Eyelid aging is usually due to loosening of the skin and protrusion of fat. In the upper eyelids this often causes a hooded appearance. Eyelid bags often appear in the lower eyelids. Blepharoplasty is an operation that can remove the loose skin and correct the bulging fat. It is one of the most common facial cosmetic procedures. It can't remove crow's feet, eliminate dark circles under your eyes, or lift sagging eyebrows. Sagging eyebrows are often treated with a brow lift and crows feet often respond well to Botox.

Blepharoplasty can be done alone, or in conjunction with other facial surgery procedures such as a facelift or browlift.

You should not take aspirin or non steroidal anti-inflammatory drugs such as Brufen or Nurofen for two weeks before your surgery. These drugs increase the risk of post operative bleeding and have an adverse effect on bruising.

If you smoke, you will need to stop smoking for two weeks before surgery and a week afterwards. Smoking reduces the blood flow to the skin and can prevent healing.

You will need someone to drive you home after your surgery and to help you out for a few days at home.

Blepharoplasties can be performed under local or general anaesthesia. If both upper and lower eyelids are to be treated it is usual to have your operation under general anaesthesia.

In the upper lids an incision is usually made in the natural crease line, approximately 8-10mm above the eyelashes. The incision is usually extended into one of the natural laughter lines. The excess skin and fat in the upper lid is then removed and a fine suture is passed between the skin edges to close the wound. The suture generally runs beneath the skin so that there are no external stitch marks.

There are a number of techniques that can be used to treat the lower eyelids. If the main problem is due to lower eyelid bags without any loose skin it is often possible to perform a transconjunctival blepharoplasty which involves making an incision on the inside of the eyelid so that there are no external scars. If there is a significant amount of loose skin a more traditional lower lid blepharoplasty, which involves making an incision beneath the lash line and outwards into one of the natural crow's feet needs to be made. Through this incision the skin can be tightened and any underlying fat repositioned or removed.

Sometimes if there is a very loose lower eyelid a lateral canthopexy needs to be performed in order to tighten the lid to prevent sagging of the lower eyelid after surgery.

Blepharoplasty is generally a very safe operation but inevitably, as with any surgery there are a few risks, these include haematoma formation (internal bruising), which rarely may require removal of the sutures to wash out any blood clot that has formed underneath the skin. Occasionally eyes water in cold or windy weather during the first week or two after surgery. Very occasionally these symptoms can be more prolonged. There is a small risk that the lower eyelid may droop after surgery, usually this corrects itself as the swelling subsides, but very occasionally further surgery is required. It is uncommon to get prolonged redness in the scars, but occasionally this can be a problem, particularly in very fair skinned people.

There is usually mild swelling or bruising after blepharoplasty. During the first few nights after surgery it is helpful to sleep with your head elevated on two to three pillows. Your eyelids may feel dry at night. You will be prescribed some eye ointment to take home to make the more comfortable during sleep. During the first week you should avoid bending down, as this tends to increase the swelling. The stitches are removed one week after surgery. Most patients can return to work after 10-14 days.

It is important to avoid strenuous sporting activities for 3-4 weeks after surgery.

You should avoid wearing contact lenses for 2 weeks after blepharoplasty.