyelid surgery.

Keep your head propped up on pillows when you are lying down. This helps to reduce swelling and bruising.
Don't bend forwards for a few days.
Clean around your eyes and use the ointment as advised by your surgeon.
Don't wear eye make-up until your surgeon tells you it's safe to do so.
Don't wear contact lenses for at least two weeks.
Don't drive until your vision has returned to normal and your eyes have stopped watering.

Most people are able to read or watch television within a few days and can return to work after seven to ten days.

What are the risks?

Cosmetic eyelid surgery is commonly performed and generally safe. However, in order to make an informed decision and give your consent, you need to be aware of the possible side-effects and the risk of complications of this procedure.

Side-effects

These are the unwanted, but mostly temporary effects of a successful procedure, for example feeling sick as a result of the general anaesthetic.

Side-effects of cosmetic eyelid surgery include:

soreness, swelling and bruising around your eyes - this can last up to a month
sticky, dry and itchy eyes - this usually clears after a week
watery eyes - this can last for a few weeks
sensitivity to light - this will improve after a few weeks
double or blurred vision - this usually improves after a few days
scarring - this should fade over the course of a few months

Sometimes tiny whiteheads appear along the line where the stitches were. Your surgeon can remove these with a needle.

Complications

This is when problems occur during or after the operation. Most people are not affected. The possible complications of any operation include an unexpected reaction to the anaesthetic, excessive bleeding, infection, or developing a blood clot, usually in a vein in the leg (deep vein thrombosis, DVT). Antibiotics may be needed to help prevent infection.

Specific complications of cosmetic eyelid surgery are uncommon but can include:

bleeding under your skin (haematoma) - this may require surgery to stop the bleeding and to drain the area
swelling that pulls the lower lid away from your eyes - usually settles on its own after a couple of days, but sometimes further surgery is needed
damage to the surface of the eyeball or the surrounding muscles
acute glaucoma - this may need treatment by an eye specialist
inability to close your eyes when sleeping - this is very rare
partial or complete blindness - this is very rare
sunken appearance - this occurs if too much fat is removed
uneven appearance - your eyes may not look identical

It's possible that you may not be completely satisfied with your appearance after the operation.

The exact risks are specific to you and differ for every person, so we have not included statistics here. Ask your surgeon to explain how these risks apply to you.

Further information

British Association of Aesthetic Plastic Surgeons (BAAPS)
020 7405 2234
www.baaps.org.uk

Sources

Eye reduction. British Association of Aesthetic Plastic Surgeons (BAAPS).
www.baaps.org.uk
accessed 10 August 2007
Eyelid surgery (blepharoplasty). American Society of Plastic Surgeons.
www.plasticsurgery.org
accessed 10 August 2007