Blepharoplasty
Cosmetic Eyelid Surgery | Eye Bag Removal Surgery | Eye Bag Reduction Surgery

  • Blepharoplasty surgery, commonly known by various synonyms such as eyelid lift surgery, eye plastic surgery, cosmetic eye surgery literally means ‘refashioning of the eyelid’ and is an operation commonly performed to improve the appearance of the skin around the eye.
  • In the UK, most blepharoplasty operations are performed to reverse the changes of ageing (often removing excess loose folds of skin from the upper eyelids or eyelid 'bags' from the lower eyelids) and are either performed for cosmetic improvement or for functional reasons.
  • A smaller proportion of patients, undergo different types of blepharoplasty surgery for other reasons e.g. Asian blepharoplasty/ double eyelid surgery, thyroid eye disease blepharoplasty, congenital problems etc.
  • Although there are many types of operations to improve the appearance of eyelids, in general, the vast majority of patients who seek cosmetic eye surgery are usually enquiring about cosmetic blepharoplasty to reverse the signs of ageing.
  • Contrary to popular belief, not all patients need to undergo surgery and indeed excellent results can be often achieved by non-surgical methods.



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How Eyelids Age: Baggy Eyelids | Drooping Eyelids | Eyelid Bags | Heavy Eyelids | Eyelid Hooding


As we all get older, changes in the structural of the tissues of the face begin to occur. For example, tendons become lax, muscles lose their tone, fat starts to shrink and skin loses its elasticity.

  • Eyelid bags due to normal ageing

    Normal age related changes with the eyelids. Notice the bulging fat pads. These are commonly referred to as eyelid bags and patients commonly complain of baggy eyelids or heavy eyelids

  • Normal age related fat prolapse

    Normal age related changes with the eyelids. Notice the bulging fat pads. These are commonly referred to as eyelid bags and patients commonly complain of baggy eyelids or heavy eyelids

In the upper eyelids:
  • default_titleExcess skin develops leading to redundant droopy skin which can give rise to a melancholic appearance to the eyelid. Women often complain that they no longer have an eyelid on to which they can apply eye makeup. Patients remark that people comment on them looking angry, tired or frowning.
  • default_titleWeakening of one of the middle layers of the eyelid allows for outward bulging of the fat of the eye socket leading to eyelid ‘bags’ known as steatoblepharon. Sometimes the fat behind the eyelid may start to descend leading to changing contour of the eyelid.
  • default_titleAge related weakening of the main tendon involved in the lifting of the upper eyelid results in a skin crease that is less defined and sometimes a drooping upper eyelid (ptosis).
  • default_titleSometimes the tendons which keep the eyebrows in position may start to weaken leading to descent of the eyebrow itself, usually starting with the tail of the eyebrow (outer end)
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In the lower eyelid
, similar changes occur with age related stretching of the tendons of the eyelid:
  • default_titleThe lower eyelid instead of having a youthful sharp contour starts to become more concave with greater exposure of the lower half of eye.
  • default_titleWeakening of the middle layer of the eyelid results outward bulging of orbital fat and the appearance of eyelid bags or 'festoons'.
  • default_titleThe skin loses its elasticity and the muscles weaken leading to excess skin and wrinkles. As the tissues start to descend and shrink around the junction between the lower eyelid and cheek, the tear 'trough' or hollow starts become increasingly obvious and often one of the first complaints is of both men and women is of deep shadows or hollowness under their eyes.
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What are the reasons for undergoing blepharoplasty?

There are two main reasons why patients undergo blepharoplasty surgery:
  • default_titleFunctional reasons: In some patients the hooding of their eyelids is so severe that their peripheral vision becomes very compromised or cause frequent blinking. These patients commonly have to exert their forehead muscles in an attempt to lift their eyelids out of the way in order to see properly. In such severe cases, upper eyelid blepharoplasty surgery may be funded by the NHS or patient's private medical insurance schemes since it is deemed that their surgery is not for cosmetic improvement but purely for functional reasons. Similarly but less commonly, patients undergoing lower eyelid blepharoplasty/ plastic surgery may have their surgery also funded by the NHS or via private medical insurance if it is deemed that their surgery is necessary for rehabilitative purposes e.g for thyroid eye disease.
  • default_titleCosmetic reasons: The appearance of one's eyes are central to facial expression. As one ages, one's upper eyelids become more hooded and droopy, the lower eyelids often develop 'bags'; the fat within the eye socket may start to bulge forward and under eye hollows may start to develop. Unfortunately, many of these normal age related changes are misinterpreted by one's peers. Many patients who request blepharoplasty (cosmetic eyelid / eye plastic) surgery often do so because they are fed up of their peers commenting on them looking tired or angry. Cosmetic eyelid plastic surgery (cosmetic blepharoplasty) is therefore commonly performed to reverse these changes and is one of the most commonly performed cosmetic plastic surgery procedures worldwide. After blepharoplasty surgery, patients often remark that they look less tired, and even at times feel more energised in themselves. Although the majority of patients undergoing cosmetic eyelid surgery are women, increasingly men are also undergoing cosmetic eyelid surgery both for functional and cosmetic reasons. Indeed, cosmetic eyelid plastic surgery in men is one of the fastest growth sectors currently in the UK and this may be due to the perceived importance of appearance in the workplace.
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An
upper eyelid blepharoplasty is performed for people with droopy, overhanging eyelids that look cause frequent blinking, impair vision or simply for cosmetic improvement. Upper eyelid blepharoplasty is sometimes performed at the same time as ptosis surgery or brow stabilisation/ lifting surgery via the same incision, thus reducing the need for unnecessary additional surgery.


  • Stacks Image 24761

    Patient 1: This lady's upper lids are so hooded that she could barely see. Her carers complained that she had difficulty navigating around. Her upper lid blepharoplasty surgery was therefore available on the NHS for functional reasons

  • 3 weeks following surgery

    Patient 1: Following Upper Lid Blepharoplasty as funded by the NHS. She noticed a dramatic improvement in her visual field

  • Severe vision compromising eyelid hooding

    Patient 2: Before Surgery: Not only does this gentleman have severe upper eyelid hooding and complained of very heavy eyelids. In addition he also sufferes from eyelid ptosis itself (drooping eyelid). This patient underwent combined blepharoplasty surgery and ptosis correction. This is commonly referred to as eyelid lift surgery

  • He also has ptosis of the eyelids

    Patient 2: Before Surgery: Notice the low eyelid position (eyelid ptosis) even after the excess hooded skin (dermatochalasis) has been lifted out of the way. This patient needs both excess skin removal (blepharoplasty/ eyelid lift) and strengthening of the main tendon involved in lifting the eyelid itself (levator aponeurosis advancement)

  • After surgery again

    Patient 2: 3 weeks following combined blepharoplasty surgery (excess skin excision) and ptosis correction (strengthening the eyelid tendon). This patient had both procedures funded by the NHS for functional reasons.

  • Before surgery

    Patient 3: Cosmetic upper lid blepharoplasty: Pre Surgery: Prior to upper eyelid blepharoplasty (eyelid lift surgery). This lady complained of problems with eyelid make up. She was also fed up of being told she looked stern.

  • 2 months following blepharoplasty

    Patient 3: Cosmetic upper lid blepharoplasty: Post Surgery: 2 months following upper eyelid blepharoplasty One can see why blepharoplasty surgery is sometimes referred to as eyelid reduction surgery.



A lower eyelid blepharoplasty is often requested by patients who are fed up with under eye 'bags' or puffiness. Similarly, lower eyelid cosmetic surgery can be combined with other procedures, sharing the same incision, thereby minimising the need for further surgery e.g. midface lifting.


  • Before surgery pictures: This lady complained of bulging lower eyeids i.e. eyelid bags or baggy eyelids. This patient was fed up of being told she looked tired.

    Before surgery pictures: This lady complained of bulging lower eyeids i.e. eyelid bags or baggy eyelids. This patient was fed up of being told she looked tired.

  • 3 months following lower eyelid blepharoplasty surgery (eyebag removal surgery) to both eyes Because most GPs consider this to be cosmetic eyelid surgery, most GPs will not refer patients to the NHS for eye bag removal surgery.

    3 months following lower eyelid blepharoplasty surgery (eyebag removal surgery) to both eyes Because most GPs consider this to be cosmetic eyelid surgery, most GPs will not refer patients to the NHS for eye bag removal surgery.

  • Eyelid hooding and lower lid loose skin

    Before blepharoplasty surgery pictures: This lady complained of both overhanging upper eyelid skin (i.e. very heavy eyelids), lower eyelid bags (baggy eyelids) with wrinkling of her eyelids

  • 6 weeks following cosmetic eyelid surgery to all 4 eyelids. This lady has undergone upper eyelid blepharoplasty surgery to remove the excess drooping skin and lower eyelid bag reduction surgery to remove the lower eyelid bags.

    6 weeks following cosmetic eyelid surgery to all 4 eyelids. This lady has undergone upper eyelid blepharoplasty surgery to remove the excess drooping skin and lower eyelid bag reduction surgery to remove the lower eyelid bags.



How is blepharoplasty/ cosmetic eyelid surgery performed?

  • default_titlePrior to any surgery, the surgeon should discuss with you what you wish to achieve, what is safely achievable and the risks and benefits of surgery. At the end of the consultation, the surgeon should be able to develop a surgical plan for that particular patient. Each patient is an individual, and the surgical plan reflects this.
  • default_titlePrior to any eyelid operation, it is highly recommended that every patient should ideally undergo a formal eye examination either by the surgeon who is going to be performing the procedure or an impartial ophthalmologist.
  • default_titleBlepharoplasty/ eyelid cosmetic surgery is performed commonly as a day case procedure.
  • default_titleMuch like the word ‘haircut’, the term blepharoplasty describes refashioning of the eyelid in general. The procedure itself will have slight variations depending on the patient. Because oculoplastic surgeons perform more eyelid operations than any other type of surgeon, they are more equipped to offer the full repertoire of techniques to address different variations in patient anatomy.
  • default_titleLike all types of eyelid surgery, blepharoplasty surgery, either for cosmetic or functional reasons, can be performed under local anaesthesia, local anaesthesia with mild sedation, or general anaesthesia.
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Upper Eyelids
  • default_titleFor upper eyelid blepharoplasty, the surgeons will draw some lines on the upper eyelid.
  • default_title Surgery can be performed using either general anaesthetic or local anaesthetic. The vast majority of patients opt for local anaesthesia since its is quicker and very acceptable. Sometimes the anaesthetist may administer some sedation through a vein in the back of the hand to make relax the patient further.
  • default_title Removal of the excess skin is then performed using either a scalpel, carbon dioxide laser, or radiofrequency cutting device. The incisions are situated within the normal skin crease of the eyelid so that afterwards, the incision scar is hidden and becomes invisible.
  • default_titleFor those patients with bulging fat in the upper eyelid, the fat is then either sculpted away or repositioned.
  • default_titleAn oculoplastic surgeon can then perform any additional procedures as necessary , for example, correcting a droopy eyelid with eyelid ptosis surgery, repositioning a prolapsed tear gland, debulking of any prolapsing orbital fat or lifting/ stabilising the eyebrow position.
  • default_titleThe wound is then closed with sutures. Although their removal is required, non-dissolvable sutures are sometimes used, because of their more predictable cosmetic result.
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Lower Eyelids
Lower eyelid blepharoplasty is performed slightly differently to upper eyelid blepharoplasty. Again, depending on the nature of the cosmetic defect, different techniques may be used. For example:
  • default_titleFor patients excess skin causing wrinkles, the incision can be made in the skin just below the eyelash line so that the excess skin can be removed after the excess fat is addressed first. The incision is so close to the eyelash line that it becomes invisible within a few weeks of surgery. If there are eye bags ( which is usually caused by the normal orbital fat prolapsing forwards) this can be addressed at the same time through the same incision.
  • default_titleIn those patients where skin redundancy is not an issue and the only problem is eyelid bags due to bulging orbital fat, the incision can be made along the inside of the lower eyelid (transconjunctival approach) and the fat prolapse can be addressed resulting in sutureless scarless surgery. This results in a much quicker recovery time following surgery.
  • default_titleThere are various ways of addressing prolapsing fat in the lower eyelid and a good cosmetic surgeon should be able to discuss with you the most appropriate options. These include simple fat removal (debulking) to repositioning. In patients with a tear trough deformity, a popular technique which has gained popularity recently is to drape this fat over the edge of the socket and use it to replace the fat which has started to disappear on the rim of the orbit itself. Therefore, instead of simply disposing of the orbital fat, the surgeon is utilising it as a filler.
  • default_titleLower eyelid blepharoplasty is technically more challenging than upper eyelid blepharoplasty due to its slimmer margin for error and riskier potential complications. For this reason, many surgeons choose only only concentrate on upper eyelid blepharoplasty.
  • default_titleThe surgery performed will be individual to that patient. For example, eyelid tendons may need to be tightened, the bulging fat may be excised or redistributed, the midface/cheek may be lifted, some of the wrinkles may be removed, the hollows underneath the eyelids may be softened and filled. A good cosmetic surgeon should be able to discuss with the patient a personalised surgical plan: customised to the patient's anatomy, the patient's wishes and expectations.
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Frequently Asked Questions

It is often advisable to have someone accompany you on the day of surgery, particularly if the surgery is performed as a day case procedure. Rarely, the eyes may be covered with pressure dressings for an hour, to help reduce the build up of any postoperative swelling. As the anaesthetic wears off, your eyelids may feel tight and sore, but this wears off quickly and is usually easily treated with simple painkillers. If the postoperative pain is severe, this may indicate a serious problem and patients should get in touch with their surgeon immediately.
You will advised to sleep upright and apply regular cold compresses to the eyelids to reduce the postoperative swelling. It is especially important to keep your wounds clean and dry. Eye drops are commonly provided to help soothe the eyes which can feel slightly dry due to temporary impairment of the normal blink reflex following surgery.

-Swelling and minor bruising is normal and peaks about 24-48 hours after the procedure.
-However 90% of the swelling usually disappears by 10 days but minor swelling may still persist for 10-12 weeks depending on the complexity of the procedure. For example, most of Mr Cheung's patients who return to work after 10-14 days often comment that their work colleagues remark that they look fresher but often do not realise that any surgery has been performed.
-Most patients return back to work about 10-14 days after blepharoplasty surgery.
- The first clinic visit following surgery is usually scheduled for 1 - 2 weeks following surgery. Mr Cheung often personally removes any skin sutures with the aid of an examination microscope to ensure there is no retention of the fine skin stitches.
-Make up can be safely used usually from the 10th postoperative day.
- Most patients are usually discharged at 3-6 months following surgery.
Most cosmetic eyelid surgery can performed quite safely as a day case procedure so that most patients go home the same day. It is advisable that someone you know can take you home and stay with you at least overnight just to be on the safe side. For some patients attending from outside the Midlands, particularly those undergoing complex surgery, Mr Cheung may advise staying overnight in the hospital or in a nearby hotel.

As with any cosmetic procedure, the patient's part in expecting a realistic outcome and understanding the potential complications is probably more important than the skill of the surgeon. Any good surgeon will take the time to chat with the patient so that they have a good understanding of what to expect and what is realistically achievable. Patients with unrealistic expectations are likely to be disappointed no matter how skilled the surgeon or good the postoperative result.

Complications are extremely rare and the vast majority of patients are extremely satisfied following surgery. The complications of blepharoplasty surgery include:
  • default_titleEyelid Asymmetry: where one side does not match the other
  • default_titleUndercorrection where insufficient skin/ orbital fat has been removed. It is important to be realistic about how much skin can safely be removed.
  • default_titleOvercorrection-If too much skin is removed during upper eyelid blepharoplasty, the eyelid may not be able to close properly (termed lagophthalmos), which can be sight threatening. Lagophthalmos can be temporary from eyelid swelling, or permanent if too much skin from the upper eyelid was removed. The cornea (clear window on the front of the eye) may start to dry out due to the incomplete closure of the eyelid. This may be sight threatening since the cornea may ulcerate as a result. For severe cases of lagophthalmos, a skin graft or flap to replace the upper eyelid skin shortage may be necessary to allow the eyelid to function normally again.
  • default_titleTemporary dry eye commonly occurs following upper eyelid blepharoplasty surgery and is commonly due to temporary impairment of the muscles involved in eyelid closure. Ocular lubricant drops are commonly prescribed for a few weeks following surgery for symptomatic relief. Less commonly though, permanent dry eye may result particularly particularly following excessive skin removal (both in upper and lower eyelid blepharoplasty) and in patients who have pre-existing problems with dry eye, tear film problems, previous refractive surgery and ocular surface problems. It is for this reason that the Dept of Health recommends that all patients undergoing any type of blepharoplasty surgery undergo a formal assessment by an ophthalmologist including testing ocular motility, tear film production and quality assessment.
  • default_titleIf too much lower eyelid skin is removed, the eyelid may look hollowed out, too concave or may cause the eyelid to turn outwards leading to ectropion formation. All oculoplastic surgeons are trained to avoid this by performing additional procedures if necessary e.g. eyelid tendon tightening such as lateral canthopexy.
  • default_titleScarring can also occur post-operatively, leading to a poor cosmetic outcome. Scarring following lower eyelid blepharoplasty can result in the lower eyelid being pulled out and downwards, leading to an unnatural appearance and ectropion. Corrective surgery may be necessary to address this. It can usually be avoided by meticulous dissection in the correct surgical planes and is rare in the hands of oculoplastic surgeons.
  • default_titleAcute glaucoma is an rare but potentially blinding complication that can occur with any type of eyelid surgery and occurs when the internal pressure of the eye starts to rise as a result of some of the side effects of some of the drugs and injections utilised during eyelid surgery. Oculoplastic surgeons are trained to recognise and manage this complication through their general ophthalmology training. It is recommended in the US, that a formal ophthalmological assessment be performed prior to eyelid surgery to look for the potential risk factors for this complication.
  • default_titleBleeding into the skin, known as a skin haematoma, after the procedure is an uncommon complication and excessive bruising leading to a collection of blood within the tissue. It is critical to stop all tablets which may increase the risk of bleeding and your surgeon should advise you about this prior to surgery. In the first few days following surgery, you should avoid any vigourous activity such as lifting, bending, since this can worsen any bruising or swelling of the eyelids.
  • default_titleCorneal abrasion is when the corneal surface is damaged either due to the inadvertent trauma. This complication is extremely rare in the hands of oculoplastic surgeons.
  • default_titleEyelid ptosis- Uncommonly the main tendon (levator aponeurosis) within the eyelid may be damaged during cosmetic eyelid surgery causing the actual eyelid itself to descend and stay permanently low. This complication is extremely rare for oculoplastic surgeons since they routinely operate on this structure anyway and the most experienced in recognising the complex anatomy. Indeed, oculoplastic surgeons routinely perform ptosis surgery anyway and may recommend simultaneous ptosis correction/ repair in patients who already have a compromised eyelid tendon.
  • default_titleSunken eye (enophthalmos) and hollow eyelids- The fat within the socket (orbital fat) normally starts to shrink with age leading the the eyeball looking sunken over time. However, an artificially sunken eye can occur following excessive orbital fat removal. Similarly if excessive fat is removed the eyelids can look artificially hollow (sometimes known as skeletonisation). This complication occurs less commonly now surgeons have learnt to avoid it by being very conservative with orbital fat removal and performing safer techniques e.g. orbital fat repositioning.
  • default_titleBy far, the worst complication of blepharoplasty and thankfully the rarest, is an orbital haematoma. Uncontrolled bleeding, usually from a blood vessel from manipulation of some of the pockets of fat, results in compression on the optic nerve and its blood supply. If left untreated, permanent blindness can occur. Early diagnosis—recognised by severe eye pain or visual changes—is critical. Urgent reoperation may be necessary to stem the bleeding point and relieve the pressure on the optic nerve. It is for this reason, that eyelid plastic operations should ideally be performed by surgeons who are experienced in handling the fat of the eye socket to not only avoid this problem but also be able to manage it quickly and safely should it arise. Oculoplastic surgeons perform more operations within the orbit and around the eyelids than any other type of surgeon and are therefore best equipped to avoid and manage this rare but fearsome complication.
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It is for all these reasons that Mr Cheung tends to err on the side of caution i.e. towards conservative blepharoplasty surgery to reduce the risk of complications and also give a more harmonious balance appearance, to try and avoid a 'plastic' unnatural look. Most complications can be avoid with careful preoperative examination, surgical planning and meticulous operative technique.
Yes. About 50% of Mr Cheung's cosmetic patients are from outside the West Midlands region and undergo this surgery quite safely as a day case procedure. Most travel between home and hospital for their consultations and surgery to reduce accommodation costs.





Gallery

  • Lower eyelid blepharoplasty

    Lower lid blepharoplasty: This lady was always troubled by lower lid bags since her 20s

  • Note the bulging fat baggy bulges.

    Note the bulging fat baggy bulges which are due to weakness of the middle layers of the eyelid allowing forward prolapse of the orbital fat pad.

  • Note also the tear trough groove deformity

    Note also the tear trough groove deformity.

  • 1 week following lower lid blepharoplasty

    1 week following lower lid blepharoplasty: This consisted of fat pad debulking and draping, orbicularis muscle tightening, lateral canthal tendon ligament tightening, skin sliver removal.

  • Note the minimal swelling on the ocular surface.

    Note the minimal swelling on the ocular surface.

  • The incision is barely visible below the eyelashes.

    The incision is barely visible below the eyelashes.

  • 3 months following surgery.

    3 months following surgery.

  • The patient was over the moon.

    The fat pads have disappeared, the wrinkling has reduced, the tear trough deformity has gone.

  • The incision has become imperceptible.

    The incision has become imperceptible.

  • 3 months following surgery

    The patient was over the moon

  • This lady complained of upper lid hooding on both sides but with the right worse than the left.

    This lady complained of upper lid hooding on both sides but with the right worse than the left. Note the asymmetrical upper lid hooding. Her right eyebrow is lower than her left.

  • Her right eyebrow is lower than her left.

    This lady complained of upper lid hooding on both sides but with the right worse than the left. Note the asymmetrical upper lid hooding. Her right eyebrow is lower than her left.

  • 1 week following surgery

    1 week following surgery: Bilateral Upper blepharoplasty with endotine brow lifting

  • All incisons are hidden with the normal skin creases.

    All incisons are hidden with the normal skin creases.

  • Perfect symmetry at 6 weeks following surgery

    Perfect symmetry at 6 weeks following surgery

  • The incision scars gently fade away

    The incisions slowly continue to disappear completely.

  • 26 year old man complaining of his left eye looking smaller

    Asymmetrical bilateral upper lid blepharoplasty with skin crease reformation (anchor blepharoplasty)

  • 26 year old man complaining of his left eye looking smaller

    26 year old man complaining of his left eye looking smaller

  • Note the left upper lid looks more hooded.

    Note the left upper lid looks more hooded.

  • The asymmetry was due to unequal skin creases.

    The asymmetry was due to unequal skin creases.

  • 1 week following upper eyelid blepharoplasty

    1 week following upper eyelid blepharoplasty. This involved quite complex refashioning to reform symmetrical bilateral upper lid creases

  • Perfect symmetry at 6 weeks

    Perfect symmetry at 6 weeks following surgery

  • Perfect symmetry at 6 weeks post surgery

    Perfect symmetry at 6 weeks following surgery

  • The hidden incisions have faded away

    The hidden incisions have faded away

  • Before surgery again

    Before surgery again

  • After surgery again

    After surgery again

  • Before Upper and Lower blepharoplasty

    Before Upper and Lower blepharoplasty

  • Upper lid hooding, lower lids wrinkling with bulging

    Upper lid hooding, lower lids wrinkling with bulging of fat bags

  • Upper lid hooding, lower lids wrinkling with bulging

    Upper lid hooding, lower lids wrinkling with bulging of fat bags

  • Upper lid hooding, lower lids wrinkling with bulging

    Upper lid hooding, lower lids wrinkling with bulging of fat bags

  • 1 week following surgery

    1 week following surgery. It is normal to be so swollen following such complex surgery. Her upper eyelid blepharoplasty consisted of skin excision, repair of the levator tendons and reformation of the skin creases.

  • The incisions are hidden in skin creases and under eyeliashes

    The incisions are hidden in skin creases and under eyeliashes. The lower lid blepharoplasty consisted orbital fat pad repositioning and debulking, tightening up of the muscle layer, skin excision to improve surface wrinkling and tightening of the horizontal ligaments of the eyelid.

  • Temporary fluid swelling tracks on to ocular surface

    Temporary fluid swelling tracks on to ocular surface (chemosis). This often leads to temporary ocular irritation which improves as the swelling resolves. Ocular lubricants are often useful for symptomatic relief.

  • 1

    3 months following surgery. The patient was very happy. All the incisions had slowly disappeared to become invisible

  • The incisions have largely disappeared at 3 months after surgery.

    The upper skin incisions have blended away to give symmetrical skin creases

  • Patient was very happy. Notice the lack of scars

    The patient was very happy. Notice the lack of scars

  • Before surgery again

    Before surgery again

  • After surgery again

    After surgery again

  • This lady was concerned about her upper eyelid hooding and lower eyelid bags which she felt made her look constantly tired.

    Before Upper and Lower Lid Blepharoplasty

  • Upper lid hooding and lower lid bags

    This lady was concerned about her upper eyelid hooding and lower eyelid bags which she felt made her look constantly tired.

  • Upper lid hooding and lower lid bags
  • Upper lid hooding and lower lid bags

    This lady was concerned about her upper eyelid hooding and lower eyelid bags which she felt made her look constantly tired.

  • Upper lid hooding and lower lid bags

    This lady was concerned about her upper eyelid hooding and lower eyelid bags which she felt made her look constantly tired.

  • 1 week following upper and lower blepharoplasty

    1 week following upper and lower blepharoplasty.

  • Uppers: skin excision only

    Uppers: skin excision only.
    Lowers: Skin excision, fat repositioning, muscle layer lift, lateral canthal tendon tightening

  • Hidden incisions within the skin crease

    Hidden incisions within the skin crease

  • 6 weeks following surgery. Notice the natural appearance.

    6 weeks following surgery. Notice the natural appearance.

  • 6 weeks post surgery

    The patient was very happy. The hooding, wrinkling and bags have greatly improved to leave a symmetrical natural harmonious result

  • 34 year lady complained of lower eyelid bags

    Lower lid blepharoplasty. This 34 year lady complained of lower eyelid bags. Note the extremely thin skin leading to fine skin wrinkling, weakness of the middle layers of the eyelid leading to bulging of the orbital fat pad pockets.

  • 34 year lady complained of lower eyelid bags

    Lower lid blepharoplasty. This 34 year lady complained of lower eyelid bags. Note the extremely thin skin leading to fine skin wrinkling, weakness of the middle layers of the eyelid leading to bulging of the orbital fat pad pockets.

  • 1 week following lower lid blepharoplasty

    1 week following lower lid blepharoplasty. The incision is hidden under the eyelashes.

  • The incision is hidden under the eyelashes

    Her surgery also involved draping of the fat pad to fill up the tear trough deformity, tightening up of the middle muscle layers, tightening of the outer ligaments of the lower eyelids and removing a small strip of skin to tighten up the skin.

  • Details: Anterior approach, orbicularis suspension with fat draping

    One can therefore understand why there is so much postoperative swelling due to multiple anatomical structures that needed addressing simultaneously.

  • The muscle lift helps smooth out the underlying fat bags

    The muscle lift helps smooth out the underlying fat bags

  •  The incision has become invisible at 3 months

    The incision has become invisible at 3 months following surgery

  • The skin is smoother

    The skin is smoother

  • The fat bags have disappeared

    The fat bags have disappeared

  • The tear trough deformity has reduced

    The tear trough deformity has reduced




Advice Leaflets for Blepharoplasty Patients

Preoperative Postoperative


Further information
British Oculoplastic Society blepharoplasty advice
eMedicine blepharoplasty
Primary rejuvenation upper blepharoplasty - Plastic, maxillofacial and aesthetic medicine news


Cost of Self Funded Cosmetic Eyelid Surgery with Mr Cheung
The cost of cosmetic eyelid/ eye plastic/ blepharoplasty surgery (all inclusive) by Mr Cheung as a private patient is £2300-£5550 depending on the number of eyelids operated on, complexity of procedure, additional procedures performed, type of anaesthesia requested and length of hospital stay.

The vast majority of patients undergo their cosmetic eyelid surgery with Mr Cheung as a day case procedure (typical duration of attendance in hospital is 3 hours only) under local anaesthesia (numbing injections) with a typical cost of £2300 (all inclusive). The cost of the postoperative consultations including any suture removal by Mr Cheung is included within this initial cost.