Why have eyelid surgery?

The skin and muscles around your eyes can loosen as part of the aging process as skin looses elasticity. This can result in folds, creases and ‘bagginess’ or puffiness around your eyes or droopy eyelids. Having eyelid surgery can help to correct these problems. It might be possible to have other procedures, such as a brow lift done at the same time as eyelid surgery. 

How do I get eyelid surgery?

Eyelid surgery is usually classed a cosmetic procedure, so wouldn’t be covered on the NHS and you’d need to have it done privately.

It may only occasionally be offered on the NHS if loose skin around your eyes is severely interfering with your vision, or if you have a medical condition causing problems with your eyes.

Any doctor offering cosmetic surgery must be listed on the General Medical Council’s (GMC’s) Specialist Register. You can find a consultant surgeon and check their GMC registration via the consultant search on our website.

Even though you’ll usually need to have it done privately, it’s still important to let your GP know you’re thinking about having eyelid surgery. You should let your optician know when you see them too. 

Deciding on eyelid surgery

You’ll have an initial consultation with a consultant surgeon to talk about what you’re aiming for, and whether eyelid surgery would be suitable for you. Non-surgical eye lift alternatives include Botox injections for treating wrinkles, and skin resurfacing techniques to improve the texture and look of your skin.

Eyelid surgery can’t be used to remove crow’s feet or dark shadows under the eyes.

Preparing for eyelid surgery

It’s important that you’re as healthy as possible and that your weight is steady before you undergo this surgical procedure. If you smoke or use other forms of nicotine, you’ll be asked to stop, usually at least six weeks beforehand. Nicotine has a negative effect on wound healing, and smoking significantly increases the risk of other complications too. There may be certain medications that you’ll need to stop taking before the operation, as they can increase the risk of bleeding. Your surgeon will tell you what these are.

You might have eyelid surgery under a general anaesthetic (meaning you’ll be asleep) or a local anaesthetic (where the area being treated is numbed) with a sedation, which makes you drowsy. Eyelid surgery can often be done as a day case procedure, but sometimes you may need to stay overnight. If you do go home on the same day, you’ll need someone who can stay with you overnight. Either way, you won’t be able to drive after the procedure, so arrange for someone to take you home.

What happens during eyelid surgery?

You can have this type of surgery on the eyelid skin of your upper eyelid, lower eyelid or both. Lower lid surgery mainly involves removing excess fat from the bags under your eyes.

Your surgeon will make cuts in the natural eyelid creases, or sometimes inside your eyelid for your lower eyelid. They’ll remove excess fat, skin and muscle through these cuts, before stitching them back up.

Recovery and what to expect after eyelid surgery

The skin around your eyes may feel tight and swollen at first. Aftercare can include taking simple painkillers to help manage any pain. Cold compresses can also help with bruising and swelling. Your surgeon will tell you how to keep the area clean, and you might be given some eye drops or ointment to use.

You should be out of bed and mobile on the day of your surgery, and back to doing light activities within a couple of weeks. You may need to avoid strenuous activities and heavy lifting for longer though. It is not unusual to have watery eyes for a couple of weeks after eyelid surgery. Don’t drive until your vision is back to normal and you feel safe to do so.

Your stitches will be removed after a few days. It can take a few weeks for swelling to settle down, and you may need to give it several months before you can judge the final results.

Potential complications of eyelid surgery

All plastic surgery procedures carry some risk of complications. Here are some of the most common complications associated with eyelid surgery.

• Problems with your wound, including infection and delayed healing.
• Dry eyes.
• Bleeding behind your eye – this is unusual but possible, and may mean you need another operation.
• Changes in sensation around your eyes.
• Problems with scars – they may become red, painful and thicker, rather than fading over time.
• Problems with the position of your eyelid after surgery, due to swelling.

Complications of any operation include bleeding during or after the procedure, allergic reactions to the anaesthetic and blood clots developing in your legs or lungs.

There’s also a risk that you might not be happy with the end result. You also need to bear in mind that the appearance of the area you had treated will change over time as a natural result of ageing. Changes in weight may also alter your appearance.

You’ll be given information on what to look out for and what to do if you develop any complications. Your doctor can also tell you how likely they are to affect you. 

Eyelid surgery costs and fees

As a cosmetic procedure, eyelid surgery wouldn’t typically be available through private medical insurance. You’ll usually need to self-fund this treatment. Eyelid surgery costs in the UK vary.

Typically, an initial consultation with the surgeon will cost between £100 and £250 depending on where you live. If you move forwards with the procedure, you’ll be offered one of the following.

An all-inclusive ‘package price’, where you know the full costs before undergoing treatment. Not all consultants and hospitals offer this.

A ‘fee-per-service’ deal, where you receive different invoices from the surgeon, the anaesthetist and the hospital. You often won’t know the full costs until you receive the invoices.

For more information, you can read our guide on self-pay.

Sources

• Eyelid surgery (blepharoplasty). British Association of Aesthetic Plastic Surgeons (BAAPS). baaps.org.uk (accessed 29 April 2021).
• Rostami S, de la Torre JI, Czyz CN. Lower eyelid blepharoplasty. StatPearls. www.ncbi.nlm.nih.gov, last updated 31 July 2020.
• Patel BC & Malhotra R. Upper eyelid blepharoplasty. StatPearls. www.ncbi.nlm.nih.gov, last updated 25 February 2021.
• Frequently asked questions. British Association of Aesthetic Plastic Surgeons (BAAPS). baaps.org.uk (accessed 29 April 2021).
• Cherney K. What to expect from blepharoplasty. Heathline. www.healthline.com, updated 2 November 2017.
• Upper eyelid blepharoplasty. Medscape. emedicine.medscape.com, updated 5 February 2021.
• McDaniel JC, Browning KK. Smoking, chronic wound healing, and implications for evidence-based practice. J Wound Ostomy Continence Nurs 2014;41(5): 415-23.