Upper Eyelid Surgery: Assessment, Planning and Recovery Considerations

Upper blepharoplasty, also known as upper eyelid surgery, is a surgical procedure that may be considered when assessing upper eyelid skin, eyelid tissue position, eyelid function, and the relationship between the brow and upper eyelid area.

The suitability of upper eyelid surgery varies between individuals. A consultation and examination are required to assess eyelid anatomy, visual symptoms, eye health, brow position, medical history, previous surgery, medications, healing factors, and the reasons a person is seeking information about surgery.

This article provides general information about upper blepharoplasty. It is not a substitute for personalised medical advice.

What is upper blepharoplasty?

Upper blepharoplasty is a surgical procedure involving the upper eyelid. Depending on the patient’s anatomy and the surgical plan, it may involve removal or repositioning of skin, muscle, or fat.

The surgical approach depends on the individual assessment. Factors that may influence planning include upper eyelid skin position, eyelid crease anatomy, brow position, eyelid function, eye health, previous procedures, scarring, and general medical factors.

No specific outcome can be predicted from the procedure name alone.

Functional assessment and visual symptoms

Some patients seek advice about upper eyelid surgery because of heaviness around the upper eyelid area or visual symptoms. These symptoms can have several causes, including upper eyelid skin position, brow position, eyelid muscle function, eye conditions, or other medical factors.

Where visual symptoms are present, assessment may include examination of the eyelids, brow position, ocular surface, and visual field concerns. In some cases, further testing or referral may be recommended.

Upper eyelid surgery is not suitable for every visual or eye-comfort concern. Suitability should be assessed by the treating practitioner.

The relationship between brow position and upper eyelid surgery

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

In some cases, upper blepharoplasty alone may be discussed. In other cases, brow lift surgery or no surgery may be discussed. The appropriate option depends on clinical assessment, patient factors, and the risks and benefits of each approach.

How the procedure may be performed

Upper blepharoplasty is usually performed through an incision placed in the upper eyelid crease. The exact incision position and surgical plan depend on the patient’s anatomy and the treating practitioner’s assessment.

The procedure may be performed under local anaesthesia, sedation, or general anaesthesia depending on the procedure, patient factors, and clinical recommendation.

Upper blepharoplasty still involves surgery, incisions, wound healing, and recovery time. The procedure should not be described as minor or simple in a way that downplays risk.

Scarring and healing

Scarring is an expected part of surgery. Scar appearance varies between individuals and may be affected by skin type, genetics, wound healing, infection, tension on the wound, smoking or vaping, and post-operative care.

Although incision placement is planned carefully, no practitioner can guarantee how a scar will heal or how visible it will be over time.

Recovery after upper eyelid surgery

Recovery after upper eyelid surgery varies between individuals. Swelling, bruising, tightness, discomfort, dryness, watery eyes, temporary blurred vision, altered sensation, and changes around the incision sites may occur.

The time required to return to work, exercise, driving, and usual activities depends on the procedure performed, whether other 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 any symptoms can be reviewed.

Risks of upper blepharoplasty

All surgery has risks. Risks of upper blepharoplasty 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
• 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 upper 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 upper 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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