Eyelid surgery

Also known as blepharoplasty

Key points about eyelid surgery

  • The tissues of the eyelid include skin, muscle and fat. Eyelid tissue changes as the body ages, which can lead to sagging and drooping.
  • Eyelid surgery, or blepharoplasty, involves the removal or evening out of your eyelid tissue.
  • It's commonly used to repair these age-related changes. 
  • In some people, these changes occur at a younger age or may be the result of a medical condition.
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Some people elect to have eyelid surgery to improve their appearance for cosmetic reasons. This is the most common reason blepharoplasty is performed.

In other cases, eyelid surgery may be recommended for medical reasons, such as:

  • when a drooping eyelid or eyelid skin affects your vision
  • to reconstruct the eyelid following removal of an eyelid tumour.

There is a racial difference between the upper lids in Europeans and Asian people. Some people of Asian origin may have very low or absent skin creases. Here, blepharoplasty involves creating a skin crease in the upper lid, forming what is known as the double eyelid.

Image credit: Canva

If you choose to have eyelid surgery for cosmetic reasons, it is unlikely to be covered by your insurance policy. However, you may be covered if:

  • there is a functional reason for the surgery, such as improving the field of vision
  • the problem is caused by a medical condition, such as thyroid eye disease or paralysis.

Eyelid surgery is most commonly done under local anaesthetic while you are awake. It usually takes less than an hour.

  • You will be given a medicine to help you to relax and the area around your eye will be numbed so you do not feel pain.
  • Excess skin, muscle and/or fat will be removed via tiny cuts (incisions) which are hidden in natural skin lines.
  • Close attention is paid to the position and balance of the upper lid skin creases and the height of the upper lids.
  • At the end of surgery, the incisions are closed with stitches or with surgical glue.

After the surgery, the eyelids take 1–2 weeks to settle. To help reduce bruising and swelling, firm patches are placed over the eyes immediately after surgery. The regular use of ice pads for 48–72 hours after the surgery may also help. If bruising occurs, it can take up to several weeks to settle entirely.

Usually eyesight is not affected, however there may be a small amount of temporary blurring after surgery from a mild alteration to the blink and tear film.

There have been reported cases of loss of vision with lower lid blepharoplasty. This is very rare (estimated at only 1 in 40,000 cases) and should be avoidable with careful surgery and appropriate post-operative care.

Optometrists are listed in the 'Yellow Pages' of your telephone book.
Eye specialists are listed with registered medical practitioners at the front of the white pages of your telephone book.
Search online for local optometrists(external link)(external link) NZ Association of Optometrists, 2015 

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Credits: Healthify editorial team. Healthify is brought to you by Health Navigator Charitable Trust. Content used with permission from Auckland Eye Institute.

Reviewed by: Kenny Wu, Optometrist, Eye Institute, Auckland

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