Upper & Lower Eyelid


Blepharoplasty can be both a functional and cosmetic surgical procedure intended to reshape {the} upper eyelid or lower eyelid by {the} removal or repositioning of excess tissue as well as by reinforcement of surrounding muscles and tendons.

  • Eyelids (and your eyes) are, perhaps, what other people notice initially.
  • Eyelid surgery to improve {the} appearance of {the} eyelids is often called 'eyelift' or 'blepharoplasty'.
  • As we age, your eyelids (both upper and lower) might become 'droopy' or 'baggy'. The eyelid skin stretches and muscle tone weakens
  • In addition, your eyebrows might also droop.
  • Your droopy upper eyelids and droopy brows might give you {the} appearance of being sleepy, tired and aging prematurely
  • In addition, this sagging, might lead to brow/eyelid strain
  • Excess skin can hang over {the} eyelid and interfere with vision

This surgery can be performed on both {the} UPPER and on {the} LOWER eyelids - or both.

  • Patients with a less severe amount of excess skin might have a similar procedure performed for cosmetic reasons.
  • Lower eyelid blepharoplasty is almost always done for cosmetic reasons, to improve puffy lower eyelid "bags" and reduce {the} wrinkling of skin.
  • Blepharoplasty is performed through external incisions made along {the} natural skin lines of {the} eyelids, such as {the} creases of {the} upper lids and below {the} lashes of {the} lower lids, or from {the} inside surface of {the} lower eyelid. Initial swelling and bruising take one to two weeks to resolve but at least several months are needed until {the} final result becomes stable.
  • Depending upon {the} scope of {the} procedure, {the} operation takes one to three hours to complete.



Combined Upper and Lower Eyelid Blepharoplasty

Blepharoplasty or eyelid surgery, commonly known as an ‘eyelift’ surgery is done to reduce bagginess of lower eyelids and to remove excess skin and fat from {the} upper eyelids. A combined upper and lower eyelid blepharoplasty is done to tackle both problems together at {the} same sitting.

This surgery is usually done for cosmetic reasons or to improve sight in older people with obstructed visual axis due to loss of elasticity and sagging of {the} eyelids.

Indications for a Combined Blepharoplasty

Baggy or droopy eyelids

  • Excess skin of upper eyelids blocking {the} visual axis
  • Droopy lower eyelids
  • Excess skin of {the} lower eyelids
  • Bags under your eyes

Ideal Candidate for Combined Blepharoplasty

The ideal candidate for a combined upper and lower eyelid blepharoplasty is a patient with realistic expectations and one who is in pretty good physical and mental health. The candidate is usually 35 years or older, having baggy, tired-looking lower eyelids and droopy upper eyelids and one who is willing to go under {the} knife.

Combined Blepharoplasty Procedure  

A combined blepharoplasty usually requires about 1 to 3 hours and might be done under local anaesthesia or under general anaesthesia.

A combined upper and lower eyelid blepharoplasty involves {the} following steps:

  • Local Anaesthesia: The procedure is done under local or modified local anaesthesia and patient co-operation is of utmost importance in achieving a symmetrical surgical outcome.
  • Making {the} Skin Incision: Incision lines are made in {the} natural creases of {the} upper eyelids such that any resultant scar is camouflaged. Incision lines are made below {the} lower eyelashes in a discreet manner such that {the} incision is hidden from plain view.
  • Skin Excision: The skin is removed using Westcott scissors along {the} eyelid crease.
  • Orbital Septum Excision: A strip of orbital septum is removed across {the} entire eyelid. This permits access to {the} eyelid fat pads beneath {the} orbital septum. Orbicularis muscle in {the} lower eyelid might or might not be removed depending on {the} desired end results.
  • Fat Removal: The eyelid is then re-contoured by a graded removal of {the} eyelid fat pad from different regions. Fat might also be transferred just below {the} eyelids to provide it fullness and readjustment of contours in sunken eyes.
  • Haemostasis: Aggressively control bleeding, particularly those arising from {the} orbicularis muscle as it might lead to loss of vision.
  • Closure: The wound is closed using either absorbable or non-absorbable sutures. Sutures should be removed at 7 to 8 days following surgery.

Risks and Complications of Combined Upper and Lower Blepharoplasty

Orbital haemorrhage is {the} most dangerous complication when it comes to blepharoplasty and can cause loss of vision in rare cases. Other complications include lagophthalmos, dry eyes, pain, swelling and stiffness of {the} eyelids, scarring, ectropion, infection, excessive tearing, and excess removal of eyelid tissues.

Results of Combined Blepharoplasty Surgery

Combined blepharoplasty surgery can be one of {the} best decisions for a person with tired, droopy upper eyelids and saggy or puffy lower eyelids caused by {the} ageing process. It can produce a smooth, firm, younger-looking surface around {the} eyes by correcting puffiness in {the} upper eyelids and bagginess of {the} lower eyelids as obvious in {the} pictures given below.

It can also correct any visual field defect cause by droopy eyelids, giving rise to {the} commonly used misnomer, ‘eyelift’ for {the} procedure. The procedure actually does not lift {the} eye skin in any way.

A perfectly sculpted blepharoplasty does not show any visible scars and {the} aesthetic improvement achieved is dramatic and transforming for both {the} surgeon and {the} patient alike. The following figure shows {the} contrasting looks of {the} patient before and after a combined blepharoplasty procedure.

Immediately during {the} postoperative period, there will be pain, irritation, swelling and discomfort which gradually resolves over time. The final results might take months to consolidate after which {the} beneficial effects lasts for 5 to 7 years on average. In fact, {the} effects of a perfectly healed blepharoplasty might last a lifetime for some patients who will continue singing praises for this procedure.


Overall, combined blepharoplasty can be a very fulfilling experience in both aesthetic and psychological terms. But, it is always wise to consider all possible outcomes before {the} surgery with your surgeon to achieve {the} best possible result.




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