Upper blepharoplasty removes loose, sagging skin and sometimes a little muscle and fat from the upper eyelids. Most people have it to lift hooded or heavy lids that make the eyes look tired, or to clear skin that has started to block the upper field of vision. Mr Christopher West carries it out under local anaesthetic as a day case. It usually takes about an hour.
Suitability and results vary from person to person and are always confirmed at a consultation with Mr Christopher West. This page covers what the procedure involves, who it suits, how to prepare, what recovery looks like and the results you can expect.
The basicsWhat is upper blepharoplasty?
Upper blepharoplasty, also called upper eyelid surgery or hooded eyelid surgery, removes the spare skin that gathers above the eye as we age. Over time the skin on the upper lid loses elasticity and starts to droop. In some people this forms a fold that hangs over the natural eyelid crease, which is where the term hooded eyelids comes from.
Mr West removes a measured strip of excess skin and, where needed, a small amount of muscle and fat. The incision sits in the natural crease of the eyelid, so the scar is hidden in a fold and is hard to see once healed. The aim is a brighter, more rested eye area with a defined upper lid crease.
SuitabilityWho is it for?
Upper blepharoplasty tends to help people who are bothered by the look of their upper eyelids, or whose eyelids have started to affect everyday life. Signs it may help include:
- Loose or sagging skin on the upper eyelids
- A hooded fold that hangs over the eyelid crease
- Eyes that look tired or heavy even after rest
- Difficulty applying make-up because the lid skin folds over
- Upper eyelid skin that rests on the lashes or starts to block the upper field of vision
If you smoke or use any form of nicotine, you should stop at least six weeks before surgery, in line with BAAPS guidance. This includes vapes, patches and gum. Nicotine reduces blood flow to the skin, which raises the risk of poor healing.
It may not be the right option for everyone. The procedure may not suit you if your main concern is lines around the eyes, dark circles, or puffiness below the eye, as these usually need a different treatment. People with certain eye conditions, dry eye problems, or health conditions that affect healing may need extra checks first. Mr West will talk through your medical history and examine your eyes to confirm whether surgery is suitable for you.
What happens nextWhat happens during the procedure
Upper blepharoplasty is a day case, so you go home the same day. Mr West carries it out under local anaesthetic. The team settles you in, talks through the procedure and takes photographs, then the main steps are:
- Mr West marks the planned incision while you are sitting up, so the amount of skin to remove is measured accurately.
- Local anaesthetic is injected. It stings for a few seconds, then numbs the area.
- A fine incision is made along the natural crease of the upper eyelid.
- The excess skin is removed, along with a small strip of muscle and any excess fat.
- The skin is closed with a single running stitch and small steristrips are placed over the scar.
The surgery usually takes about an hour. Before you leave, the team explains your aftercare and arranges your follow-up appointments.
Surgical readinessHow to prepare
Your clinic will give you a full set of instructions before surgery. In general, preparation means:
- Stopping smoking and all nicotine at least six weeks beforehand
- Stopping blood-thinning medicines or supplements if advised to do so
- Keeping alcohol to a minimum in the days before surgery
- Arranging for someone to drive you home and stay with you afterwards
- Coming to your operation without eye make-up, false lashes or contact lenses
Tell Mr West about any medicines you take and any history of dry eyes or other eye conditions, so your plan can account for them.
HealingRecovery, step by step
Most people recover well and are back to normal within a couple of weeks. Bruising and swelling are normal at first and settle steadily.
You will be given clear aftercare advice and follow-up appointments so your healing can be checked. Recovery times vary from person to person.
The outcomeResults and how long they last
The result is a more open, rested eye area with a defined upper lid crease that looks natural. Once the swelling has settled, you should see the full effect within a few months.
The results are long lasting. It is unusual for excess lid skin to build up again in the same way once it has been treated. Your eyes keep ageing naturally and the brow continues to drop, so the area can look heavier again over the years. Genetics, sun exposure and your skin type all play a part in how long the result holds.
Honest informationRisks and things to consider
Upper blepharoplasty is a well established and generally safe procedure, but like any surgery it carries some risks. Possible risks and side effects include:
- Swelling, bruising and temporary blurred vision in the first days
- Dry, irritated or watery eyes for a time. People who already have dry eyes can find them made worse and may need lubricating drops for longer, so dry-eye sufferers need careful assessment first
- Scarring. The incision is placed in the natural crease to keep it discreet
- Slight differences between the two sides, as no two eyes are perfectly symmetrical
- Temporary difficulty fully closing the eyes
- Removing too much skin, which can stop the eyes closing fully and occasionally needs a skin graft to correct
- Unmasking of a pre-existing droopy eyelid (ptosis) that was being held up by the excess skin
- A collection of blood (haematoma) that may need draining
- Infection, or rarely a reaction to the anaesthetic
Any surgery around the eye carries a rare risk to sight from bleeding behind the eye (retrobulbar haemorrhage). Mr West puts this at around 1 in 20,000. It is a surgical emergency that needs urgent treatment.
Seek urgent medical advice straight away if, after surgery, you have sudden or worsening pain, fresh heavy bleeding, rapidly increasing swelling, or any sudden change in your vision. These can be signs of a serious problem that needs treatment within hours.
Serious complications are uncommon. Mr West will go through the risks that apply to you, based on your health and your eyes, so you have a clear picture before you decide. Taking time over this decision is sensible and there is no pressure to proceed.
Other optionsAlternatives to surgery
Surgery is not the only option. Whether an alternative helps depends on the cause of your concern. Non-surgical options to ask about include:
- Anti-wrinkle injections. These can soften fine lines around the eyes but do not remove loose skin.
- Energy-based skin tightening. Treatments such as laser or radiofrequency may help mild skin laxity, but the effect is limited compared with surgery.
- Dermal fillers. These can address volume loss in the surrounding area rather than excess eyelid skin.
- Brow lift. If a heavy or low brow is the main cause of the hooding, lifting the brow may be more suitable than eyelid surgery. Read about brow lift surgery.
For loose, hanging upper eyelid skin, surgery remains the most reliable way to get a lasting change. Mr West will give you an honest view of whether a non-surgical option could work for you, or whether surgery is the better route.
RelatedUpper and lower eyelid surgery
Upper blepharoplasty treats the upper lids. If your concern is puffiness, bags or excess skin below the eye, that is treated with lower blepharoplasty. Some people have both at the same time. Mr West will advise what suits you at your consultation.
Your surgeonWhy patients choose Mr Christopher West
Mr Christopher West is a consultant plastic, reconstructive and aesthetic surgeon. He trained in medicine at Sheffield and completed his higher surgical training in plastic surgery in Edinburgh. In the NHS he works at Leeds Teaching Hospitals. In private practice he focuses on facial plastic surgery, including eyelid surgery and the deep plane facelift. He was featured on the BBC series Saving Lives in Leeds.
You will be seen by Mr West himself at your consultation, where he examines your eyes, talks through what you want to change and gives you a clear, honest recommendation.
Book a consultation
If you are thinking about upper eyelid surgery, the best next step is a consultation. Mr West will assess your eyes in person, answer your questions and tell you honestly whether the procedure is right for you.
QuestionsFrequently asked questions
Is upper blepharoplasty painful?
Most people find it more uncomfortable than painful. The eyelid is numbed with local anaesthetic, which stings for a few seconds as it goes in, so you should not feel pain during surgery. Afterwards there is usually some tightness and mild soreness, which most people manage with over-the-counter pain relief.
How long does upper eyelid surgery take?
It usually takes about an hour, depending on whether one or both eyelids are treated and what the surgery involves. It is a day case, so you go home the same day.
Is upper blepharoplasty done awake or asleep?
Mr West carries out upper blepharoplasty under local anaesthetic. The eyelid is numbed, so you stay awake and pain-free during the procedure.
How long is the recovery from upper blepharoplasty?
Most people are back to work and everyday activities within a couple of weeks. Stitches and steristrips come out at five to seven days. Bruising and swelling settle over the first week or two. Exercise is fine from about three weeks once Mr West is happy with your healing.
When can I go back to work after upper eyelid surgery?
Many people return to office or desk-based work after about a week, once visible bruising and swelling have settled enough to feel comfortable. Physically demanding jobs may need longer. Mr West will advise you based on your role and how you are healing.
How much swelling and bruising should I expect?
Swelling and bruising around the eyes are normal in the first days and are at their most noticeable in the first week. They settle steadily over the following one to two weeks. Keeping your head raised and using cold compresses helps bring the swelling down.
Will I have a visible scar?
The incision is placed in the natural crease of the upper eyelid, so it sits within a fold. Once healed, the scar is usually very hard to see. It continues to fade over the months after surgery.
How long do the results last?
The results are long lasting and it is unusual for excess lid skin to build up again once treated. Your eyes still age naturally and the brow keeps dropping over time, so the area can look heavier again over the years. How long the result holds varies from person to person.
Will upper eyelid surgery help with hooded eyes?
Yes, removing loose, hanging skin from the upper lid is one of the main reasons people have this surgery. If a low or heavy brow is causing the hooding rather than the eyelid skin itself, a brow lift may be more suitable. Mr West will check which is the cause at your consultation.
Do I need a blepharoplasty, a brow lift or ptosis surgery?
It depends on the cause of the heaviness. Loose, excess eyelid skin is usually treated with upper blepharoplasty. A low brow pushing skin down may need a brow lift. If the lid itself droops because of a weak lifting muscle (ptosis), ptosis surgery may be needed. An assessment tells you which one, or which combination, suits you.
Does upper blepharoplasty get rid of wrinkles or crow's feet?
No. The surgery removes excess eyelid skin but does not treat the fine lines or crow's feet at the side of the eye. Those are usually treated separately, for example with anti-wrinkle injections.
What is the difference between upper and lower blepharoplasty?
Upper blepharoplasty treats loose skin and heaviness on the upper eyelids. Lower blepharoplasty addresses puffiness, bags or excess skin below the eye. Some people have both, depending on their concerns.
Can upper and lower blepharoplasty be done at the same time?
Yes. Upper and lower blepharoplasty can often be carried out in the same operation when both areas are a concern. Whether that is right for you depends on your assessment and goals, which you can discuss at your consultation.
When can I wear contact lenses after eyelid surgery?
Most people are advised to leave contact lenses out for at least one to two weeks after upper eyelid surgery, then go back to them gradually once cleared. Glasses are usually fine in the meantime. Mr West will confirm the right timing for you.
When can I wear make-up after upper eyelid surgery?
Eye make-up is usually avoided for around two weeks and often until your stitches are out and the incisions have started to heal. Putting make-up on too early raises the risk of irritation and infection, so wait until Mr West gives the go-ahead.
What age should you have upper eyelid surgery?
There is no set age. Many patients are in their 40s to 60s, but younger people with inherited hooding can be suitable too. What matters more is the amount of excess skin, your general health and realistic expectations. Suitability is confirmed at a face-to-face consultation.
Can I get upper eyelid surgery on the NHS?
The NHS only funds eyelid surgery when there is a functional problem, such as excess skin shown to block part of your field of vision on a visual field test. Surgery for cosmetic reasons is not funded and is carried out privately. Your GP and an eye assessment determine whether you meet the criteria.
When can I drive after upper eyelid surgery?
Do not drive until your vision is clear and comfortable, you can perform an emergency stop, you meet the legal eyesight standard and Mr West has advised it is safe. The timing varies from person to person.
