Stephen McCulley, Reconstructive and Aesthetic Surgeon. MBChb, FCS(SA)Plast, FRCS(plast)

Eyelid surgery (blepharoplasty) is a form of treatment for upper and lower eyelid bags

Why Choose To Have Eyelid Surgery (Blepharoplasty)?
Eyelid bags are a combination of excessive skin on the lid, with or without bulging fat from under the eyelid. This can make the eye look older, tired or ‘puffy’. The eye-lid bags can be composed of both skin and fat, and this varies between people. Older people usually have extra skin with variable amounts of fat, while younger people tend to have prominent fat.

Procedure In Brief
The standard blepharoplasty consists of removing the unwanted extra skin and then removing or occasionally re-distributing the bulging fat in to the upper cheek. The incisions are just below the lid margin on the lower lid and in the lid crease on the upper lid. (In some younger patients the incision can be made inside the lid to remove fat only Trans-conjunctival blepharoplasty). This is a very effective procedure for both men and women.

Having my upper and lower eyelid surgery was one of the best decisions I ever made and not a day passes that I thank goodness I found a surgeon and hospital in which I could totally trust to perform the procedure.
ML, Chesterfield

Incisions
The incisions on the eye-lids heal extremely well and can be very difficult to see, particularly in the upper lid. The use of eye shadow and mascara makes it easier to hide the scars in the early days of recovery.

Scars
Scars on the eyes tend to heal very well. Although a little pink initially in the first few weeks they then fade to white. Most patients form very good quality scars over time. The length of time will vary in each individual patient. A very small number produce red or raised scars although this is very rare on the eyelids.

Medicines
A full medical history will be obtained before any surgery. As a precaution, do not take any over the counter medicines or herbal remedies prior to surgery or for 3 days following. Also avoid aspirin, ibuprofen and Voltarol based tablets. It would be useful to bring a list of any prescribed medications to your pre-op assessment.

Smoking
If you are a smoker, ideally try and stop for six weeks before and two weeks after surgery as it can reduce the chances of complications.

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Recovering from Eyelid Surgery (Blepharoplasty)

Length Of Surgery
The operation takes 60 minutes for the upper eyelids and 90 minutes for the lower lids. The upper lids can be done under local anaesthetic as a day-case, but if all four lids are to be treated Stephen McCulley recommends general anaesthetic and an overnight stay.

p>Length Of Stay In Hospital
Patients may be seen as a day case or may require a one night stay.

Dressings And Stitches
Sutures are buried and the wound closed with special human super-glue so avoiding any sutures to be removed. Occasionally, one long stitch will be placed on each eyelid that is treated. When the suture is used this will be easily removed at your appointment on day 5.

Time Off Work And Socialising
People vary in recovery, but patients should allow at least 1-2 weeks of recovery. Most patients are very comfortable after a few days, and it will only be the bruising and swelling that may make you feel uncomfortable about returning to work. Most of the bruising will have gone by the second week.

Time To Exercise
Patients usually feel able to walk a distance at 3 days, swim by 10-14 days (if fully healed). Strenuous exercise (aerobics etc) should be avoided for 4 weeks.

Post-Operative Instructions
Day 1-2 You should be taking it very easy! Either relax in the hospital or at home.
Day 2-5 You can be up and about but your eyes will be swollen and have stitches that are visible. Sunglasses will be useful if going outside.
Day 5-14 Your stitches will be removed and most of the swelling and bruising will settle over this time. You will be feeling much better from here onwards and will be able to start building up your exercise over the next 10 days.
Week 3 onwards you will be nearly back to normal.

Driving
Patients should avoid driving until they are completely free of pain and restriction, and be able to confidently perform an emergency stop. This is to ensure they will be covered by their insurance policy. It may take up to two or three weeks to recover sufficiently.

Follow Up
We will check your wound and remove the stitches at day 5. You will then have a follow-up checkup with a cosmetic nurse or Stephen McCulley as required. You will have a final appointment with Stephen McCulley at 3 months. You will not be charged for any follow up appointment relating to your surgery.

Final Outcome
Although your result will be noticeable early it will continue to improve over the first three months.

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Potential Complications With Eyelid Surgery (Blepharoplasty)

This is a routine operation that is a great success for the vast majority of patients. However, as with any procedure, it is very important you understand what can go wrong as well as right. The potential complications are listed below.

  • Ectropion: This is very uncommon. It is where the eyelid gets pulled down and does not rest on the eyeball. It occurs in the lower lid if it is weak or the skin closed too tight. Great care is taken in the lower lid to avoid this and checks will be made to ensure you are not at risk. If you are, then variations in the technique will be discussed with you during your consultation with Stephen McCulley.
  • Small degrees of asymmetry: The same operation will be performed on both sides. There is a small risk of minor irregularities in the skin surfaces in either side.
  • Scars: The quality of scars vary between patients.
  • Wound breakdown: Although very uncommon this can result in delay in wound healing and scar quality.
  • Bleeding: A blood clot can collect under the skin, which would result in going back to theatre for its removal.
  • Infection: Also very uncommon but if occurs you will need a course of antibiotics.
  • Eye injury: The eye will be protected during the procedure, but injury can occasionally occur. The most common is a small abrasion to the cornea (front of eye-ball), although painful it heals without detriment in a few days.
  • Epiphora: This is watering of the eye following temporary or rarely permanent change to the tear drainage of the eyelids

If you experience any side-effects that you are concerned about please don't hesitate to contact us.

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What does Eyelid Surgery (Blepharoplasty) cost?

Blepharoplasty - both upper and lower eyelid from £4,375
Blepharoplasty - lower eyelid from £3,475
Blepharoplasty - upper eyelid from £3,225

What Is Included In The Cost?
The prices listed are all inclusive and cover:

  • The pre-operative assessment and investigations
  • The operation
  • Hospital stay and any treatment required
  • All follow up (nursing and with Stephen McCulley) relating to your surgery
  • Any emergency problems or re-admissions relating to your surgery within the first year

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Frequently Asked Questions

If you'd like to see more then please view our frequently asked questions on Cosmetic Face Procedures!

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