Blepharoplasty: A Complete Guide to Eyelid Surgery and Periorbital Rejuvenation

17 December 2025

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Face
Surgical vs Non-Surgical

Duncan Brennand

Aesthetic Doctor and Radiologist

What is a Blepharoplasty? Review our Complete Guide to Eyelid Surgery and Periorbital Rejuvenation

The eyes are often the first facial feature to show signs of ageing. Changes in the eyelids can make an individual appear tired, worried or older than they feel. Blepharoplasty, commonly known as eyelid surgery, is a precise and highly effective procedure that rejuvenates the upper or lower eyelids by removing excess skin, repositioning or reducing fat and restoring smoother, more alert contours around the eyes.

At 101 Harley Street, blepharoplasty is performed by specialist surgeons who focus on natural refinement. The aim is not to change the character of the eyes, but to restore a well rested and balanced appearance while preserving eyelid function and expression. This article explains how blepharoplasty works, who may benefit and why the procedure remains one of the most popular and impactful forms of facial rejuvenation.

What is a Blepharoplasty?

A blepharoplasty is a surgical procedure designed to correct age-related changes in the upper or lower eyelids. Over time, the delicate tissues around the eye can loosen, causing excess skin, prominent fat pockets or hollowing beneath the eye. These changes often occur earlier than ageing in other areas of the face.

Upper blepharoplasty focuses on lifting heavy upper lids by removing redundant skin and addressing underlying structures that create heaviness or hooding.

Lower blepharoplasty focuses on smoothing under eye bags, repositioning fat pads and refining lower lid support, which can improve both form and function.

The result is a fresher, more open appearance that still looks entirely natural.

Why Ageing Affects the Eyelids

The eyelid area is anatomically complex and particularly vulnerable to structural change. Contributing factors include:

Thinning of eyelid skin
Weakening of the muscles and ligaments that support the eyelids
Protrusion of fat pads that create under eye bags
Loss of volume beneath the eye
Redundant skin creating hooding or heaviness on the upper lids

These changes can progress gradually and may eventually obstruct makeup application or even peripheral vision.

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Who Is Suitable for Blepharoplasty?

Blepharoplasty may be suitable for individuals with hooded upper eyelids, excess skin or puffiness around the eyes, or those who feel their eyes look tired or heavy despite adequate rest. It can also benefit patients who experience makeup transfer due to upper eyelid overhang and those seeking subtle refinement without changing the natural shape of their eyes. Good overall health and realistic expectations are important, and during your consultation the surgeon will carefully assess eyelid anatomy, brow position, skin quality and muscle support to confirm whether blepharoplasty is the right option for you.

Blepharoplasty can improve both the appearance and comfort of the eyes. Key benefits include:

Benefits of a 'Bleph' Treatment
A more alert and youthful expression
Smoother upper lids with reduced heaviness
Refined lower eyelids with reduced puffiness
Better eyelid contour and definition
Restoration of symmetry
Potential improvement in field of vision
Long-lasting results that maintain natural character

The procedure is subtle but transformative, often creating a significant improvement with minimal visible change to overall identity.

Upper vs Lower Blepharoplasty

Upper Blepharoplasty

Removes excess skin and may adjust underlying muscle or fat. It restores lid definition and opens the eye.

Lower Blepharoplasty

Addresses under eye bags by repositioning or removing fat and refining support. Hollowing may also be corrected through fat redistribution.

Some patients benefit from combined upper and lower blepharoplasty for comprehensive rejuvenation.

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1. Incisions in Natural Creases

Upper eyelid incisions are hidden within the natural crease. Lower eyelid incisions may be placed along the lash line or inside the eyelid when no skin removal is required.

2. Adjustment of Fat and Tissue

Protruding fat pads are carefully repositioned or reduced. Muscle tightening may be performed where necessary.

3. Removal of Redundant Skin

Excess skin is precisely trimmed to restore contour without creating tension.

4. Closure with Fine Sutures

Sutures are placed to ensure discreet healing.

Blepharoplasty typically takes between 60 and 120 minutes depending on the areas treated.

Recovery After Blepharoplasty

Recovery is generally faster than many other facial procedures.

Patients may experience:

Mild swelling or bruising in the first few days
A sensation of tightness as the area begins to heal
Light sensitivity or temporary dryness
Sutures removed after several days

Most individuals return to office based work within one week and resume gentle activity soon after. Full refinement continues over several weeks.

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Risks and Considerations

Blepharoplasty is safe and well established but carries potential risks, including:

Temporary dryness or irritation

Swelling or bruising

Asymmetry

Visible scarring in rare cases

Changes in eyelid sensation

Tightness during early healing

Your surgeon will discuss all considerations thoroughly during your consultation.

Frequently Asked Questions About Blepharoplasty

What is Blepharoplasty Surgery?

Blepharoplasty, often referred to as eyelid surgery, is a surgical procedure designed to improve the appearance and function of the upper and or lower eyelids. It involves the careful removal or repositioning of excess skin, fat and, where appropriate, muscle to create a more refreshed, open and youthful eye area. Blepharoplasty can address concerns such as hooded upper eyelids, under eye bags, puffiness and a tired or heavy appearance. In some cases, upper eyelid surgery can also improve vision if excess skin is obstructing the visual field. The procedure is tailored to each patient’s anatomy to ensure natural looking results that preserve the individual character of the eyes.

Blepharoplasty vs Non-Surgical Eyelid Treatments

Blepharoplasty offers a long-term, structural solution for moderate to severe eyelid concerns, particularly where excess skin or prominent fat pads are present. Surgery allows precise correction of hooding, sagging and under eye bags, delivering results that cannot be fully replicated with non-surgical treatments.

Non-surgical options, such as skin tightening devices, injectable treatments or laser therapies, may be suitable for patients with early signs of ageing, mild skin laxity or fine lines around the eyes. These treatments can improve skin quality, firmness and hydration but they do not remove excess skin or reposition fat. As a result, non-surgical treatments are often best viewed as preventative or maintenance options, or for those not yet ready for surgery.

During consultation, your clinician will assess your eyelid anatomy, skin quality and aesthetic goals to advise whether blepharoplasty or a non-surgical approach is most appropriate, or whether a combination of treatments may offer the best outcome.

How long does blepharoplasty last?

Results are long lasting. Upper blepharoplasty often maintains improvement for many years, while lower blepharoplasty may offer results that endure even longer.

Will blepharoplasty change the shape of my eyes?

Blepharoplasty at 101 Harley Street is designed to maintain your natural eye shape. The goal is refined rejuvenation, not alteration.

Is blepharoplasty painful?

Most patients experience mild discomfort or tightness rather than significant pain. Recovery is typically well tolerated.

When can I return to work after blepharoplasty?

Most individuals feel comfortable returning to work within one week, maybe sooner if you are working from home.

Can non-surgical treatments replace blepharoplasty?

Non-surgical options can improve skin quality but cannot correct structural issues such as fat prolapse or significant excess skin. They may be used alongside surgery to support long-term results.

Is blepharoplasty suitable for all ages?

Suitability is based on anatomy rather than age. Some individuals choose blepharoplasty in their 30s if hereditary concerns are present.

Will I have visible scars after blepharoplasty?

Incisions are placed in natural eyelid creases or inside the lid. Scarring is typically discreet once healed and can be improved by non-surgical treatment options offered at L’Atelier Aesthetics at 101 Harley Street.

So what treatments can be used to support the recovery of a Bleph treatment?

Supporting Recovery with Non-Surgical Treatments

Although blepharoplasty addresses structural eyelid changes, non-surgical treatments can support healing, enhance results and maintain long-term eyelid quality. Certain treatments available at L’Atelier Aesthetics complement surgical outcomes when introduced at the appropriate stage of recovery. L’Atelier Aesthetics is part of our 101 group and available at the same location.

Skin Health Programmes

Medical grade skincare can improve the elasticity and texture of eyelid skin before and after surgery. Reducing inflammation and supporting barrier function helps the surgical area settle smoothly.

Light Based Treatments

LED therapy promotes cellular repair and can help reduce swelling and redness following blepharoplasty once the initial healing period has passed.

Microneedling or Fractional Resurfacing

When suitable, gentle resurfacing treatments can further improve crepiness or fine lines around the eyes. These treatments are performed only after a full surgical recovery period and with surgeon approval.

Injectable Support

Some patients may still benefit from light use of injectables or polynucleotides to balance brow position or soften lines that are not addressed by blepharoplasty. These treatments are tailored carefully to preserve natural expression.

These supportive treatments must always be staged appropriately. Your clinical team will advise the correct timing based on your healing progression.