Aesthetic surgery
Eyelid surgery
A small operation with an outsized effect on how tired a face looks — provided the eyelid is actually the structure at fault.
What this treatment involves
Blepharoplasty treats the eyelids. On the upper lid, a strip of excess skin is removed through an incision hidden in the natural crease, sometimes with a small amount of fat. On the lower lid, the usual problem is not skin but fat that has bulged forward through a weakened septum, producing what people describe as bags.
Lower-lid surgery is approached in two ways. A transconjunctival incision inside the lid leaves no external scar and is used when fat is the only issue. A subciliary incision just below the lashes is used when skin also needs removing. Rather than simply excising the fat, many surgeons now reposition it into the hollow below, because removing it can leave the eye looking skeletal in later years.
Where the upper lid is heavy because the brow has descended, eyelid surgery is the wrong operation. Removing lid skin in that situation pulls the brow down further. Which structure is descending is determined by examination — by lifting the brow to its correct position and seeing how much lid skin remains.
Who may be suitable
Considered for adults with excess upper-lid skin, with lower-lid fat prominence, or with a heavy upper lid affecting the field of vision.
An eye assessment matters before surgery. Dry eye is common and often undiagnosed, and blepharoplasty can make it worse; a patient with significant dry eye may be advised against lower-lid surgery in particular. Thyroid eye disease, previous laser eye surgery, glaucoma and any tendency to lid laxity all change the plan.
The question of brow position is asked at every consultation. So is the question of what is producing the appearance the patient dislikes: skin, fat, a descended brow, hollowing, or pigmentation of the lower-lid skin, which is not surgical at all.
Why patients choose it
The upper-lid operation is one of the more reliable procedures in facial surgery. The scar sits in the crease and is generally inconspicuous once healed, and the change tends to read as looking rested rather than as looking operated on.
Where the upper lid has descended far enough to obstruct the upper field of vision, removing it produces a functional improvement as well as a cosmetic one.
On the lower lid, repositioning fat rather than removing it addresses the bulge and the hollow beneath it at the same time, which is why it has largely replaced simple excision.
How treatment works
Consultation and examination
Day 1
Brow position, skin excess, fat prominence and lid laxity are assessed separately, along with tear film and any history of dry eye. This is where an unsuitable plan is caught.
Planning
Day 1–2
Which lids are being treated, whether fat is removed or repositioned, and where the incisions sit are agreed with photographs.
Pre-operative tests
Day 2
Blood tests and anaesthetic review as indicated. Upper-lid surgery alone is often performed under local anaesthetic with sedation.
Surgery
Day 2–3
Generally one to two hours depending on how many lids are treated. Same-day discharge is usual.
Sutures out
Day 5–7
Sutures removed and the wound checked. The team confirms when it is safe to fly.
Settling
2–6 months
Swelling resolves and scars fade. Small asymmetries present early frequently even out over this period.
What happens in Istanbul
Facial surgery requires a stay of seven to ten days. Consultation, examination and pre-operative tests take the first day or two, followed by surgery and, depending on the procedure, one night in hospital or a same-day discharge. You then remain in Istanbul for review and for removal of sutures before flying. Departure is confirmed by the surgical team rather than by your booking — flying too soon after surgery raises the risk of swelling and blood clots.
Recovery
Bruising and swelling around the eyes are marked for about a week and usually settle substantially by ten to fourteen days. Sutures come out at five to seven days.
Vision is often blurred for the first days from ointment and swelling, and the eyes may feel dry and gritty for some weeks. Reading and screen use are tiring initially. No contact lenses until the surgeon confirms, and no strenuous exercise or heavy lifting for two to three weeks.
Most people are presentable at two weeks with makeup. Scars are pink for two to three months and continue to fade beyond that. Fine adjustments in symmetry continue to settle for several months, and the lower lid in particular can remain slightly swollen for longer than patients expect.
Risks and considerations
Dry eye is the most common problem after blepharoplasty and can persist for months; in patients who already have it, it can be made significantly worse.
On the lower lid, the serious complication is malposition — the lid pulling away from the eye (ectropion) or sitting lower than before (scleral show), caused by removing too much skin or by lid laxity that was present before surgery. It can require corrective surgery.
Other recognised risks include asymmetry between the two sides, over-correction leaving a hollow or under-correction leaving residual skin, visible or thickened scarring, difficulty closing the eyes fully, double vision from injury to an eye muscle, and — rarely but seriously — bleeding behind the eye, which is a surgical emergency because it can threaten vision.
Eyelid surgery does not treat crow’s feet, dark pigmentation of the lower-lid skin, or a descended brow. Expecting it to is the most common source of disappointment.
This information is general and educational. Whether a procedure is appropriate for you can only be determined by a qualified medical professional after an individual assessment, including your medical history and an examination.
Common questions
Will the scar be visible?
On the upper lid the incision is placed in the natural crease, so once healed it is hidden when the eye is open and generally difficult to see when closed. On the lower lid, a transconjunctival approach leaves no external scar at all; a subciliary incision sits just below the lashes and is usually inconspicuous. All scars are pink and more noticeable for the first two to three months. How a scar finally settles depends partly on how your skin heals, which no surgeon can promise in advance.
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