Upper Blepharoplasty

Upper blepharoplasty

Upper eyelid blepharoplasty is a surgical procedure designed to improve the appearance and function of the upper eyelids. It involves the removal of excess skin, muscle, and sometimes fat, giving a more youthful and refreshed look. It can also improve vision in patients with severe upper eyelid hooding.

The upper eyelid plays an essential role in protecting the surface of the eye. It is a hard-working structure blinking millions of times over the course of our lifetime.

Eyelid hooding is a common and natural part of the aging process but these changes can obstruct the upper visual field, and can be aesthetically undesirable.

Upper eyelid blepharoplasty surgery addresses the aging changes of the upper eyelid, restoring function and refreshing the appearance of the upper eyelid. It can be combined with a ptosis repair (eyelid lift) if necessary.

Miles is a triple fellowship trained oculoplastic surgeon with specific expertise in eyelid plastic surgery and regularly carries out upper eyelid blepharoplasty surgery.

Upper blepharoplasty

  • Procedure time 1-1.5hrs

  • Anaesthetic Local or General

  • Downtime 7-10 days

  • Driving 5 days

  • Exercise 7 days

  • Final result 2-3 months

  • Upper blepharoplasty should be pain free and can be performed under local anaesthetic (usually with sedation) or general anesthesic.

    Surgical incisions are carefully planned to minimise any scarring or signs of intervention. The incision is placed within the natural skin crease of the upper eyelid and is usually undetectable.

    Skin incisions are closed with fine sutures which are usually removed at 5-10 days following surgery.

  • The recovery period is typically one to two weeks, with a short downtime of seven days. The final result of surgery is appreciated at around two months.

    Discomfort is usually minimal following the surgery, controlled with simple pain killers such as paracetamol.

    Swelling and bruising varies between patients. Cold compresses and sleeping propped up in the days following surgery can speed up recovery.

  • Upper eyelid blepharoplasty surgery is generally considered to be safe.

    As with any cosmetic eyelid procedure, there are potential risks including infection, bleeding, scarring, asymmetry, over- or under-correction, dry eye, and need for further surgery. Thankfully these complications are unusual.

    Infection

    Post-operative infection is very rare and can be treated with antibiotics. Further surgery may be required and cosmesis can be affected. A severe infection is extremely unlikely.

    Bleeding

    A small amount of bloody discharge from the skin incision is expected post-operatively. A sight-threatening bleed into the eye socket is extremely rare.

    Scarring

    Surgical incisions are meticulously planned to minimise scarring. Incisions are made in the natural skin crease of the upper eyelid and scarring is usually very subtle.

    Asymmetry

    When comparing the two sides of the face, we are all slightly asymmetrical. During the healing phase following surgery, asymmetry between the upper eyelids may be noted but this is usually temporary and the vast majority of patients are very happy with final results.

    Dry eye

    Dry eye tends to get worse with age and many people use lubricant drops to moisturise the surface of the eye, similar to the need to moisturise dry skin. Lubricants are recommended for all patients in the post-operative recovery period and some patients find it helpful to continue to use these, especially those who have an element of dry eye prior to surgery.

    The inability to close the eye following upper eyelid blepharoplasty surgery is very rare as surgical planning is meticulous and tailored for every patient. If this occurs lubricants and possibly further surgery may be required.

    Allergy

    Allergic reactions are rare and precautions are taken for anyone pre-existing allergies.

    Short and Long Term Outcomes

    Final results are seen at 2 months and may last for many years. That said, the aging process cannot be stopped and the anatomical changes that occur secondary to aging are an ongoing process for all of us. Top up treatment or surgery may be required in the future.

Miles is a consultant ophthalmologist and oculoplastic surgeon with a private practice at The London Clinic on Harley Street. He specialises in ophthalmic cosmetic, reconstructive, and lacrimal (tear drainage) surgery.

In addition to his private practice, Miles holds a substantive NHS consultant post at the Royal Free London and he established and runs the oculoplastic service at North Middlesex University Hospital. He also has expertise in cataract and pterygium surgery.

As an honorary clinical lecturer at UCL and assistant professor at St. George's University, Miles is actively involved in training the next generation of ophthalmologists.