Although Eyelid surgery aka blepharoplasty, is not one of the more widely discussed forms of plastic surgery, it might come as a surprise to learn that it is one of the most popular procedures amongst both men and women. This is due to the fact that the procedure makes such a dramatic difference both aesthetically and functionally and is therefore frequently recommended to many middle aged to elderly patients who request facial rejuvenation treatments.

With age, the skin around the eyes begins to droop which can lead to a tired, aged and perhaps prematurely aged appearance. Correcting this can have the same kind of dramatic effect as a surgical Facelift, but with a significantly less degree of invasiveness.

It is interesting to note that many people tend to base their judgements about a person based on the look of their eyes. For example, we frequently say that we don’t trust someone because they can’t look us in the eye. We determine if a person is tired or intoxicated to a certain extent depending on how bloodshot their eyes are. And we make judgements regarding their age based on the skin around their eyes. These assumptions are frequently quite erroneous, but it is nevertheless a common way for individuals to make quick assessments of each other. For this reason, those with droopy or folded eyelids are regularly considered to be older than they are in reality.

To discover the benefits of eyelid surgery, we spoke to Mr Allen Rezai, a senior Consultant Plastic, Aesthetic and Reconstructive Surgeon in London’s Harley Street, who is highly experienced has in both surgical and non-surgical aesthetic treatments. Mr Rezai explains that “As we age, our skin naturally loses some of its elasticity. This can cause a build-up of loose skin around the eyelids that, in the upper lid, can fold over, producing a hooded effect. In the lower lid the effect may be deepening furrows or creases. Advancing years also result in a weakening of the muscles in our face. This can encourage the fat that naturally sits around the eye, protecting and cushioning it, to protrude through the weak muscle, producing even larger eye-bags. The main benefit of blepharoplasty is a reduction of the excess upper eyelid skin and the eye-bags. This in itself will immediately improve a person’s appearance by removing the constantly tired look that they will formerly have had. Also if vision was affected by drooping, puffy eyelids, then following surgery this will also no longer be a problem and the eyelids will be firmer and tighter. Wrinkles will also be noticeably reduced. The overall effect is that a person’s eyes will look brighter and clearer and, combined with trimmer eyelids, will result in a more youthful rejuvenated appearance. Blepharoplasty patients look fresher and brighter where once they looked tired and stressed.”

According to Mr Rezai, there are essentially two basic types of blepharoplasty. In the upper eyelids, excess skin and fat can create a heavy looking eyelid, aged appearance, puffiness, and sometimes even limit the person’s vision. An upper blepharoplasty is preformed to address these issues. A lower blepharoplasty is performed to remove the excess skin, reduce wrinkles, and improve the shape of the lower eyelid by removing skin and fat.

Upper blepharoplasty procedure involves making an incision in the crease of the eyelid to allow for removal of excess loose skin and fat. A thin suture is then used to bring the skin together allowing for the creation of an eyelid crease. Lower eyelid surgery can involve skin incisions directly below the lash line or an incision on the inside of the eyelid, known as a transconjunctival approach. The transconjunctival approach allows for access to the eyelid fat without visible incisions, making this technique perfect for patients with no excess skin, who need fat either removed or added

When asked who is suitable for blepharoplasty, Mr Rezai explains that “There can be considered to be three categories of patient: firstly, those who have developed excessive skin and eye-bags due to advancing years. Then there are those who have an inherited tendency to develop prominent eye-bags or droopy eyelids in their twenties or thirties. And thirdly, those who have had significant eye and eyelid changes due to thyroid disease or other medical conditions.” Mr Rezai advises that before going to see a plastic surgeon, it is important for the patient to consider exactly what it is they are trying to achieve. “In particular, patients should understand that the plastic surgeon will only be removing the skin or fat from the region immediately around the eyes. The operation does not affect wrinkles, creases and folds that are distant from the eye socket itself. However, these can be treated by a variety of other procedures, both surgical and non-surgical.”

According to Mr Rezai, the procedure itself can be carried out under local anaesthetic alone, local anaesthetic with sedation, or general anaesthetic, and either the upper or lower lids, or both may be treated during the same operation. Incisions are made in the natural lines of the eyelids, which allow for both skin and fat removal and also conceal the scars within the eye’s natural creases. The operation itself takes between 30 to 45 minutes and many patients will return home the same day, others staying in hospital overnight. Usually patients need only a short recovery period after blepharoplasty. Although bruising and swelling is usually worse on the day after surgery, they quickly begin to disappear. Typically, patients can expect to return to work within 1 week and resume normal physical exercise within 2 to 4 weeks.

Most people considering eyelid surgery do so for the aesthetic benefits. However, the extent of such benefits will depend upon a number of factors, not least of which is the extent of the problems to be addressed. In general, the more dramatic the problem, the more dramatic will be the result. But generally speaking, most patients who have drooping or sagging around the eyes will find that blepharoplasty can produce the kind of results that make a major difference.

Unlike a facelift, a blepharoplasty is typically long lasting. Mr Rezai explains that “Facelifts are generally affected by gravity, whereas eyelid surgery does not. For the large majority of patients, the results of blepharoplasty are permanent. However, unhealthy lifestyle or the younger a patient undergoes surgery, the more likely it is that further eye-bags may develop over time. However as long as the patient has realistic expectations about the outcome of the surgery, then they are very likely to be highly satisfied with the results.”

Mr Rezai continues: “There is also alternative non-surgical treatment such as Dermal fillers, Profhilo and energy based procedures like RF & Ultrasound, however not everyone are good candidates for the non-surgical options and it is important to consult a specialist in order to determine which type of procedure would address the specific concerns the individual has in order to acheive the best possible outcome”

Mr Rezai offers various surgical and non-surgical procedures for the rejuvenation of the eye region and improvement of dark circles around the eye. For more details regarding Eyelid Surgery, other surgical and non-surgical rejuvenation procedures or to book a Consultation Call +44 20 7580 8001.