Eyelid surgery, or blepharoplasty, addresses changes to the upper and lower eyelids that affect both how your eyes function and how they look. Ageing can lead to excess skin on the upper eyelids or drooping of the upper eyelid, which can cause visual obstruction and make your eyes feel tired, especially at the end of the day. Lower lid changes usually show as under-eye bags, creased skin or hollowing beneath the eye.
At our Sydney rooms, eyelid surgery covers three distinct operations: upper blepharoplasty, lower blepharoplasty and ptosis repair. Excess upper lid skin is a soft tissue problem, while ptosis is weakness of the levator muscle that lifts the lid margin. Both can exist in the same eye, so each is assessed separately.
Dr Maryam Seyedabadi, Specialist Plastic Surgeon, MBBS FRACS, has a particular interest in eyelid surgery and considers function alongside appearance. Assessment covers eyelid position, muscle action, skin quality, brow height and tear film, because a low brow or dry eyes change what is advisable.
Removal of excess upper lid skin, and where it contributes to fullness a strip of muscle or a small amount of fat, through an incision placed in the natural lid crease. Where upper eyelid skin demonstrably affects the field of vision, a Medicare item number may apply subject to clinical criteria, sometimes including a visual field test.
Read more about upper blepharoplasty
Treatment of under-eye bags, excess lower lid skin and tear trough hollows, through an incision just below the lash line or inside the lid. Fat may be removed, repositioned, or supplemented with fat grafting, depending on whether the issue is fullness, hollowing or both.
Read more about lower blepharoplasty
Tightening or reattachment of the levator muscle to raise the lid margin itself. Ptosis may be present from birth or develop later with ageing, contact lens wear, previous eye surgery or trauma. Removing skin alone will not correct it.
Eyelid procedures are usually day surgery, and most people go home the same day. Recovery varies with the procedure, your healing and how many lids are treated.
Risks include bleeding and haematoma, infection, dry or gritty eyes, watering, temporary blurred vision, difficulty closing the eyes fully, visible or thickened scarring, asymmetry between the two sides, eyelash loss and reaction to anaesthetic. Rare but serious complications include lower lid malposition, injury to the eye and loss of vision.
Ageing continues after surgery, and laxity can return over the years. Some patients need a further procedure to adjust height, symmetry or residual skin, and revision is more common after ptosis repair than after skin removal alone.
A referral from a registered medical practitioner is required before your consultation, and a GP referral is preferred so your general health and any eye conditions are taken into account. Dr Maryam examines your lids and brows, measures eyelid muscle function, arranges a visual field test where vision appears affected, and takes preoperative photographs.
Before you decide, the risks, possible complications and alternatives are discussed, including doing nothing. A cooling-off period of at least seven days applies between consultation and booking surgery. Patients under 18 have a cooling-off period of at least three months and also require assessment by an appropriate registered health practitioner. Our rooms are at 2c Heeley Street, Paddington NSW 2021, and enquiries can be made on 1300 067 668.
Not always. While ageing is a common cause, genetics can also contribute to under-eye fullness. Some people develop eye bags at a younger age because of inherited facial features, while others notice them gradually as the tissues around the eyes change over time.
Eyelid surgery may be considered if you have heavy or excess upper lid skin, upper lids that sit low over the eye, under-eye bags, loose lower lid skin or hollowing in the tear trough. Some people notice their upper field of vision is reduced. Assessment includes your eyelid position and function, brow position, tear film and dry eye symptoms, thyroid and eye health, and any medications that affect bleeding. Suitability is decided at consultation.
Upper eyelid surgery usually removes a measured strip of excess skin, with a small amount of muscle or fat if needed, and the scar sits within the natural upper lid crease. Lower eyelid surgery may reposition or remove fat, tighten the lid and treat excess skin, through an incision just under the lashes or inside the lid. Depending on the plan, surgery may be performed under local anaesthetic with sedation or under general anaesthetic, usually as day surgery.
There is no specific age for blepharoplasty. Some people consider the procedure earlier because of inherited eyelid features, while others seek advice as age-related changes become more noticeable. Suitability is based on your individual assessment rather than your age alone.
Depending on your individual assessment and treatment plan, upper and lower blepharoplasty may be performed during the same operation. Dr Maryam Seyedabadi will discuss the available options, along with the potential risks, benefits, and whether this approach is appropriate for your circumstances.
Most people take about one to two weeks away from work and social activities. Bruising and oedema are expected, sutures are usually removed within a week, and scars typically fade over months. Risks include bleeding, infection, dry or watery eyes, temporary blurred vision, asymmetry, difficulty closing the eyes, lid position changes needing revision, and rarely serious problems affecting vision. Healing varies from person to person, and your risks and complications are discussed at consultation.
Yes. In Australia a GP referral is required before a consultation for cosmetic surgery, and it is also needed if a Medicare rebate may apply. Dr Maryam Seyedabadi is a female Specialist Plastic Surgeon, MBBS FRACS, AHPRA registration MED0001341746, who consults at 2c Heeley Street, Paddington. A cooling-off period applies between consultation and surgery so you have time to consider the information, and risks are discussed before you decide. Phone 1300 067 668.