Eyelid surgery (blepharoplasty) is a procedure in which excess skin, muscle and fat tissue of the upper and/or lower eyelids is reshaped. The eye area is where signs of ageing appear earliest: thinning of the skin and loosening of the membrane that holds the fat tissue lead to a tired, worn-out expression. While the operation corrects this appearance, it also provides a functional benefit when sagging narrows the visual field.
Who is eyelid surgery suitable for?
- People with sagging skin on the upper eyelid to an extent that narrows the visual field
- People with permanent bagging and puffiness of the lower eyelid
- People who constantly look tired because of laxity around the eyes
- People whose general health is suitable for surgery
The procedure is usually considered from the age of 35 onwards; however, due to genetic predisposition, eyelid sagging and bagging can also occur at a younger age. If you have an existing condition related to dry eyes, thyroid disease or intraocular pressure, it must be mentioned at the examination; in these cases the plan may change.
Puffiness or bags? Why does the distinction matter?
Not every under-eye swelling requires surgery. The right method is determined by the source of the problem:
| Appearance | Possible cause | Approach |
|---|---|---|
| Puffiness that is marked in the morning and decreases during the day | Oedema, salty diet, lack of sleep, allergies | Lifestyle adjustments and treatment of the underlying cause |
| Palpable bagging that does not change throughout the day | Bulging of fat tissue | Lower eyelid blepharoplasty |
| Excess skin and wrinkles on the eyelid | Reduced skin elasticity | Removal of excess skin |
| Hollowness and shadowing under the eyes | Volume loss | Volume correction with fillers |
How is the operation performed?
The procedure is mostly performed under local anaesthesia with sedation; general anaesthesia can be chosen if preferred. On the upper eyelid, the incision is made along the natural fold line of the lid and excess skin is removed. On the lower eyelid, the incision is placed just below the lashes or, if there is only excess fat, on the inner surface of the lid — this route leaves no external scar. It takes 1-2 hours on average, and the patient is usually discharged the same day.
Recovery process
| Period | What to expect | Recommendations |
|---|---|---|
| First 2-3 days | Bruising and swelling around the eyes | Cold compresses, sleeping with the head elevated |
| Days 5-7 | Stitches are removed | Screen use is limited |
| End of week 1 | Bruising decreases noticeably | Most people return to daily life |
| Weeks 2-4 | Swelling largely resolves | No strenuous exercise; sunglasses and sun protection |
| Months 2-3 | Scars fade and the result settles | Contact lenses and make-up are resumed with the doctor's approval |
Risks and what you should know
As with any surgical procedure, there is a risk of bleeding, infection, scarring and asymmetry. After surgery there may be dry eyes, a gritty sensation or temporary blurred vision that can last a few weeks. After lower eyelid surgery, the lid margin may rarely pull downwards. These possibilities and the risks specific to you are discussed in detail at the examination.
Eyelid surgery is often planned together with rhinoplasty or other facial aesthetic procedures. To have your suitability assessed, you can contact the clinic.
Frequently Asked Questions
Why do under-eye bags form?
The membrane that holds the fat tissue around the eyes loosens with age, and the fat tissue bulges forward, creating a baggy appearance. Reduced skin elasticity, genetic predisposition, lack of sleep, a salty diet, allergies and smoking make this appearance more pronounced. Puffiness that is more noticeable in the morning is usually due to oedema, whereas marked bagging that does not change throughout the day is due to displacement of the fat tissue.
How can under-eye bags be treated?
For temporary puffiness caused by oedema, sleep habits, salt restriction and treating allergies make a noticeable difference. For permanent bagging caused by bulging fat tissue, however, these measures are not enough; the permanent solution is eyelid surgery (blepharoplasty). In the operation, excess fat tissue is removed or redistributed into the hollow area, and loose skin is removed if necessary. Which method is suitable is determined at the examination.
How is eyelid surgery performed and how long does it take?
On the upper eyelid, the incision is hidden within the natural crease of the lid. On the lower lid, access is either just below the lashes or, if there is only excess fat, through the inside of the lid (a route that leaves no external scar). Excess skin and fat tissue are reshaped. The procedure is usually performed under local anaesthesia with sedation; it takes about 1 hour for a single lid and around 2 hours when all four lids are done together.
How long does recovery take after eyelid surgery?
Stitches are usually removed within 5-7 days. Bruising and swelling are noticeable in the first days; most people return to social life within 1 week. In the first days, cold compresses and keeping the head elevated reduce swelling. Computer and screen use is limited because it can tire the eyes. Contact lens use and a return to sport happen with the doctor's approval, usually after 2-3 weeks.
Does eyelid surgery affect vision?
The aim of the operation is not to impair vision but to improve it where necessary: if sagging of the upper eyelid covers the upper part of the visual field, removing the excess skin widens the visual field. After surgery there may be temporary dryness, a gritty feeling or blurred vision that can last a few weeks. A permanent vision problem is not expected; if you have an existing eye condition, you should mention it at the examination.