Dear doctor, is eyelid surgery right for me?

18 October 2018

I’m only 39 but feel my eyelids look really droopy, giving me a tired and ageing appearance. Is eyelid surgery right for me?

As we get older, time and gravity work their mischief on most parts of the body, including the eyelids. Excess skin in the upper eyelids can lead to a hooded appearance that can make the eyes look smaller and give the appearance of tiredness or grumpiness. Although it is certainly not suitable for everyone, an upper eyelid reduction (or blepharoplasty) involves removing the excess skin in the upper eyelid just enough to show the eyelid crease along the entire length of the upper lid but not so much that the end result is a startled appearance or so that it is difficult to close the eye.

The scar is one of the least visible of all cosmetic surgical procedures as the skin quality in this area is usually excellent and the scar is hidden within the natural crease of the eyelid. A suitably qualified cosmetic surgeon will be able to formally assess the nature of the eyelid and it is often useful to bring along a photo of your younger self for comparison. Sometimes it may seem that the eyelid itself is drooping but it is, in fact, the eyebrow that has descended and this may need lifting into a better position.

The same can happen to the lower eyelid but, in this case, the fat that normally surrounds the eyeball can also become displaced and push out the lower eyelid skin and muscle to form a pouch. These lower eyelid ‘bags’ can throw shadows onto the cheek and be very visible, aging the face significantly. This is usually addressed by an incision just beneath the eyelashes that is also very well-hidden. The excess fat is either removed or re-draped and the extra skin is smoothed out and excised taking care not to remove too much to prevent the eyelid from sagging downwards.

The surgery can be done under a general (asleep) or local (awake) anaesthetic and is usually a day case procedure so that you can go home on the same day. Blepharoplasty is one of the longest-lasting of all cosmetic procedures and often does not need repeating even many years later. As with all cosmetic procedures, it is important to see a qualified surgeon so that all options as well as the risks and possible complications of the surgery can be discussed in detail before deciding to proceed.

Find out more about Mr Charles Durrant, a Consultant Plastic, Cosmetic and Reconstructive Surgeon practising at Spire Portsmouth Hospital.


The content of this article is provided for general information only, and should not be treated as a substitute for the professional medical advice of your doctor or other health care professional.

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