Upper eyelid blepharoplasty – what the procedure involves and why a natural result matters

Upper eyelid blepharoplasty is one of the most frequently performed eyelid operations. With age the eyelid skin loses elasticity, forms a fold that hangs over the lashes, and the gaze becomes heavy and tired. In some people the excess skin also covers the upper part of the visual field. The procedure removes this excess and, where needed, fat prolapses, restoring the natural eyelid crease.

Who it is for

Upper eyelid blepharoplasty is indicated when:

• a fold of skin hangs over the edge of the eyelid or rests on the lashes,
• the eyes look tired or sad despite being rested,
• you reflexively raise your brows to see better, which causes fatigue and forehead pain,
• excess skin restricts the visual field from above – in which case the procedure is medical, not only cosmetic.

At the qualification visit we check whether the problem is the skin alone, or also a drooping eyelid (ptosis) or low brows. Each of these situations calls for a different approach, and confusing them is the most common reason for disappointment after surgery.

The key criterion: a natural result

Well-performed eyelid surgery is invisible. People notice that someone looks rested, not that they “had an operation”. To achieve this we follow a few rules:

• We remove as much skin as is needed, not as much as possible. Over-aggressive excision produces a “surprised” look, can make it harder to close the eyes and worsens dry eye. We plan the excision with the eyes open, in a sitting position, taking into account how much skin the eyelid needs to close freely.
• We preserve fat. In the past a lot of fat was removed, which years later produced hollow, older-looking eye sockets. Today fat is removed only where it genuinely forms a prolapse.
• We keep the natural eyelid crease at the height appropriate for the individual. In men the crease is lower and the lid fuller – a “feminine” elevation changes the expression of the face, so in men we plan the procedure differently.
• We assess the brows. If low brows are the cause of the excess skin, eyelid surgery alone gives a short-lived result and may even pull the brows lower. In such cases we additionally propose a brow lift.
• We aim for symmetry, but not mirror-image sameness – natural faces are not symmetrical, and overly “perfect” eyelids look artificial.
• We protect the function of the eye. Before surgery we assess the tear film and eyelid closure. This is why eyelid surgery is best entrusted to an ophthalmologist: the eyelids are part of the visual system, and their primary job is to protect the eye.

What the procedure involves

The procedure is performed under local anaesthesia as a day case. The incision runs in the natural eyelid crease, so the healed scar is practically invisible. We remove the planned strip of skin and, if needed, a small amount of fat, and close the wound with fine sutures. You go home the same day.

Recovery

• For the first few days: cold compresses, sleeping with the head raised, avoiding bending and exertion.
• Swelling and bruising usually last 1–2 weeks; sutures are removed after about a week.
• Most people return to office work after 7–10 days; make-up once the sutures are out and the wound has healed.
• Strenuous exercise, sauna and sunbeds – after a few weeks.
• The scar matures and fades over several months; the final result is assessed after about three months.

Combined procedures

Upper eyelid blepharoplasty can be combined with ptosis repair, lower eyelid blepharoplasty or a direct brow lift – one procedure, one recovery. What makes sense in a given case is decided together at the qualification visit.

Cost

Upper eyelid blepharoplasty costs PLN 4,000 at OKUMED; the combined upper and lower eyelid procedure PLN 12,000. The qualification visit is PLN 200.

Book a qualification visit with Dr Jarosław Rachoń – Świętojańska 135/2, Gdynia, phone +48 882 650 299 or book online.

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This article is for information only and does not replace a medical consultation.