Is Blepharoplasty Right for Me? Common Patient FAQs

Blepharoplasty surgery addresses concerns that affect your confidence, comfort and, in some cases, your vision. You might be a good candidate for blepharoplasty if:

You have drooping or loose skin on your upper eyelids that affects your appearance or vision.

You’re struggling with persistent under-eye bags that are caused by the underlying eyelid anatomy.

You are generally in good health and any medical conditions are appropriately managed.

Your eye health and eyelid function have been assessed and are suitable for the proposed procedure.

You hold realistic expectations about what surgery can achieve.

You can allow time for recovery and follow your surgeon’s aftercare advice.

During your consultation, your surgeon will evaluate your facial anatomy, skin quality and medical history to determine whether blepharoplasty is right for you. They will also assess your eye surface and how well your eyelids close.

Smoking can impair wound healing. If you smoke or use nicotine products, tell your surgeon so they can advise you on preparing for surgery.

This table is a starting point for discussion. An examination is needed to identify the cause of your concern and the appropriate treatment.

Some people consider surgery because they feel their eyelids make them look tired. Others find that excess upper eyelid skin obstructs part of their vision. These concerns can overlap.

If your vision is affected, your surgeon may recommend visual field testing to help assess the obstruction. Blepharoplasty can help when eyelid skin is the cause, but it does not treat every cause of reduced vision.

If you’re unsure which procedure you need, contact Sapphire Eye Care to discuss arranging a specialist assessment.

Before-and-after photographs can help you discuss the changes you would like to achieve. The example below comes from Sapphire Eye Care’s existing blepharoplasty gallery. Your own result will depend on your eyelid anatomy, the treatment agreed with your surgeon and how you heal.

You can view more blepharoplasty before-and-after photographs on our treatment page and discuss relevant examples with your consultant.

The best treatment depends on what is causing your symptoms. Surgery may need to be postponed, adapted or avoided if your surgeon identifies a risk to your eye health or healing.

Dry eye symptoms, thyroid eye disease, diabetes, previous eyelid surgery and medicines that affect bleeding are particularly important to discuss. Having one of these does not automatically mean you cannot have surgery, but it may change the recommendation. Bring a full medication list and do not stop prescribed medicines without advice from the clinician managing them.

Blepharoplasty also has limits. It will not necessarily remove dark circles, correct a low eyebrow position or treat puffiness caused by another condition. Your surgeon should explain what the proposed operation can reasonably achieve for you. You can also choose not to have surgery.

Excess upper eyelid skin is often called dermatochalasis. Ptosis means that the upper eyelid itself sits too low, commonly because of a change in its lifting muscle or tendon. They can look similar and may occur together.

Blepharoplasty addresses excess eyelid tissue. Ptosis surgery addresses the eyelid lifting mechanism. Your surgeon will assess both the skin and eyelid position, as well as the eyebrows, before recommending treatment.

Learn more about ptosis surgery for drooping eyelids.

If an eyelid droops suddenly, seek an urgent GP or optician appointment or contact NHS 111. Sudden drooping should be urgently medically assessed rather than treated as a routine cosmetic concern.

Choosing the right surgeon is one of the most important steps when you’re considering eyelid surgery.

While general plastic surgeons also perform cosmetic surgery on upper or lower eyelids, blepharoplasty requires precision, experience and a deep understanding of both eyelid anatomy and function.

Oculoplastic surgeons are ophthalmologists, (eye surgeons), with further specialist training in surgery involving the eyelids, eye socket and production and drainage. Their work includes both cosmetic procedures and functional problems, such as drooping lids that impair vision or eyelids that do not sit correctly against the eye.

This background means that they understand the relationship between eyelid surgery and the health of the eye itself.

Specialist oculoplastic training brings:

A detailed understanding of the interactions between eyelid function and eye health.

Experience in managing both the aesthetic and medical aspects of eyelid concerns.

Microsurgical skills suited to the delicate tissues around the eyes.

An oculoplastic assessment considers how your eyelids protect your eyes as well as how they look. Ask about your surgeon’s experience with the procedure you need, the risks that apply to you, and the follow-up care available.

Mr Andre Litwin is a Consultant Ophthalmic Surgeon with expertise in eyelid aesthetic surgery, including blepharoplasty. He undertook two fellowships in oculoplastic and orbital disease and holds a consultant post at Queen Victoria Hospital, East Grinstead.

As Andre explains on his Sapphire profile: “I passionately strive to deliver the best personalised care for every one of my patients.”

Your consultation is an opportunity to explain what bothers you about your eyelids and discuss whether surgery could help. Your surgeon will review your medical history, examine your eyes and eyelids, and discuss achievable results, risks and aftercare. Clinical photographs may be taken to help with assessment and planning.

Useful questions to ask include:

• Is my concern caused by excess skin, prominent fat, ptosis or eyebrow position?
• Would you recommend upper, lower or combined eyelid surgery?
• How could my eye health or medication affect the treatment plan?
• What recovery time should I allow for my work and lifestyle?
• What is included in the treatment fee and aftercare?

You should have time to consider the advice and ask further questions before deciding whether to proceed.

If you would like to understand what treatment involves, this video follows a Sapphire Eye Care patient through upper eyelid surgery, from assessment and surgical marking to the operation and the before-and-after result.

The video illustrates one patient’s experience. Your own treatment will be planned around your eyelids, eye health and goals, and may differ from what you see here.

Please note: this video contains footage of a real surgical procedure.

As with any surgery, blepharoplasty carries risks. Bruising and swelling are expected during early recovery. Potential complications include infection, noticeable scarring, asymmetry, dry eyes and difficulty closing the eyelids. Further treatment or surgery may sometimes be needed.

Rare complications include bleeding behind the eye and damage to vision. Your surgeon will explain the risks relevant to your operation and how any complications would be managed.

Understanding these risks helps you weigh the possible benefits against the recovery and potential disadvantages for you personally.

It’s natural to have questions about your recovery. Most people experience temporary swelling and bruising in the first one to two weeks after blepharoplasty. Many plan around two weeks away from work, depending on their job, the procedure and how they heal. Some bruising or swelling can last longer.

Cold compresses may help reduce swelling, but follow your surgical team’s instructions on how and when to use them. Your surgeon will also explain wound care and when you can resume activities.

The appearance continues to settle after the initial recovery period, and scars may take several months to soften and fade. Everyone heals differently, and your surgeon will give you personalised guidance on what to expect and how best to support your recovery. 

For more detailed advice, read our upper blepharoplasty recovery guide or lower blepharoplasty recovery guide.

If you develop severe pain, a sudden change in vision or other concerning symptoms after surgery, seek urgent advice from your surgical team or an emergency eye service.