Eyelid surgery Q&A

Two of our leading consultants answer common questions on eyelid surgery, also known as blepharoplasty.
They talk about possible reasons for having the procedure, what's involved, risks and alternative options.

Elena Prousskaia Peredugova
Blepharoplasty is a surgical procedure to remove excess skin and sometimes excess muscle and fat from your upper eyelids. Blepharoplasty does not improve the “crow’s feet” wrinkles and those between the eyebrows, the dark circles around your eyes or the low position of your eyebrows.


Mark Joseph Vose
This simply means restoration of normal eyelid structure and function. The more common procedure is upper lid blepharoplasty to reduce the appearance of baggy upper eyelids and to restore a normal/less tired appearance. Lower lid blepharoplasty is much less commonly performed (see complications below)

Elena Prousskaia Peredugova
Blepharoplasty can reduce skin excess, puffiness caused by protrusion of fat pads and even improve your visual fields in situations where heavy excess skin causes hooding over the eyes. Blepharoplasty offers you a refreshed and younger looking appearance around your eyes.


Mark Joseph Vose
Sometimes the upper lids become so baggy that they cut across the pupil and limit light entering the eye with subsequent reduction in vision.

Elena Prousskaia Peredugova
It can be performed under general anaesthetic or local anaesthetic and sedation. General anaesthetic may be preferable in cases where fat pads have to be removed or redistributed, as this can be painful under local anaesthetic. Surgical time is about an hour, but can vary depending on the complexity of each individual case.


Mark Joseph Vose
The procedure is usually carried out under local anaesthetic (injected into the eyelids - which does sting). Some patients opt for a general anaesthetic or sedation (where the level of consciousness is reduced).

Elena Prousskaia Peredugova
There are alternative non-surgical treatments such as the use of peeling, anti wrinkle injections or laser treatments to improve the wrinkles and skin quality.


Mark Joseph Vose
There are some forms of laser treatment for less baggy eyelids. I always start from the point that the best operation - is no operation - then discuss with patients why they want the surgery and what it is they are hoping to achieve - and if I can help them to achieve their goals without operating, then that is a good outcome. Equally if surgery is the best option for them then I will advise.

Elena Prousskaia Peredugova
Any surgical treatment involves certain risks. It is important to understand all the risks associated with the blepharoplasty procedure. Your decision to have this operation should be based on your careful evaluation of all the possible risks and the potential benefits. Most patients undergoing this surgery do not experience complications. However you should discuss all possible risks and your tolerance of complications with your consultant surgeon, in order to make sure that you fully understand the implications and consequences of having a blepharoplasty.


Mark Joseph Vose
The main risk from upper lid blepharoplasty is infection, bleeding and bruising. If the surgeon removes too much tissue - this can lead to a poor blink function and corneal exposure. Tissue removed at the time of surgery is stored in saline until the procedure is  completed. If the surgeon has any doubts - tissue can be regrafted into the wound. Lower lid surgery carries a higher risk of bleeding because of disturbance of  the fatty tissue around the eye. This bleeding can track towards the optic nerve, leading to pain and  potential loss of vision if not diagnosed early enough. Scarring of the lower lids can be very unsightly.

Elena Prousskaia Peredugova
The final result will be seen after 3 months. The scars are usually very well hidden and not easy to see.


Mark Joseph Vose
I see patients 2 weeks after surgery - when most of the bruising and swelling has settled.

Elena Prousskaia Peredugova
I chose to become a consultant because I was passionate about helping breast cancer patients and being able to perform major reconstructive surgery on breast cancer patients is very rewarding.


Mark Joseph Vose
I was working at a Leprosy Mission Hospital in India. An ophthalmologist came for two weeks - carried out multiple procedures and trained the local health care workers to diagnose and treat sight threatening conditions in poor rural india. with sight saved - the could lead normal lives and make a living. That is when I thought - thats what I want to do.

Elena Prousskaia Peredugova
The highlight of my career to date was that I recently chaired the Breast Reconstructive session at the BAPRAS meeting.


Mark Joseph Vose
As a Registrar at Manchester Royal Eye Hospital - A young man with significant disabilities who couldn't see due to white cataracts in both eyes. The anaesthetist said - “I can only put him to sleep once” - so I had to do both eyes at one sitting. when he woke up his first words were “I can see”. I asked him how he was going to celebrate? “fish and chips for my tea”. It made me realise how we can can take things for granted - but if we keep it simple - life’s good.

To find out more about eyelid surgery (blepharoplasty) call us on 0808 101 0337 or make an online enquiry.

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