Ask a Surgeon: Blepharoplasty Q & A with Mr Adel Fattah

Estimated Reading Time: 7 minutes

In this blog post, consultant surgeon Mr Adel Fattah answers the most common questions regarding blepharoplasty.

Q1: What is blepharoplasty?

a) Upper lid blepharoplasty is the removal of excess skin (and sometimes fat) from the upper eyelids in order to give a more youthful appearance to the eye. It does not stop the ageing process and it may need to be repeated in the future in response to changes in ageing, weight changes and sun exposure.

How long does it take?

Upper lid blepharoplasty is a relatively quick procedure that can be performed as a day case procedure and under local anaesthetic. The excess skin of the upper eyelid is precisely removed, leaving a scar in the natural crease of the eyelid. It takes around 30 – 60 minutes depending on what is being performed and whether local or general anaesthetic is being used.b) Lower lid blepharoplasty is different from the upper lid surgery and depending on requirements can be a simple or more complex procedure. It is the redraping of the skin of the lower eyelid typically using a scar just below the lash line. It can also address the bulging of the lower lid (“bags”) that is sometimes seen as we age. If there is no excess skin and just the bulge then the procedure can be performed using an incision on the inside of the eyelid.

How long does it take?

This varies with the extent of the procedure but typically a minimum of an hour for a simple skin redraping and longer if more sophisticated procedures to treat the bags are used. Typically, the fat can be removed or redraped to smooth the bulge into that of the cheek. Often, removing the fat can lead to a hollow look, so your surgeon will advise you as to what options are best for you and help you reach an informed decision.

Q2: What should I expect after surgery?

As the eyelids are so delicate, swelling will occur after the operation and usually increase over the following 48 hours. Sometimes, icepacks at home can help significant swelling (a bag of frozen peas wrapped in a tea towel) placed on the area for a few minutes every 15 to 30 minutes can help. You will likely want to wear sunglasses outside for the next few days but after a week you should be almost back to normal.

Q3: How long would I need off work?

You will likely want to adopt the movie star look and wear sunglasses outside for the next few days but after a week or so you should be almost back to normal. You will have sutures that will need to be removed the following week in clinic and typically some steristrips (butterfly stitches) to cover the wound. It doesn’t matter if the steristrips fall off after a couple of days; eyelid skin generally heals very quickly. For this reason, I usually suggest at least a week off work, two if you are in the public eye.

Q4: What can I do to get the most out of my consultation?

You should have clear goals about what you want to achieve. If you have excess skin that creates a fold on your eyelid, then you are an ideal candidate. Have a look at photographs of yourself: do you have wrinkled brow? If so, you may need a brow lift rather than (or with) an upper blepharoplasty.Bring some photos of yourself (good quality portrait pictures are ideal) when you were younger and as you have aged. This can demonstrate the changes over the years that need to be addressed.

Q5: Who should I see for a blepharoplasty?

Plastic surgeons, ENT surgeons (‘facial plastic surgeons’), ophthalmic (‘oculoplastic’) surgeons and maxillofacial surgeons all perform blepharoplasty and their surgical background doesn’t make their skill in blepharoplasty any different. You should see a surgeon with experience of blepharoplasty and I suggest that you see more than one surgeon. Ideally, they should be FRCS(plast), FRCS(ORL/ENT), FRCOphth or FRCS(OMFS) and be full members of their respective societies: BAPRAS, ENT-UK or BAOMS. Find a surgeon you develop a good rapport with; the doctor patient relationship is important and as you will be seeing each other many times a good relationship pays dividends in terms of putting your mind at ease and giving you confidence in the advice you receive. You should feel relaxed enough to ask any questions you need before making a decision to have surgery.Read more on our post How to Choose a Cosmetic Surgeon

Q6: What will I achieve?

You should expect an improvement in the amount of excess skin around the eyelids and this usually makes the eyelid look more youthful. Sometimes your surgeon may advise additional procedures such as fat injection, browlift or canthopexy to make the eye look more youthful. It won’t suddenly make you look much younger, but most patients comment that others complement them on their refreshed look.

Q7: Any last titbits of advice?

Your surgeon should spend a significant part of the consultation carefully examining and taking a detailed history relating to your eyes. The complications relating to surgery around the eyes should be discussed in detail. Be wary of cheap deals where surgeons treat blepharoplasty as ‘simple surgery’, do a quick examination and sign you up. Even the best surgeons have complications and you should feel that your surgeon is taking the utmost care to avoid them.Here you can find our guide prices for eyelid surgery (blepharoplasty)Read more cosmetic surgery blog posts to find answers from our consultants to the most common questions including: best place for breasts implants, breastfeeding and implants, cosmetic surgery after weight loss surgery.

About Mr Adel Fattah

Mr Adel Fattah is a Consultant Plastic Surgeon at Renacres Hospital in Lancashire.He is the first British-trained surgeon to have achieved Distinction for the post-graduate Diploma of Aesthetic Surgery from the University of London.His professional memberships include the British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS), AO North America (cranio-maxillo-facial), Sir Charles Bell Society and Facial Palsy UK Medical Advisory Board.He is committed to teaching and has taught alongside distinguished international faculty at facial aesthetic courses. His research is widely published, has been presented internationally and been awarded numerous prizes.Read more about Mr Fattah's qualifications, background and clinical interests.

About Ramsay Health Care Cosmetic Services

Cosmetic Surgery from Ramsay is a leading provider of cosmetic surgery and non-surgical treatments in the UK.Ramsay offers a wide range of cosmetic surgery procedures including breast augmentation, breast reduction, breast uplift, eyelid reshaping, tummy tuck, apronectomy (mini tummy tuck)gynaecomastia surgery, nose reshaping, prominent ear correction and liposuction.Also available are a number of cosmetic enhancing procedures that do not involve any incisions, surgery or general anaesthetics and include acne treatment, dermal fillers, skin resurfacing and laser hair removal.Cosmetic Surgery from Ramsay is a leading provider of cosmetic surgery and non-surgical treatments inBingley, Doncaster, Manchester, Middlesbrough, Newcastle, Chorley, Preston and Ormskirk.Please contact us if you would like to make an appointment with one of our plastic surgeons.

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