Eyelid Surgery: Assessment, Planning and Recovery Considerations

Eyelid surgery may be considered when assessing the upper eyelid, lower eyelid, brow position, eyelid function, and eye health. The procedure discussed will depend on the patient’s anatomy, symptoms, medical history, previous surgery, medications, healing factors, and suitability for surgery.

The term “eyelid lifting treatment” can be unclear. In a medical context, the relevant procedure may be upper blepharoplasty, lower blepharoplasty, brow lift surgery, ptosis surgery, or another form of eyelid or periocular assessment. A consultation is required to determine which, if any, procedure is suitable.

This article provides general information only. It is not a substitute for personalised medical advice.

What concerns may be assessed?

Patients may seek advice about eyelid surgery for a range of reasons. These may include upper eyelid skin position, lower eyelid tissue position, eyelid heaviness, visual symptoms, eye irritation, asymmetry, previous surgery, or changes in the relationship between the brow and eyelid area.

These concerns can have different causes. Assessment may include the eyelids, brow position, ocular surface, eyelid muscle function, tear film, previous medical history, and any functional symptoms reported by the patient.

Surgery is not suitable for every patient. In some cases, no procedure may be recommended, or further assessment may be needed before any surgical option is discussed.

Upper eyelid assessment

Upper eyelid assessment may consider the amount and position of upper eyelid skin, the upper eyelid crease, eyelid function, brow position, and whether the eyelid skin is affecting the visual field.

Upper blepharoplasty may be discussed where clinically appropriate. This procedure can involve removal or repositioning of upper eyelid skin, muscle, or fat depending on the patient’s anatomy and the surgical plan.

If eyelid height or muscle function is affected, ptosis assessment may be required. Ptosis surgery is different from upper blepharoplasty and should be assessed separately.

Lower eyelid assessment

Lower eyelid assessment may include the lower eyelid skin, fat position, eyelid support, tear trough region, eyelid tone, and eye surface health.

Lower blepharoplasty may be discussed in some cases. Surgical planning depends on the individual’s anatomy, eye health, skin quality, eyelid position, and whether lower eyelid support procedures are required.

Lower eyelid surgery can affect eyelid position and eye comfort, so assessment of dry eye symptoms, previous eye surgery, contact lens use, thyroid eye disease, or other eye conditions is important.

Brow position and eyelid appearance

Brow position can affect the upper eyelid area. In some patients, brow position contributes to the amount of upper eyelid skin visible during examination. For this reason, the brow and eyelids may need to be assessed together.

Depending on clinical findings, a practitioner may discuss upper blepharoplasty, brow lift surgery, another procedure, or no surgery. The appropriate option depends on the individual assessment and the risks and limitations of each approach.

Functional symptoms and eye health

Some patients report visual symptoms, heaviness, eye strain, dryness, watering, irritation, or difficulty with eyelid function. These symptoms can have several causes and may require further assessment.

Where functional symptoms are present, assessment may include eye health, eyelid position, ocular surface, eyelid muscle function, and visual field concerns. Referral to another health practitioner may be recommended where clinically appropriate.

Surgery should only be considered after a suitable assessment and discussion of risks, alternatives, and expected recovery.

Recovery after eyelid surgery

Recovery varies between individuals and depends on the procedure performed. Swelling, bruising, tightness, discomfort, dryness, watery eyes, temporary blurred vision, altered sensation, and changes around incision sites may occur.

The time required to return to work, exercise, driving, and usual activities depends on the procedure, whether procedures are combined, individual healing, and the treating practitioner’s post-operative advice.

Follow-up appointments are important so that healing, eyelid position, incision sites, and eye symptoms can be reviewed.

Risks of eyelid surgery

All surgery has risks. Risks of eyelid surgery may include, but are not limited to:

• bleeding or haematoma
• infection
• scarring
• delayed wound healing
• pain or discomfort
• bruising and swelling
• dry eye symptoms or eye irritation
• watery eyes
• temporary or persistent blurred vision
• altered sensation or numbness
• asymmetry
• changes in eyelid position
• difficulty closing the eyes fully
• ectropion or lower eyelid retraction, where lower eyelid surgery is performed
• visible or raised scarring
• dissatisfaction with the outcome
• anaesthetic complications
• need for revision surgery

Rare but serious complications can occur. Personal risk factors should be discussed with the treating practitioner before deciding whether to proceed.

Suitability and decision-making

A consultation is required to assess whether eyelid surgery is appropriate. The consultation should include discussion of the patient’s reasons for seeking information about surgery, medical history, eye symptoms, risks, recovery, alternatives, costs, and the option of not proceeding with surgery.

Surgery should not be presented as a way to achieve a particular social, emotional, or psychological outcome. Individual experiences vary, and surgery may not address broader concerns about appearance, self-image, confidence, work, relationships, or wellbeing.

Patients should have adequate time to consider the information provided before deciding whether to proceed.

Consultation and further information

A consultation with Dr Adam Honeybrook can be used to discuss eyelid surgery, available surgical options, risks, recovery, alternatives, and whether surgery is suitable for your circumstances.

Dr Adam Honeybrook is a registered medical practitioner with specialist registration in Surgery – Otolaryngology – Head and Neck Surgery. Registration number: MED0001602935. To contact the practice, call:

• New patients: 07 3485 0596
• Existing patients: 07 3488 8118

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