Blepharoplasty

Blepharoplasty is a surgical procedure designed to correct excess skin, fatty pouches, or sagging of the upper and/or lower eyelids. It is suited to individuals who wish to improve the appearance of their eyes, reduce a tired appearance, or correct a functional impairment caused by excess upper eyelid skin. The goal is a natural, harmonious result adapted to each patient's anatomy. The information below is intended for general guidance and does not replace a personalised medical consultation.

The Different Techniques

Upper eyelid blepharoplasty

• Goal: remove excess skin and, if necessary, reduce fatty pouches that create a heavy or drooping appearance.
• Technique: discreet incision in the natural upper eyelid crease, resection of skin and/or removal or repositioning of fat as appropriate.
• Advantages and limitations: improves the opening of the gaze and can correct a functional impairment; the scar tends to be barely visible once mature. Does not always correct deep crow's feet or brow ptosis, which may require additional procedures.

Lower eyelid blepharoplasty

• Goal: reduce under-eye bags and smooth the transition between the eyelid and the cheek.
• Possible techniques:
• Transconjunctival approach (no visible skin scar): incision on the inside of the lower eyelid, indicated primarily for fatty pouches without significant skin excess.
• Subciliary (skin) approach: incision just below the lashes, allowing treatment of skin excess and skin tightening if necessary.
• Advantages and limitations: reduces pouches and evens the orbital contour; complication risk is low when the indication and technique are well chosen. Does not always replace treatment for significant skin laxity or pigmented dark circles.

Complementary techniques

• Fat grafting, hyaluronic acid filler, or skin resurfacing may be proposed as adjuncts to treat hollows, dark circles, or periorbital fine lines.
• Options are chosen based on the clinical examination to achieve a harmonious and natural result.

Pre-operative Consultation

• Medical interview: discussion of motivations, past medical history, medications, smoking, ophthalmological history (dry eye, previous eye surgery, glaucoma, thyroid disease).
• Clinical examination: assessment of skin, eyelid tone, brow position, quality of the tear film, and orbicularis muscle tone.
• Technical choice: explanation of options (upper, lower, transconjunctival or skin approach), advantages and limitations adapted to the case.
• Documents provided: written quote, anaesthesia information, information leaflets, and informed consent.
• Reflection period: in accordance with legislation, a minimum 15-day period between the initial consultation with provision of the quote and the procedure is observed for aesthetic surgery.

Procedure

• Setting: procedure performed in a surgical setting, most often on a day-surgery basis (same-day discharge), sometimes with short hospitalisation depending on the case.
• Anaesthesia: local anaesthesia with sedation, or general anaesthesia depending on the extent of surgery and patient preference.
• Duration: generally 45 minutes to 2 hours depending on the extent and any complementary procedures.
• Main steps: marking of incisions, incisions in natural creases or on the inside of the eyelid, removal or repositioning of fat, skin adjustment if necessary, closure of incisions.
• Safety and traceability: complete operative record, pre- and post-operative photographs, detailed medical report, and scheduled follow-up.

Post-operative Recovery

• Common signs: bruising, swelling, feelings of tension, temporary watering or dry eyes.
• Care: light dressing, intermittent cold application, lubricating eye drops if prescribed, local care, and sun protection on scars.
• Suture removal: generally between 4 and 7 days if skin sutures were performed.
• Indicative recovery times: return to work generally between 5 and 14 days depending on bruising and profession; resumption of sport and intensive activities after 3 to 6 weeks.
• Monitoring: scheduled post-operative appointments to verify healing and ocular function. Any intense pain, decreased vision, or persistent bleeding must be reported immediately.

Results and Limitations

• Evolution: improvement becomes visible progressively; bruising and swelling decrease over several weeks, the result stabilises over several months, and scars fade over time.
• Individual variability: the result depends on skin quality, age, lifestyle, and anatomical features; it may evolve with natural ageing.
• Durability: blepharoplasty generally provides long-lasting improvement in eyelid appearance, but the natural ageing of the face may require additional procedures over time.

Risks and Complications

• General risks: haematoma, infection, unsightly scar, anaesthetic reaction.
• Eyelid-specific risks: dry eye, irritation, asymmetry, poor healing, ectropion (lower eyelid pulled downward), lagophthalmos (temporary inability to close the eye fully), temporary decreased or blurred vision, chemosis (conjunctival swelling), recurrence of pouches.
• Frequency: these complications remain rare but possible; they will be explained and specified during the pre-operative consultation.

Alternatives and Non-surgical Options

• Hyaluronic acid injections: can fill certain hollows (dark circles) and improve the eyelid-to-cheek transition but do not remove excess skin or fatty pouches.
• Botulinum toxin: useful for treating periorbital wrinkles (crow's feet) and brow elevation in some cases, but does not replace blepharoplasty.
• Skin resurfacing (laser, peels, radiofrequency): improves skin quality and fine lines but has limited efficacy on significant skin excess.
• Thread lifts or combined techniques: may be offered to selected patients, with limitations on the extent of correction.
• These alternatives have precise indications and their limitations will be discussed during the consultation.

FAQ (Frequently Asked Questions)

Does blepharoplasty leave visible scars? Scars are located in natural creases (upper eyelid) or discreetly below the lashes (lower eyelid); they fade progressively but remain visible up close for several months.

Is the procedure painful? Post-operative pain is generally moderate and controlled by simple analgesics. The most common sensations are tension and discomfort rather than intense pain.

Can I wear make-up after the procedure? Make-up must be avoided during the initial healing phase (often 7 to 10 days); the medical team will specify when and under what conditions make-up can safely be resumed.

Is there a risk to vision? Complications affecting vision are rare. Any change in vision after the procedure must be reported immediately for urgent management.