Eyelid surgery is one of the most reliably satisfying facial operations and one of the easiest to get wrong, and the difference is almost entirely in the assessment rather than the surgery. The eyelid is a small structure sitting between two larger ones — the brow above and the cheek below — and either can produce a problem that looks like an eyelid problem.
- Upper blepharoplasty
- Removes excess skin, sometimes a strip of muscle and a little fat
- Lower blepharoplasty
- Addresses bags — usually by repositioning fat rather than removing it
- Anaesthesia
- Often local with sedation for uppers; general is common for lowers
- Presentable
- Commonly around two weeks, with makeup
The upper lid
Skin on the upper lid loses elasticity and gradually rests on the lashes. At its most advanced it reaches the edge of the visual field, which is why upper blepharoplasty is sometimes a functional operation rather than a cosmetic one.
The incision is placed in the natural crease, which is where a scar is least visible on the whole face — closed and healed, it sits inside a fold that only appears when the eye is open.
The lower lid
Lower lid bags are usually fat pads pushing forward through a weakening barrier, not excess fat. That distinction changes the operation: modern technique tends to reposition that fat into the hollow below it rather than remove it.
Removing it instead can produce a hollow, skeletal look that is much harder to correct than the bag was, and appears years later as the face continues to lose volume. This is the single most common reason a lower blepharoplasty ages badly.
Where the skin itself is fine, the incision can be placed inside the lid with no external scar at all. Where skin needs removing, it sits just beneath the lash line.
What eyelid surgery does not fix
- Dark circles from pigmentation rather than shadow — surgery does not lighten skin.
- Fine lines and crepey texture, which are a skin-quality problem and need resurfacing.
- Crow’s feet, which are muscle movement and respond to botulinum toxin.
- A hollow under the eye caused by cheek volume loss, which is a midface problem.
Recovery
Days 5–7
Sutures come out. Vision can be blurred early from ointment and swelling.
Days 10–14
Bruising and swelling settle substantially.
Week 2
Most people are presentable with makeup.
Weeks 2–3
No strenuous exercise or heavy lifting. No contact lenses until confirmed.
Months 2–3
Scars fade. The lower lid can stay slightly swollen longer than expected.
Will my eyes feel dry afterwards?
Dryness and a gritty feeling for some weeks are common. If you already have dry eye, say so before surgery — it influences how much skin can safely be removed, particularly on the lower lid.
Can both lids be done at once?
Frequently they are. Combining them means one recovery rather than two, and the assessment is what decides whether both are actually indicated.
Will it make me look younger?
It makes most people look less tired, which is a different thing and often the one they wanted. If the goal is a broader rejuvenation, eyelids alone will not deliver it.
How long does it last?
Upper lid results are generally long-lasting; skin continues to age but rarely returns to the starting point. Lower lid results depend heavily on whether volume was preserved rather than removed.