Eyelid surgery or eyebag removal (blepharoplasty)

Eyelid surgery, or blepharoplasty, is a procedure that reshapes the upper or lower eyelids by removing or repositioning excess skin and fat. Upper eyelid surgery can improve vision if drooping skin gets in the way, while lower eyelid surgery reduces puffiness or ‘bags’ under the eyes. The result is a more rested, refreshed and youthful appearance.

Reasons for having eyelid surgery

With age, the skin and tissue around the eyes can start to sag or bulge, making the eyelids look heavy or puffy. These changes can happen gradually and are sometimes influenced by genetics.

Some people naturally have hooded eyes (ie more skin folding down from the brow bone), which can make the eyes look smaller.

Upper eyelid drooping may reduce your vision, while lower eyelid puffiness can make the eyes appear tired or uneven. If these changes are affecting your self esteem or confidence, a consultation with a qualified surgeon can help determine whether eyelid surgery is suitable.

Is eyelid surgery right for you?

Eyelid surgery may be considered by adults who find that drooping eyelids or under-eye puffiness make them feel less confident. For some, these changes can create a sense that their outward appearance does not reflect their energy and wellbeing.

If you have a droopy eyelid from cataract surgery, it may resolve on its own in a few weeks to months. However, you may consider surgery if it hasn’t resolved after 6 months.

During a consultation, your surgeon will review your overall health, examine your eyelids and eyes, and talk through what the procedure can achieve. They will explain the potential benefits and risks, helping you decide if surgery is the right choice.

Alternative treatments to eyelid surgery

Not everyone with droopy eyelids or under-eye puffiness needs surgery. Non-surgical options may help improve the appearance of the eyes or delay the need for an operation. These include treatments such as dermal fillers or fat transfer to smooth out the hollows under the eyes, or skin-tightening procedures using lasers or radiofrequency to improve elasticity.

While topical creams, lifestyle changes, and good skincare can sometimes reduce mild puffiness or improve skin quality, they cannot remove significant excess skin. Your consultant can explain which alternatives might be suitable for your situation and whether they could help you achieve your goals without surgery.

What are the benefits of eyelid surgery?

• Boosts confidence, outwardly reflecting how you may feel inside
• Can enhance vision if the upper eyelid is obstructing sight
• Creates a more rested, alert and youthful appearance
• Improves symmetry between the eyes
• Improves the appearance of droopy or sagging eyelids

It’s normal to feel nervous about surgery, even for a procedure as common as eyelid surgery. Our skilled clinical team will guide you through every stage, answer your questions, and make sure you feel safe and supported throughout.

During surgery, the focus is on either the upper eyelids, the lower eyelids, or both. The procedure usually takes around 1–2 hours under general anaesthetic, though it can be shorter if only one eyelid is treated. Some people may be suitable for local anaesthetic with sedation, which numbs the area while keeping you awake.

Once the necessary adjustments are made, the surgeon closes the cuts (incisions) with fine stitches and applies small protective dressings. The exact approach depends on whether the upper lids, lower lids, or both are being treated, and your surgeon will tailor the procedure to your needs.

Upper eyelids

For the upper lids, the surgeon makes small, carefully placed cuts along natural folds in the skin. Through these, excess skin, fat, and sometimes muscle can be removed or adjusted. Placing the incisions in natural lines helps minimise visible scarring.

Lower eyelids

On the lower lids, the cut is usually made just under the lash line. If only fat is being removed, the incision may be made inside the eyelid, leaving no visible mark. The surgeon carefully reshapes or removes tissue to create a smoother contour.

Before the procedure

You begin with a consultation, where you can discuss your goals, ask questions, and understand what eyelid surgery can realistically achieve. Bringing photos can help to communicate your expectations and a friend or family member can come with you for support.

Your surgeon may also discuss additional treatments, such as brow lifts or wrinkle-reducing injections, if you wish to enhance other areas around your eyes. If you decide to proceed, surgery is usually scheduled a few weeks later, giving you time to prepare and feel confident in your decision.

Food and drink

You may be asked to avoid food or drink (fast) for a specified amount of time before your operation if you’ll be having general anaesthetic.

Arriving at the hospital

On arrival, the care team will check your medical history, confirm any medications you’re taking or allergies, and answer your questions. You will meet your anaesthetist to review the anaesthetic plan and give your informed consent for the procedure.

Who will be involved?

From your first consultation to the end of your recovery, your care team are highly trained and focused on your comfort and safety. You’ll meet a consultant surgeon who specialises in eyelid procedures and will discuss your goals, answer questions, and guide your care plan. All our cosmetic surgeons are registered with the General Medical Council (GMC).

In the operating theatre, your surgeon will be supported by an experienced team, including nurses and an anaesthetist, all trained in managing both routine and more complex eyelid surgeries. This team works together to ensure the procedure runs smoothly and that you feel reassured at every stage.

How long does eyelid surgery take?

The procedure usually takes around 1–2 hours, depending on whether upper, lower, or both eyelids are being treated.

Anaesthetic choices

The procedure can be performed under local anaesthetic with sedation or general anaesthetic, where you’ll be asleep.

Pain during and after eyelid surgery

The anaesthetic will ensure you won’t experience any pain during the procedure. After surgery, you may experience mild discomfort, soreness, or a gritty sensation in your eyes. Your care team will provide guidance and medication to help manage your pain.

What to expect after eyelid surgery

You will be taken to a recovery area immediately after surgery and monitored as the anaesthetic wears off. You may feel nauseous or light-headed for up to 24 hours after a general anaesthetic.

Your hospital stay

Eyelid surgery is usually performed as a day case, so you can go home on the same day. You should arrange for someone to drive you home and, if possible, stay with you for the first day to help with meals, medication and general support as you start your recovery.

Managing discomfort

Some tenderness, swelling, or mild soreness around the eyes is common immediately after surgery. Your care team will provide any necessary medications to help manage this, which you can take at home as directed.

End results

You’ll start to notice the difference once swelling and bruising settle, usually in around 2–3 weeks. The eyes often appear fresher and more open, with results continuing to refine over the following months as the tissue heals.

Your consultant will discuss what’s realistic for you before surgery, so you have a clear understanding of the likely outcome and how it aligns with your goals.

Everyone heals at a different pace, but most people can expect to return to work in about 1–2 weeks. You’ll need to take it easy at home initially, avoiding strenuous activity.

Short-term side effects

It’s common to notice puffiness, mild bruising or watery eyes in the first few weeks after surgery. You may also experience dryness, itchiness, or a sticky sensation. These symptoms usually ease over time and your care team can advise on eye drops or gentle cleaning techniques to support healing. Most bruising will settle within about 3 weeks.

First 24 hours at home

You should have someone with you for the first day to help with meals, medications, and general care. Rest with your head slightly elevated and follow your care team’s instructions around applying cold compresses or other measures to reduce swelling and discomfort.

Ongoing recovery

Follow your surgeon’s guidance on rest, eye care and activity. Avoid rubbing your eyes and try not to strain your vision. Attend all follow-up appointments so your surgeon can check on healing and address any concerns.

Wound care

After surgery, you may have fine stitches and light dressings to protect the delicate skin around your eyes. Before you go home, we’ll schedule a follow-up outpatient appointment to check on your healing and remove your stitches.

Cleaning care

Gently clean around the eyes as advised by your surgeon. Avoid harsh cleansers or rubbing the area, and use prescribed eye drops or ointments as directed.

Pain relief 

Mild discomfort is common. Your surgeon will provide medications to help manage any pain for up to 2 weeks, which you should take as instructed.

Smoking

Smoking can slow healing and increase the risk of infection, so this is a good time to quit.

Driving

Driving should be avoided for at least 24 hours if you’ve had a general anaesthetic, and until your vision has returned to normal.

Time off work

Plan for at least a week off work. Some people may need up to 10 days depending on the nature of their work and the extent of the surgery.

Support at home

After your surgery, you’ll need someone to take you home, as you won’t be able to drive. It’s a good idea to plan this in advance and let friends or family know what support you might need.

Having someone available to assist you during recovery can make the first few days easier. During the first few days, they can help with simple tasks like preparing meals, picking up groceries, or running light errands while you focus on resting and recovering.

They can also provide emotional support while your eyes heal.

What you should/shouldn’t do after surgery

Avoid strenuous activity, rubbing your eyes, or wearing contact lenses until your surgeon advises it is safe. Follow aftercare instructions carefully to protect your healing eyes.

When to resume normal activities

Most patients gradually return to everyday activities within 1–2 weeks. Swelling and bruising improve over time, and your surgeon will advise when it’s safe to resume full exercise, work, and other routine tasks.

Eyelid surgery is low-risk, but all procedures carry some risks.

General risks

All surgery includes the risk of excessive bleeding, infection, blood clots, allergic reactions to medications or anaesthesia, visible scars and delayed recovery.

Rare complications also include breathing problems, or blood clot formation in the legs and lungs (deep vein thrombosis – DVT).

Risks specific to eyelid surgery

With eyelid surgery (upper or lower lids), you may experience:

• A haematoma (collection of blood under the skin) behind or around the eye; in extremely rare situations this can lead to pressure in the eye socket or vision impairment
• Asymmetry of the eyelids, hollowing under the eyes if too much fat is removed, or the lower lid pulling down
• Double vision (temporary or persistent)
• Dry, sticky or sore eyes if tear-film or eyelid closure changes
• Inability to close the eyelid
• Motor or sensory nerve injury
• Seroma (collection of fluid under the skin) that may need needle-drainage or surgery
• Skin contour irregularities; puckering, visible lumps due to fat or tissue manipulation 

Serious complications

Seek emergency medical attention if you notice:

• Bleeding or swelling that won’t settle or a rapidly growing bruise/haematoma
• Blurred or double vision, worsening vision or inability to close your eyelid fully
• Redness, warmth, pus-like discharge, or fever — signs that may point to infection
• Sudden or increasing pain around the eye or eyelids

Your consultant will talk you through the risks beforehand and explain how they relate to your individual case. Your care team will keep in touch during your recovery, and you’ll have clear guidance on what to expect and when to seek support.

Eyelid surgery can deliver lasting results, helping your eyes look brighter and more refreshed for many years. However, the natural ageing process continues, and over time, your skin and muscles may gradually loosen again.

The results from upper eyelid surgery often last longer, while changes such as drooping brows or new puffiness under the eyes can develop with age. Maintaining a healthy lifestyle, protecting your skin from the sun and avoiding smoking can help preserve your results for as long as possible.