What Is Blepharoplasty? A Surgeon’s Guide to Eyelid Surgery (2026)

What Is Blepharoplasty (Eyelid Surgery)?

Blepharoplasty is a surgical procedure that targets the upper eyelids, the lower eyelids, or both, to remove or reposition excess skin, muscle and fat and restore a smoother, fresher eye contour. The aim is to rejuvenate the eye while keeping it unmistakably your own; done well, it refreshes your appearance without changing your expression. It can be performed on its own or combined with other facial procedures, such as a brow lift or facelift,t for more complete rejuvenation.

Upper vs Lower Blepharoplasty: What Is the Difference?

Upper blepharoplasty addresses excess hooding in the upper eyelid that can make the eyes look heavy or tired and, in more advanced cases, obstruct the upper field of vision. The incision is hidden within the natural crease of the upper lid, so the scar becomes very difficult to see once healed.

Lower blepharoplasty addresses under-eye bags, puffiness and loose skin beneath the eye. The incision is placed just below the lash line (1mm) or, in some cases, the inner side of the eyelid so there is no visible external scar (transconjunctival approach). Many people have one or the other; some benefit from both. Which is right for you depends on what is troubling you, and that is exactly what a consultation is for.

What About Hooded Eyes?

Hooded upper eyelids are one of the most common reasons people consider eyelid surgery. In fact, this is probably one of the earliest signs of facial ageing in both sexes. Hooding is usually caused by excess upper-lid skin (dermatochalasis). Still, it can also be driven by a descended brow or a drooping lid margin, and the right treatment depends entirely on which it is. Because this is such a frequent and important question, I have written a separate, detailed guide on hooded eyelids, including how they are assessed and treated. If hooding is your main concern, that article is the best place to start, and we link to it below.

How Is Blepharoplasty Performed?

After a detailed consultation and assessment, the procedure is carefully planned based on your anatomy. For upper blepharoplasty, a precise incision is made along the natural eyelid crease, and excess skin is removed. In most cases, a strip of orbicularis muscle is removed, while bulging fat can be either reduced or transposed. Upper eyelid surgery is often performed under local anaesthetic, sometimes with sedation.

For lower blepharoplasty, the incision is placed below the lash line (usually within 1-2mm) or inside the lid to address bags and puffiness. The procedure typically takes between one and three hours, depending on whether the upper lids, lower lids or both are treated, and most patients return home the same day.

In both upper and lower blepharoplasty,s the incisions extend laterally beyond the outer corner of the eyes (also known as the outer canthus) by 3 to 10mm. This extension is also carefully placed into the most appropriate smile lines (upper, mid or lower)

An essential component of my technical assessment before surgery includes an evaluation of the “lid-to-cheek junction”. In cases where the cheek looks deflated or descended, I recommend combining lower eyelid surgery with a “mid-face lift,” as both operations can be performed through the same incision. The mid-face lift is one of my favourite surgical techniques, performed with a deep-plane approach, and there is a dedicated session on this very powerful procedure for facial “normalisation”.

The guiding principle of my approach is that enough skin must always be preserved for the eye to close completely. Removing too much is the most common cause of a poor or ‘over-done’ result, which is why careful planning matters as much as the surgery itself.

Recovery After Eyelid Surgery

Recovery is usually straightforward. Some swelling, bruising and mild discomfort around the eyes are normal for the first few days and improve over one to two weeks, helped by cold compresses and resting with the head elevated. Stitches are generally removed within about a week. Most patients return to normal daily activities and feel comfortable in public within ten to fourteen days. Strenuous activity, heavy lifting and swimming should be avoided for at least two to three weeks. The fine scar within the eyelid crease is pink at first, fades over the following months, and continues to settle fully over a few months.

Risks and How to Avoid a Poor Result

Searches for ‘botched’ eyelid surgery are common, and they reflect a real concern, so it is worth addressing honestly. Blepharoplasty is one of the most frequently performed and well-studied facial procedures, and in trained hands, serious complications are uncommon; most issues are minor and temporary, such as bruising, swelling, or short-lived dry-eye symptoms. The results people fear, such as difficulty closing the eyes or a hollow or startled appearance, almost always come from removing too much tissue. The best ways to avoid a poor result are to choose a surgeon on the GMC Specialist Register for plastic surgery, to insist on a proper assessment of the brow and lid before any decision, and to favour a conservative approach that preserves enough tissue. I discuss all risks fully at the consultation.

How Much Does Blepharoplasty Cost in the UK?

Cost is one of the most common questions, and the honest answer is that it varies because it depends on whether you are having upper, lower, or both eyelids treated; the complexity of your case; the anaesthetic used; and whether the surgery is combined with another procedure. Upper eyelid surgery alone is at the lower end; treating both lids or combining it with a brow lift or midfacelift costs more. Any figure online should be treated as a guide only.

As with all surgery, the lowest quote is not the thing to optimise for, and very cheap procedures, particularly abroad, can carry real costs in safety and aftercare if a problem arises. At your consultation, I provide a clear, personalised quote covering the surgery, anaesthetic, facility, and aftercare, with no hidden extras.

Is Eyelid Surgery Available on the NHS?

Eyelid surgery is usually performed in the private sector as a form of facial “normalisation”. The NHS may fund upper eyelid surgery only where excess skin causes a measurable obstruction of the upper field of vision, which usually requires a formal visual-field test, and eligibility criteria vary by region. Ptosis, either unilateral or bilateral, is another valid indication to receive treatment through the NHS.