Oculoplastic eyelid surgery for cosmetic and functional concerns — upper & lower blepharoplasty
Blepharoplasty is a specialist surgical procedure to correct drooping upper eyelids, remove excess skin, and address under-eye bags. It can be performed for cosmetic reasons or to improve vision where heavy, sagging eyelids obstruct the visual field - a condition known as dermatochalasis.
At Vale Eye Surgeons, blepharoplasty is performed by a fellowship-trained oculoplastic surgeon and member of the British Oculoplastic Surgical Society, with combined expertise in ophthalmology and eyelid surgery covering both the functional and aesthetic aspects of the procedure.
Upper blepharoplasty involves removing a carefully measured crescent of excess skin (and sometimes a small amount of fat) from the upper eyelid. The incision is hidden within the natural eyelid crease, so scarring is virtually invisible once healed.
The procedure is performed under local anaesthetic as a day case, using precise surgical techniques developed through years of oculoplastic fellowship training and NHS practice, ensuring natural-looking results that preserve the character of your face.
Lower blepharoplasty addresses under-eye bags and excess skin of the lower eyelid. Depending on the anatomy, the approach may be transconjunctival (through the inner surface of the eyelid, leaving no visible scar) or transcutaneous (through a fine incision just below the lash line). Fat may be repositioned or removed, and excess skin addressed where appropriate. Your surgeon will recommend the most suitable approach based on your anatomy and goals.
A detailed assessment of your eyelid anatomy, skin quality, and visual field. Photographs will be taken and your goals discussed. If the procedure is being considered for functional reasons, visual field testing may be performed.
Upper blepharoplasty takes approximately 45 minutes under local anaesthetic. Lower blepharoplasty may take slightly longer depending on the technique used. You will be awake but comfortable. Fine sutures are used to close the incisions.
Expect some bruising and swelling for one to two weeks. Cold compresses and head elevation help reduce this. Sutures are typically removed after seven days. Most patients return to work within 10 to 14 days, and final results are visible after two to three months.
Lower lid specific: Swelling beneath the eye can take four to six weeks to fully resolve, and the final result is best judged at three months. Sleeping slightly elevated and using cold compresses in the first 48 hours significantly reduce early swelling.
If excess upper eyelid skin is making you look tired, older than you feel, or is genuinely obstructing your peripheral vision, upper blepharoplasty may be an excellent option. If persistent under-eye bags are your main concern, lower blepharoplasty may be more appropriate. Your surgeon will give you an honest assessment of what surgery can realistically achieve and whether non-surgical alternatives might be more appropriate.
Where drooping eyelids are significantly affecting your field of vision, the procedure is considered functional rather than purely cosmetic. Your surgeon will discuss this distinction with you during your consultation.
Oculoplastic surgery is the subspecialty of ophthalmology focused on the eyelids, orbit (eye socket), lacrimal (tear drainage) system, and the surrounding facial structures. A fellowship-trained oculoplastic surgeon combines the precision of an eye surgeon with the aesthetic skills of a plastic surgeon — making them uniquely qualified to operate in this delicate area. At Vale Eye Surgeons, blepharoplasty and all eyelid procedures are performed by a surgeon with formal oculoplastic fellowship training and membership of the British Oculoplastic Surgical Society.
In addition to blepharoplasty, our oculoplastic services include removal of eyelid lumps and lesions (chalazia, papillomas, skin tags), CO₂ laser resurfacing of the periorbital skin, and ptosis correction. Pricing for oculoplastic procedures starts from £500 for minor lesion removal, through to £6,500 for combined upper and lower blepharoplasty.
Sight-threatening complications from blepharoplasty are exceptionally rare. The most serious risk is retrobulbar haemorrhage — bleeding behind the eye — which occurs in fewer than 1 in 2,000 upper lid procedures. Because our surgeon is a qualified ophthalmologist as well as an oculoplastic specialist, any ocular complication is recognised and managed immediately. This level of expertise is one of the key advantages of having eyelid surgery performed by an oculoplastic ophthalmologist rather than a general cosmetic surgeon.
In unskilled hands, over-resection of skin or fat can leave the eyelids looking hollow, skeletonised, or unnaturally tight — a result that can add years rather than remove them. Our approach is deliberately conservative: we remove only what is necessary to achieve a natural, rested appearance that suits your face. Photographs are reviewed carefully at your consultation and realistic outcomes are discussed honestly before any procedure is agreed.