Upper Blepharoplasty: Before, During and Recovery Timeline

   Article produced by Mr Omar Dawood, Consultant Plastic Surgeon

Upper blepharoplasty is a surgical procedure designed to remove excess skin, and sometimes excess fat and muscle, from the upper eyelids. The procedure aims to improve the appearance of drooping or hooded upper eyelids and, in some cases, to improve vision when excess skin obstructs the upper visual field.

The surgery can provide a more refreshed, alert, and youthful appearance while maintaining the natural characteristics of the eyes.

Preoperative Recommendations

Careful preparation before your upper blepharoplasty can help optimise your surgical outcome and support a smooth recovery. During your consultation, your surgeon will provide personalised advice based on your medical history, overall health and treatment goals.

Medical Assessment

Before surgery, you will undergo a thorough assessment to ensure the procedure is safe and appropriate for you. This typically includes:

• A detailed review of your medical history and current health
• Review of any medications and allergies
• Evaluation of your eyelid anatomy, eyelid function and vision
• Clinical photographs to assist with surgical planning and to document your baseline appearance

Medication Adjustments

Certain medications and supplements can increase the risk of bleeding and bruising during and after surgery. Your surgeon may recommend temporarily stopping these before your procedure. These may include:

• Aspirin
• Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen
• Warfarin and other anticoagulant medications (only under the guidance of the prescribing physician)
• Fish oil supplements
• Vitamin E supplements
• Herbal remedies, including ginkgo biloba and ginseng

Always consult your surgeon before stopping any prescribed medication.

Smoking and Alcohol

Smoking and nicotine products can significantly impair healing by reducing blood flow to the tissues and increasing the risk of complications. Patients are typically advised to:

• Stop smoking and using nicotine products for at least 4–6 weeks before surgery and throughout the recovery period
• Limit alcohol consumption in the days leading up to surgery

Preparing for the Day of Surgery

To help ensure your procedure proceeds safely and comfortably, you should:

• Follow any fasting instructions provided by your surgical team if sedation or general anesthesia is planned
• Arrange transportation home after the procedure
• Avoid wearing contact lenses on the day of surgery
• Attend your appointment without eye makeup, facial lotions, creams, perfumes or jewellery

Following these recommendations can help reduce the risk of complications and support a smoother recovery process.

What Happens During Upper Blepharoplasty Surgery?

Anaesthesia

Upper blepharoplasty is commonly performed using either local anaesthesia with sedation or general anaesthesia, depending on the patient’s individual needs and the surgeon’s preference. At LycaHealth Orpington, upper blepharoplasty is routinely performed under local anaesthesia.

Surgical Technique

The procedure is carefully planned and tailored to each patient’s unique anatomy and aesthetic goals.

The surgery typically involves the following steps:

1. The surgeon marks the natural upper eyelid crease and determines the amount of excess skin to be removed
2. A carefully planned incision is made within the natural eyelid crease to minimise visible scarring
3. Excess skin is removed, and excess fat and muscle may be adjusted if necessary
4. The tissues are reshaped to create a smoother and more youthful eyelid contour
5. The incision is closed with fine sutures

Throughout the procedure, great care is taken to preserve normal eyelid function while achieving a balanced and aesthetically pleasing result.

Duration of Surgery

Upper blepharoplasty is typically completed within 45–90 minutes when both upper eyelids are treated. The exact duration may vary depending on the complexity of the procedure and whether additional treatments are performed at the same time.

Postoperative Recovery After Upper Blepharoplasty

Understanding what to expect during your recovery can help you feel more comfortable and prepared following upper blepharoplasty surgery. While everyone heals at a slightly different pace, most experience a relatively straightforward recovery with gradual improvement over the weeks following the procedure.

Immediately After Surgery

In the first few days after surgery, it is normal to experience a range of temporary symptoms as your body begins the healing process. These may include:

• Mild discomfort or tightness
• Swelling of the upper eyelids and surrounding tissues
• Bruising around the eyes, which can vary in severity between individuals
• Temporary blurred vision caused by protective ointments applied to the eyes
• Increased tearing, watery eyes, or occasionally dry eye symptoms

These effects are generally expected and should gradually improve over the first several days. Most patients find that any discomfort can be effectively managed with prescribed or recommended pain relief medication.

The First Week After Surgery

The first week is an important stage of recovery, and following your surgeon’s aftercare instructions carefully can help promote optimal healing and minimise swelling.

Recommendations typically include:

• Applying cold compresses as directed to help reduce swelling and bruising
• Keeping your head elevated, including while sleeping, to minimise fluid accumulation around the eyes
• Using prescribed eye drops and medications, as instructed
• Avoiding rubbing or touching the eyelids
• Avoiding strenuous exercise, heavy lifting and activities
• Limiting screen time if it causes discomfort

If non-absorbable sutures have been used, they are typically removed approximately 5–7 days after surgery during a follow-up appointment. At this stage, many patients begin to notice a significant reduction in swelling and bruising.

Weeks 2–4 After Surgery

By the second to fourth week, the majority of visible bruising and swelling has usually settled considerably. The eyelids begin to appear more natural and the benefits of surgery become increasingly noticeable.

During this period:

• The incision sites continue to heal and soften and swelling continues to improve
• Many patients feel comfortable returning to work, social engagements and public activities within 2 weeks
• Light exercise and normal daily activities may be gradually resumed, subject to your surgeon’s advice

Although recovery is well advanced at this stage, some subtle swelling may still be present and can take several more weeks to fully resolve.

Long-Term Recovery and Results

Healing continues for several months following upper blepharoplasty. As swelling completely subsides and the tissues settle into their final position, the full results become increasingly apparent.

Over the longer term:

• Incision lines continue to mature and fade
• Eyelid contours become more refined and natural-looking
• The eyes often appear brighter, more open and refreshed
• Scars are typically very discreet and well concealed within the natural upper eyelid crease

Upper blepharoplasty can provide long-lasting improvement in upper eyelid appearance and function. While the procedure cannot stop the natural aging process, results often remain visible for many years. Maintaining a healthy lifestyle and protecting the skin from excessive sun exposure may help prolong the benefits of surgery.

Please discuss any questions or concerns with your surgeon before deciding to proceed with treatment.

When to Contact Your Surgeon

Seek immediate medical attention if you experience:

• Sudden vision changes
• Severe eye pain
• Significant bleeding
• Rapidly increasing swelling
• Signs of infection (increasing redness, warmth, pus, or fever)
• Difficulty breathing or allergic reactions

Considering Upper Blepharoplasty surgery?

If drooping upper eyelids are affecting your appearance, comfort, or vision, upper blepharoplasty could help restore a more refreshed and youthful look. Contact LycaHealth Orpington today to book a consultation and discuss your treatment options with an experienced specialist.

Book an appointment today